Preterm labour is of growing concern these days, even in Canada, and can lead to preterm birth. In Ontario, 1 in 12 babies is born too early, which matches the national average. Preterm babies often need extra care and usually require an extended hospital stay. This depends on how early they are born and if there were any complications. Keep reading to find out how you can help yourself to have a healthy pregnancy and baby.
What is Preterm Labour?
A healthy pregnancy usually lasts between 37 and 42 weeks. You reach full term at 37 weeks. Therefore, preterm labour is any labour that happens before you hit that “term” mark. Your due date is when you reach 40 weeks. For those who have laboured before, labour will likely be recognizable. For first time parents, it might be harder to distinguish. Talk to your midwife or doctor if you begin to notice any of the following signs or symptoms. Some expectant parents have none of the symptoms below but will just feel “off.”
Signs and Symptoms
- Regular menstrual like cramps in the lower pelvis or low back, increasing in intensity and different from what you are used to that don’t go away when you rest, change your activity level, stretch, take a bath or shower – regular comfort measures for sore back.
- Increased pelvic pressure or pain, feeling like the baby is low in your pelvis
- Change in amount or type of vaginal discharge (mucous or blood)
- “Water breaking” – fluid leaking from the vagina, either a gush or a continuous trickle of fluid
- Feeling that something isn’t right
Luckily, not all preterm labour will result in preterm birth. In 30-40% of cases, those babies will hang in there until term.
What are my risks?
In some cases there is no known reason for having preterm labour. There are known risks factors, listed below, that can increase your chances of having labour and potential a baby before term. These are what we call “modifiable” risk factors, meaning that they can be changed by improving our health and wellbeing. If you have any of these risk factors, talk to your care provider to get some help to try to prevent an early labour and birth.
Risk Factors
Modifiable risk factors include the ones below.
- Poor health status, poor nutrition in pregnancy, and poor weight gain in pregnancy
- Low or high BMI (body mass index)
- Smoking and the use of recreational drugs
- Infections, including bladder, dental, uterine, and vaginal (including sexually transmitted infections like chlamydia and gonorrhea and bacterial vaginosis
- Type of work that you do if it involves prolonged standing, heavy lifting, job stress, or working in temperature extremes
- Stress at home from violence or abuse in the house or family
Other risk factors include:
- History of preterm labour and/or birth
- Multiple pregnancy (twins or more)
- Younger (less than 18) or older (older than 35) in pregnancy
- Preterm breaking of water
What if it happens to me?
If you begin to experience any of the above symptoms, get in touch with your care provider right away. It is very important to seek care and potential treatment as soon as possible to be able to lessen potential risks to you and the baby. An early assessment and admission to an appropriate care facility can have a big impact on the outcome of preterm labour and/or birth. There are tests and procedures that will be offered or recommended to you to confirm labour and the potential for impending birth.
You and your baby will likely be monitored closely using an external fetal monitor, and tests for infections will be recommended. An ultrasound might be useful to measure the length of the cervix. A vaginal swab for fetal fibronectin can give an indication is birth is likely to happen. If it seems as though your baby will come early, medications may be given to help with your baby`s lung maturity (steroids). Sometimes medications are given to slow your labour to buy some time for the steroids for the baby to take effect. Unfortunately, it is difficult to stop the labour once you are on your way to birthing.
And if my baby is born early?
As we know, preterm labour more often leads to preterm birth than not, but not all preterm babies are equal. One sure thing to expect is a longer hospital stay for your baby, and the length of stay really depends on your baby`s well-
being and any complications from the labour or birth. Earlier babies can expect a longer stay until they are growing well. Extremely premature babies (younger than 28 weeks) are more likely to have long-term health concerns and require treatment for physical and developmental issues. Very premature babies (28-32 weeks) may have fewer adverse outcomes but still require in-hospital care until they’ve grown enough. Some babies that are near term might only have a couple of days of observation but are still at higher risk for complications like jaundice, poor feeding and infection.
How can I prevent preterm labour?
By using the list of risk factors above, you can treat your body well by avoiding risks. If possible, start on a good path before you even 
consider pregnancy. You should also find a good care provider as soon as you find out that you are pregnant. Check this link out for some guidance on finding the care provider that is right for you. Your care provider can answer questions and guide you in making positive health changes if they are needed. In addition, check out this post for some great nutritional guidelines. If you can’t be rid of any risk factors, you may be able to reduce your risk by making small steps. Cutting down on smoking or changing your job duties may help to having a healthier pregnancy and birth.
Becca Raper is a Registered Midwife with Generations Midwifery Care. You can learn more about her here.