Premature Labour or Preterm Labour means you go into labour early before 37 weeks of pregnancy.
About 8 our of 100 babies are born prematurely so its important to know what the signs of premature labour are.
What are the signs and symptoms of preterm labour?
You may have some signs that labour has started but not others.
If you have any of the following symptoms you may be going into preterm labour so call our MATERNITY TRIAGE on 0151 604 7111 straight away.
- regular contractions or tightenings
- period-type pains or pressure in your vaginal area
- a “show” - when the plug of mucus that has sealed the cervix during pregnancy comes away and out of the vagina
- a gush or trickle of fluid from your vagina – this could be your waters breaking - or any vaginal bleeding
- backache that's not usual for you
Preterm labour may feel similar to normal labour or it may be faster or less painful, particularly if very preterm.
Try not to panic - most women who experience signs of premature labour don't actually go on to have a premature labour buts its always best to get to the hospital to be assessed and monitored.
You can find out other reasons to call Maternity Triage by clicking this link Maternity Triage 24/7 | Wirral University Hospital NHS Foundation Trust
Braxton Hicks
Many women and birthing people experience Braxton Hicks when the womb (uterus) contracts and relaxes. They are sometimes known as practice contractions or false labour pains..
These can become quite strong during the third trimester (after 28 weeks), and it's easy to mistake them for the real thing.
Braxton Hicks contractions usually:
- are uncomfortable rather than painful
- do not last long
- do not happen often
- do not build up.
They are usually not painful, so it is important to get checked in hospital if you are having painful contractions.
What happens at the hospital?
The triage midwife and doctor at the hospital will carry out some assessments, offer to examine you and offer you tests to find out if:
- your waters have broken
- you’re in labour
- you have an infection
These tests may include:
- urine tests to check for infection (or protein, which can be a sign of pre-eclampsia)
- checking your pulse, blood pressure and temperature
- feeling your bump to check the baby’s position
- monitoring and recording any contractions
- a check of your baby’s heartbeat
- a speculum or vaginal examination to check if your cervix is opening
- a vaginal swab to see if your body is preparing to give birth
- a vaginal swab to see if there is any infection present
- blood tests to check for infection
Your overall risk of preterm labour is assessed and you may be admitted to the Maternity Ward or the Delivery Suite depending on what is happening with your body and what the findings are from your Triage assessment. The midwife or doctor will talk to you about whether it’s best to birth your baby now (either by vaginal delivery or caesarean section) or try to slow down labour using medication called Nifedipine to be able to give you a course of steroids. They will
consider:
- how many weeks pregnant you are
- you and your baby’s health
- whether you need to be moved to another hospital if our Neonatal Unit is very busy
- what you want to do.
Depending on the situation and your gestation you may be offered different medications if the doctors think there is a change you may give birth prematurely. These can include steroid injections to boost the development of the babies lungs and the production of a substance called surfactant, which helps provide oxygen to the body. Steroids also help to reduce the risk of bleeding into the brain (called intraventricular haemorrhage) and other complications which affect the bowel and circulatory system.
It is likely you will have a cannula sited (known as a ‘drip’, a small plastic tube to allow intravenous medications to be given) and routine blood tests taken.
In some cases where preterm labour occurs, a medication called Magnesium Sulphate is given through a drip in the arm to help protect the baby’s brain. Evidence has shown that it reduces the risk of cerebral palsy in babies born early. You may be given IV Antibiotics to help prevent against infection.
Someone from the Neonatal Team may come to speak to you about what might happen and what to expect if your baby is born prematurely.
What happens if I'm not in labour?
If labour hasn't started, our doctors and midwives will investigate what may be causing your symptoms and if you and your baby would benefit from further treatment.
It might be recommended that you stay in hospital so they can monitor you and your baby.
In 7 out of 10 cases, the symptoms go away and women give birth at term (after 37 weeks).
More than 9 out of 10 women do not give birth within 14 days of having these symptoms.
What if my waters break early (Preterm Pre labour Rupture of Membranes PPROM)
Normally your waters break shortly before or during labour. If your waters break before labour at less than 37 weeks of pregnancy, this is called preterm prelabour rupture of membranes or PPROM. If this happens, you have a higher chance of giving birth prematurely. You and your baby are also more likely to get an infection that could make you ill. You’ll be offered antibiotics to reduce that risk and help your pregnancy to carry on.
If you and your baby are well, and depending on your circumstances and preferences, it may be best to let your pregnancy carry on until 37 weeks. You will be monitored closely until you give birth. Initially this will be done whilst you stay on our Maternity Ward but you may be able to be discharged with monitoring done at our Maternity Day Unit.
What can I do to prevent premature birth?
Most of the time premature labour happens naturally and no one knows why. There are some things that can increase your chance of premature birth and you should know about these. They include:
- having had a previous premature birth
- having a urine infection - its important to get these treated straight away - you can contact our Maternity Triage
- smoking - get yourself some support to help you quit smoking Smoking in pregnancy | Wirral University Hospital NHS Foundation Trust
- using alcohol or substances - you can tell your midwife if you want help and support with this
- bleeding in pregnancy - make sure you contact our Maternity Triage
- stress in pregnancy - if you are struggling with this speak to your midwife or GP who can provide emotional and practical support or give you details of further services
Planned Premature Birth
Sometime premature birth is planned if it is thought to be safer for you or baby. This may be due to complications in your pregnancy such as pre-eclampsia or fetal growth restriction. Your Midwives and Doctors will discuss with you the benefits and risks of continuing with the pregnancy versus your baby being born prematurely and you will be involved with the decision making. You can still make a birth plan/preference list and discuss these with your midwife and doctor. If you are advised to give birth early you may be recommended to give birth by induction of labour or by Caesarean Birth, You can find out more about these types of birth here: Labour and Birth | Wirral University Hospital NHS Foundation Trust
Where can I find out more information?
Tommy's website - Premature (preterm) birth | Tommy's
NHS Website - Premature labour and birth - NHS
National Guidance - Information for the public | Preterm labour and birth | Guidance | NICE