SIGNS AND SYMPTOMS OF PREMATURE LABOUR

What is premature labour and birth?

Preterm labour is when labour begins before you reach week 37 of your pregnancy.  Most cases of premature labour begin with the start of regular contractions, waters breaking or a ‘show’. However, in some cases babies are delivered early because there are concerns about the health of the mother and/or the baby. When this happens labour is induced or the baby is born by Caesarean section.

Did you know: Around eight in 100 babies in the UK are born before 37 weeks.  

What are the signs of a premature labour?

Your midwife will discuss with you the symptoms of pre-term labour and offer checks to see if you are in labour. These checks can include asking you about your medical and pregnancy history. Possible premature labour signs are:

• Contractions
• Any pain
• Vaginal loss - such as waters or a show

Causes of premature labour and birth

So, what causes preterm labour? Often the cause of preterm labour remains unknown, though there are different reasons which can increase your chances of going into labour early. These include:

• Waters breaking early
• A previous premature birth
• A previous late miscarriage (after 14 weeks of pregnancy)
• An abnormally shaped womb or a cervical weakness
• Cigarette smoking
• Illicit drug taking
• Being overweight
• If you are expecting more than one baby

Interventions aimed at improving the outcomes for you and baby if preterm labour occurs:

• A course of two or four steroid injections over 24-48 hours to help reduce the chance of your baby having breathing problems.
• Antibiotics to reduce the risk of infection if your water's have broken.
• The chance to talk to one of the neonatal team about the care your baby will receive.

• If you are less than 34 weeks pregnant and likely to give birth within 24 hours you may be offered treatment with magnesium sulphate through a drip to help the development of your baby’s nervous system .

Planned premature labour

In some cases premature labour is planned and induced because it is safer for the baby to be born sooner rather than waiting to go full-term. This could be for a number of reasons, including pre-eclampsia. Your midwife or GP will discuss with you the benefits and risks of having a planned premature labour.

What happens when premature labour begins?

You will need to contact your maternity unit or midwife straight away so that labour can be confirmed and your baby can be checked.

If labour is suspected, you will be advised to stay in hospital where you will be offered:

• medication to try and delay labour if your waters haven’t broken and there are no immediate concerns about you or your baby.  This can suppress your contractions long enough for you to complete the course of steroids or to be transferred to a hospital that offers specialist care.

What happens if your waters break early?

If your waters have broken there is an increased risk of infection to you and your baby and therefore you will be offered either:

• Tests for infection which could include blood or urine tests.

• Antibiotics for a maximum of ten days - or until labour starts.

Your waters breaking early may not definitely mean you'll go into labour and you may be able to go home if there's no infection and you don't go into labour within 48 hours. If you do go home you will be told to contact your midwife immediately if:

• Your temperature is raised - you should check your temperature every 4 hours while you're awake.

• Any fluid from your vagina is coloured or smelly.

• You bleed from your vagina.

• Your baby's movements slow down or stop.

What if your waters haven't broken?

Your midwife or GP will discuss with you the symptoms of premature labour and offer checks to see if you are in fact in labour. These checks can include asking about your medical and pregnancy history and possible labour signs. In addition you may be offered a vaginal examination and your pulse, blood pressure and temperature should also be checked.

It's also likely that your midwife or GP will want to check your baby by feeling your bump to find out the baby's position and how far into your pelvis the baby's head is.

What will happen to your baby if they are born early?

All babies born early require some form of specialist care.

If your baby needs to go into a neonatal unit you will be encouraged to spend as much time as you can with them. Breast milk is very important for premature babies and you will be offered all the help and support you need to produce enough milk for your baby’s needs.

Babies that are born early have an increased risk of health problems, especially with breathing, feeding and infection. The earlier your baby is born the more likely they are to have these problems. This means that your baby may need to be transferred to a specialist neonatal unit as soon as they are born.

Most premature babies survive and only a few have long-term health problems.