Preterm Labour: Early Warning Signs & Prevention

Preterm labour is one of the most important pregnancy complications that every expecting mother should be aware of. It occurs when labour starts before 37 completed weeks of pregnancy. As a Gynaecologist with 27+ years of clinical experience, I have seen that early awareness and timely intervention can prevent most cases of preterm birth and protect the baby’s health.

This detailed 2025 guide explains the warning signs, causes, prevention tips, treatment options and when to seek emergency help.

What Is Preterm Labour?

Preterm labour happens when the uterus starts contracting and the cervix begins opening too early. Babies born before term may have breathing issues, feeding difficulties, or need NICU care. Preventing early labour gives the baby more time to grow inside the womb.

Types of Preterm Labour

  • Early Preterm: Before 32 weeks
  • Moderate Preterm: 32–34 weeks
  • Late Preterm: 34–37 weeks

The earlier the labour, the higher the risk, making early detection crucial.

Common Warning Signs of Preterm Labour

Call your doctor immediately if you notice:

  • Persistent lower abdominal cramps
  • Backache that does not go away
  • Tightening or pressure in pelvis
  • Uterine contractions every 10–15 minutes
  • Watery discharge or leaking fluid
  • Bloody or brown discharge
  • Increased white discharge with pain

Causes & Risk Factors

Preterm labour can happen to any woman, but risk is higher if:

  • You have had a previous preterm baby
  • You are carrying twins
  • You have short cervix
  • You have infections (UTI, BV)
  • There is placenta previa or bleeding
  • There is uncontrolled thyroid or diabetes
  • You had IVF pregnancy
  • You smoke or consume alcohol

What Does a Preterm Contraction Feel Like?

Unlike Braxton Hicks (false pains), preterm labour contractions:

  • Become regular
  • Get stronger with time
  • Do not go away with rest
  • May come with back pain or pressure

Prevention Tips for Preterm Labour

Most cases can be reduced or prevented with these steps:

1. Treat Infections Early

UTIs, yeast infections and bacterial vaginosis increase risk. Seek treatment if you notice burning, discharge or pelvic pain.

2. Cervical Length Screening

A transvaginal ultrasound at 16–24 weeks helps identify short cervix, a major risk factor for preterm labour.

3. Progesterone Support

Women with previous preterm birth or short cervix often benefit from progesterone supplements.

4. Avoid Heavy Lifting

Excess pressure can stimulate contractions in sensitive pregnancies.

5. Manage Thyroid & Diabetes

Uncontrolled levels increase complications; regular monitoring is essential.

6. Stay Hydrated

Dehydration can trigger uterine contractions. Drink 2–3 litres daily.

7. Reduce Stress

High cortisol levels increase risk. Meditation, rest and emotional support help significantly.

8. Avoid Long Travel

Road jerks and long sitting hours may stress the uterus in high-risk pregnancies.

Treatment Options for Preterm Labour

1. Tocolytic Medicines

These help relax the uterus and slow contractions.

2. Steroid Injections

Given if labour is likely before 34 weeks to improve baby’s lung maturity.

3. Magnesium Sulphate

Protects the baby’s brain if early birth is expected.

4. Hospital Monitoring

CTG monitoring, IV fluids, and rest may be advised depending on severity.

When to go to the hospital immediately?

Seek urgent care if you experience:

  • Strong regular contractions
  • Vaginal bleeding
  • Gushing of fluid (water breaking)
  • Severe abdominal pain
  • Baby movement is less

How Preterm Labour Affects the Baby

Babies born early may face:

  • Breathing problems
  • Low birth weight
  • Temperature instability
  • Feeding difficulties
  • Increased NICU stay

But with timely care and modern NICU facilities, survival rates are very high.

Long-Term Outlook

Most babies born after 32–34 weeks do extremely well. Early detection and proper obstetric care are the biggest predictors of good outcomes.

What WHO Recommends

  • Regular antenatal visits
  • Early ultrasound scanning
  • Avoid smoking and alcohol
  • Screen for infections
  • Treat anemia & thyroid disorders early

Authoritative External Links

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Frequently Asked Questions (FAQ)

1. What is the earliest week when preterm labour can start?

It can start anytime before 37 weeks, but early detection is key.

2. Can dehydration cause preterm contractions?

Yes. Dehydration can trigger uterine contractions in many women.

3. Is bed rest required for preterm labour?

Not always. Only specific high-risk cases require limited mobility.

4. Can stress lead to preterm birth?

Severe or chronic stress may increase risk, so emotional wellness is important.

5. If I had one preterm birth, will it happen again?

Risk is higher, but preventive treatment like progesterone significantly reduces recurrence.

author avatar
Dr. Mamta Agrawal
Dr. Mamta Agrawal is a senior Gynecologist & Obstetrician with over 27+ years of clinical experience in women’s healthcare. She specializes in high-risk pregnancy care, normal & C-section deliveries, PCOS, infertility treatment, menstrual disorders, menopause care, and safe medical abortion services.Dr. Agrawal holds an MBBS and DGO and is known for her ethical, patient-first approach and evidence-based treatments. She has successfully treated thousands of women across all stages of life—from adolescence to menopause.She currently practices at Agrawal Clinic, New Ashok Nagar, Delhi, and Virmani hospital, mayur vihar phase2 providing compassionate, confidential, and personalized gynecological care. Dr. Mamta Agrawal regularly educates patients through medically reviewed articles to ensure accurate and trustworthy health information.
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