Preterm labour is any labour that begins after 20+0 weeks but before 37+0 weeks of pregnancy.
If you have any of the symptoms of premature labour, including abnormal vaginal discharge (usually watery leaking or a gush of clear or pinkish fluid), bleeding from your vagina, contractions that do not go away after emptying your bladder, and become stronger over time, or a strong sense that things are not right, please call your midwife immediately for assessment.
Around 10% of pregnancies end in preterm birth. There are many risk factors for preterm labour, including if:
- you have had a preterm baby before
- your cervix is shorter – this may be checked during ultrasounds
- you have had a miscarriage after 16 weeks
- you have had three or more miscarriages at any gestation
- you have had three or more terminations of pregnancy
- you become pregnant less than 6 months after your previous pregnancy
- you have had treatments to your cervix (including LLETZ and cone biopsy procedures) since your last pregnancy, or at any time if this is your first pregnancy
- you have a congenital uterine or cervical anomaly, even if it has been surgically corrected
- you are carrying twins or higher order multiples
- you had a caesarean birth at full dilation or with certain complications in your most recent pregnancy
- you are a smoker, very overweight or underweight, or have certain medical conditions such as pre-existing diabetes or Ehlers-Danlos syndrome
Around half of people who have a premature baby will have one or more risk factors – but that means that half will not. Most risk factors for preterm labour are not things you can control.
Risk factors do not mean that you will have a preterm baby though – they just mean that you are a bit more likely to have your baby early. If you have major risk factors, you may be referred to the obstetric antenatal clinic early in pregnancy. Not having risk factors also does not mean that you will not have a preterm baby – it is possible to be in a low risk group and still have your baby early.
If you have your baby early, the obstetric team will try to find out why, but most preterm births remain unexplained. Don’t blame yourself if you have your baby early – preterm birth is something that is usually completely out of your control.
If you go into labour early, it is recommended that you go to hospital as soon as possible. Your midwife will most likely ask to meet you at the hospital, although this varies depending on your region and distance to the hospital.
Once in hospital, your midwife or the hospital core team will assess you, and so will the obstetric team, who will make a plan with you. If there is time, they may offer you a tour of the neonatal unit, as your baby is likely to spend time there.