Pregnancy - Preterm Labor

Is this your symptom?

  • Having contractions or other symptoms of preterm labor
  • 20-36 weeks pregnant

Key Points

  • Preterm labor can lead to the birth of a preterm (premature) baby.
  • A premature baby has a higher risk of cerebral palsy, development problems, and lung problems.
  • Contractions before the 37th week of pregnancy are one possible sign of preterm labor.

Symptoms that Strongly Suggest Preterm Labor

Labor symptoms in the preterm period (before 37 weeks) are often milder. Sometimes a pregnant woman may not notice or realize she is having preterm labor symptoms.

Each of these is concerning and can be a sign of preterm labor:

  • Bloody show
  • Contractions get more frequent (less than 10 minutes apart for 1 hour)
  • Contractions do NOT get better after drinking some water and walking around
  • Leaking fluid from the vagina (broken bag of water)

Symptoms that Might Suggest Preterm Labor

  • Diarrhea
  • Lightening (dropping)
  • Lower back pain
  • Pressure in pelvis
  • Sense of "something is just not right"
  • Tightening or cramping in lower stomach (belly) or pelvis (soft contractions)

What are the Symptoms of False Labor (Braxton-Hicks Contractions)?

  • Contractions are NOT regular.
  • Contractions do NOT increase over time in frequency or strength.
  • Contractions decrease with activity, for example, walking.
  • The pain from contractions tends to be felt in the upper stomach rather than in the back or lower stomach (belly).

What is a Lightening?

Near the end of pregnancy the baby drops or settles into the mother's pelvis. This is called dropping, lightening, or engagement. When this happens, the mother may notice her stomach looks different. She may find it easier to breathe. She might say that she is "carrying the baby lower." However, the baby puts more pressure on the bladder. This makes the mother feel like she has to urinate more often.

  • Why does this happen? The baby is moving down into the pelvis to get ready for labor.
  • What does this mean? Dropping usually occurs about 2 to 4 weeks before labor. However, it is not a good way to predict when labor will happen.

What is a Mucous Plug?

Many women will pass a small glob or chunk of jelly-like mucous at the end of the pregnancy. It may look like gelatin or snot. There may also be a small amount of pinkish, brownish, or blood-tinged mucous. This is called the "mucous plug."

  • Why does this happen? In late pregnancy the cervix (opening to the womb) starts to thin and stretch out. The mucous that seals the cervix falls out.
  • What does this mean? It may be a sign that a mother is getting closer to her delivery time. However, often it occurs a week or two before labor.

What is Bloody Show?

Most women have a small amount of pinkish, brownish, or blood-tinged mucous at the end of the pregnancy. This is called the "bloody show."

  • Why does this happen? In late pregnancy the cervix (opening to the womb) starts to thin and stretch out. This causes some of the tiny blood vessels in the cervix to bleed.
  • What does this mean? Bloody show is a sign that you're getting closer to delivery time. This often happens about 2 to 3 days before going into labor. Sometimes labor can start several hours later!

When to Call for Pregnancy - Preterm Labor

Call 911 Now

  • Passed out (fainted)
  • Very weak (can't stand)
  • Severe vaginal bleeding (non-stop bleeding or large blood clots)
  • Severe stomach pain
  • Umbilical cord hanging out of the vagina (shiny, white, curled appearance)
  • Can't control urge to push (feels like baby is coming out now)
  • Can see baby
  • You think you have a life-threatening emergency

Call Doctor Now or Go to ER

  • Stomach pain
  • Pinkish or brownish mucous discharge
  • Fever over 100.4° F (38.0° C)
  • New low back pain or pelvic pressure that does not go away
  • New hand or face swelling
  • You think you are in labor (having contractions)
  • You feel weak or very sick
  • You think you need to be seen, and the problem is urgent

Call Doctor Within 24 Hours

  • Pain or burning with passing urine
  • You think you need to be seen, but the problem is not urgent

Call Doctor During Office Hours

  • Baby has dropped
  • You do not think you are in labor
  • You have other questions or concerns

Care Advice

Preterm Labor

  1. What You Should Know:
    • Contractions before the 37th week of pregnancy can be a sign of preterm labor.
    • Preterm labor can lead to the birth of a preterm (premature) baby.
    • A premature baby has a higher risk of cerebral palsy, development problems, and lung problems.
  2. Symptoms of Preterm Labor:
    • Labor symptoms in the preterm period are often milder. Sometimes a pregnant woman may not notice or realize she is having preterm labor symptoms.
    • Symptoms include: leaking of fluid from vagina (broken bag of water), bloody show, contractions, lightening (dropping), and loss of mucous plug.
  3. Contractions:
    • Drink 2 glasses of water
    • Lie down on your left side and rest.
    • Count the contractions for a one hour period.
    • Time your contractions by measuring from the start of one contraction to the start of the next.
    • Call your doctor right away if you continue to have contractions less than 10 minutes apart.
  4. Call Your Doctor (or Go To Labor and Delivery) If:
    • Contractions less than 10 minutes apart for 1 hour (6 or more contractions per hour)
    • Vaginal bleeding occurs
    • Stomach pain occurs
    • Your baby is moving less
    • Your bag of water breaks
    • You think you are in labor
    • You think you need to be seen
    • You become worse

Baby Movement and Kick Count Instructions

  1. Baby Movement and Pregnancy Dates:
    • 1-15 Weeks: Baby is too small for mother to feel the baby move.
    • 16-18 Weeks: Some women begin to feel the baby move, especially if they had a baby before.
    • 18-20 Weeks: Most women begin to feel the baby move around this time.
    • 24 Weeks: All women should feel the baby move by this time.
    • Over 28 Weeks: Some doctors advise that women check kick counts each day.
  2. How to Do a Kick Count:
    • Pick the time of the day that your baby is most active.
    • Sit back in a comfortable chair or lie down on your left side in bed.
    • Do this in a quiet room (no TV, cell phone, computer, or children).
    • Count any baby movement (kicks, rolls, flutters). Count up to 10.
    • Normal Kick Count: 5 or more in one hour, or 10 or more in 2 hours.
    • Low Kick Count: Less than 5 in one hour, or less than 10 in 2 hours.
  3. Call Your Doctor If:
    • Low kick count (less than 5 in 1 hour, or less than 10 in 2 hours)
    • Kick count is normal, but you still are worried that something is wrong
    • You have other questions
    • You think you need to be seen
    • You become worse

And remember, contact your doctor if you develop any of the 'Call Your Doctor' symptoms.

Disclaimer: This information is not intended to be a substitute for professional medical advice. It is provided for educational purposes only. You assume full responsibility for how you choose to use this information.


Last Reviewed: 12/14/2017 1:32:40 AM
Last Updated: 5/17/2017 5:42:38 PM

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