Premature Labor: Tips for Mothers-To-Be

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Obstetrician-gynecologist Dr. Kecia Gaither with Tips for Minimizing Risks

Dr. Kecia Gaither

There is a lot that can be done to delay premature birth and many women who experience premature labor eventually deliver at 37 weeks or later. The key is early treatment.

A normal pregnancy lasts about 40 weeks. Regular contractions that cause the cervix to open are considered premature or preterm labor if they begin before 37 weeks. A baby delivered before 37 weeks is considered premature and is at higher risk of health problems. But preterm labor doesn't always result in premature birth. There is a lot that can be done to delay premature birth and many women who experience premature labor eventually deliver at 37 weeks or later. “The key is early treatment,” says obstetrician-gynecologist Dr. Kecia Gaither. “Preterm labor can't always be avoided but women can reduce their risk by doing their best to avoid the factors that put them at risk and recognizing its symptoms so they can be treated promptly.”

Who is at risk for preterm labor?
Women at greatest risk of preterm labor are those carrying multiples and those who have had a previous premature labor or birth. Additional medical and lifestyle risk factors include:

  • Smoking and abuse of alcohol or drugs
  • Inadequate prenatal care
  • Age below 17 or above 35
  • Underweight before pregnancy or too little weight gained during pregnancy
  • Previous uterine or cervical surgery
  • Health conditions such as high blood pressure, preeclampsia, or diabetes
  • A short interval between pregnancies (18 months or less)

What are the warning signs of preterm labor?
“Some of the symptoms of preterm labor can be confusing because they are hard to differentiate from normal symptoms of pregnancy, like backache and even contractions,” says Dr. Gaither. “Contractions, which may be painless, are felt as a tightening and softening of the abdomen. Women should know how to recognize harmless Braxton Hicks contractions, which are common in the third trimester and are often mistaken for labor.” Braxton Hicks contractions are sporadic, do not increase in frequency or intensity, and can often be curtailed by moving or changing position. Contractions that are regular and occur every 10-12 minutes or more often may be preterm labor. If in doubt, Dr. Gaither recommends calling the obstetrician.

Other symptoms of preterm labor that should prompt a call to the doctor include:

  • Ruptured membranes, indicated by watery fluid that leaks or gushes
  • Lower back pain that isn't alleviated by changing position or other means, especially if there has been no prior backache
  • A change in the type or amount of vaginal discharge
  • Increased pelvic pressure, a feeling that the baby is pushing down
  • Vaginal bleeding

What can be done to stop preterm labor?
For many women, preterm contractions stops on its own. When it doesn't, the steps taken depend on the duration of the pregnancy, the state of the cervix, whether the membranes have ruptured, the baby's growth, gestational age, and position. If the pregnancy is less than 34 weeks and there are no indicators for an immediate delivery, treatment to delay delivery may include antibiotics to prevent infection, corticosteroids to accelerate the baby's development, and drugs that inhibit contractions.

“Women who are at risk for preterm labor should carefully adhere to the guidelines for a healthy pregnancy,” says Dr. Gaither. “They should eat a well-balanced diet, get plenty of rest, see an obstetrician regularly, avoid unhealthy habits, and manage their stress levels. Some women who have had a previous premature rupture of the membranes may be given a hormone (progesterone) via injections/vaginal suppositories, that help to prevent a repeat preterm delivery. We've made remarkable strides in our ability to monitor and manage every aspect of the pregnancy and the baby's development and improve the likelihood of a good outcome.”

Kecia Gaither, MD, MPH, FACOG, a perinatal consultant and women’s health expert, is a double board-certified physician in OB/GYN and Maternal-Fetal Medicine in New York City. Dr. Gaither is Director of Perinatal Services at Lincoln Medical and Mental Health Center, a member of NYC Health + Hospitals System in Bronx, New York.

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