Pregnancy lasts for nine months and that is about 36 weeks. Term delivery is anytime between 37-40 weeks of pregnancy. There are possibilities of birth before the 37th week of pregnancy. Delivery between 30th to 36th weeks or simply three weeks before due date is known as preterm delivery.
Labor is the process in which fetus and placenta get ready to leave the uterus. Its onset is signified by abdominal pain with cramps or back pain.
What happens during labor?
The cervix starts to dilate with contractions. It needs to dilate 8 to 10 cm for birthing to start. It is then followed by water breaking (amniotic fluid sac ruptures). Sometimes water may break before you start experiencing contractions.
If cervix starts to dilate or water breaks before 37th week then it is preterm labor.
Risk factors causing preterm labor
- History of preterm delivery
- Underweight or overweight before pregnancy.
- Pregnant with multiple (2 or 3) babies.
- A family history of premature births.
- Working long hours and exerting body.
- Not getting good prenatal care.
- Smoking or drinking alcohol during pregnancy.
- Being pregnant with a baby from in vitro fertilization (IVF).
- Having health conditions, such as high blood pressure, preeclampsia, diabetes, blood clotting disorders, or infections.
- Getting pregnant too soon after having a baby.
- Vaginal bleeding during the second and third trimester.
- Being pregnant with a baby who has certain birth defects, like heart defects or spina bifida. Birth defects are health conditions that are present at birth.
- Cervical incompetence (inability of the cervix to stay closed during pregnancy).
- Chronic medical illness (such as heart or kidney disease).
- Inflammation of the fetal membranes.
- Short cervical length.
- Blood group incompatibility.
False or true labor
Sometimes there are false labor pains also known as Braxton Hicks Contractions. These can be described as tightening in the abdomen that comes and goes. These contractions are in intervals that do not decrease with time, do not increase in how long they last or how often they occur and do not feel stronger over time. They often come with a change of position and stop with rest.
Contractions during true labor come at regular intervals and interval tends to decrease with passing time. Each contraction lasts for about 20-30 seconds. True labor does not go away by walking and feel like menstrual cramps. It is accompanied by dilation of the cervix.
Indicators of preterm labor:
There are certain changes you need to keep observing to confirm it is true labor. If you find any of the following indicators, you need to rush to your doctor. The doctor performs a pelvic test or transvaginal ultrasound to confirm cervix dilation.
- Water breaks; the membrane supporting amniotic fluid ruptures and yellowish liquid starts to come through the vagina. This means definite delivery.
- Change in vaginal discharge (mucus/blood/watery).
- Regular or frequent uterine contractions. The interval between contractions decreasing with passing time.
- Cramps in the abdomen or tightening of the abdomen (cramps similar to menstrual cramps). These may feel like pains due to gas or acidity and may also be accompanied with diarrhea.
- Light spotting (vaginal bleeding).
- Back-ache in the lower area. This may be constant or come and go, but it won’t ease even if you change positions or do something else for comfort.
- Symptoms similar to flu. Nausea, vomiting or dizziness.
- Increased pressure in vagina or pelvis or lower belly.
If you have even one sign or symptom of preterm labor, call your health care provider right away. If you have preterm labor, getting help quickly is the best thing you can do. And even if it is not preterm labor, it’s always good to confirm it by a doctor and rule out ant mishap.
Treatment for preterm labor:
Delivering the premature baby is the last options doctors opt for, as the organs are not fully developed and baby experiences difficulty in breathing. Medical equipment and intensive care are required for preemies. Sometimes just by walking, preterm labor stops. Other options that may help to postpone untimely delivery are:
- If contractions start prematurely but cervix is not diluted then, the doctors may be able to use drugs to stop the contractions temporarily. This hopefully allows time for steroid injections to be given to speed the maturity of baby’s immature lungs as lungs are the last to develop. Steroids will reduce the risk of the baby suffering from the complications of being born very early (particularly breathing difficulties and bleeding). They can take about 24 hours to work.
- Antibiotics to treat an infection.
- Bed rest (home or hospital).
- Delivery; if treatments do not stop preterm labor or if the fetus or mother is in danger, delivery of the baby may occur. Cesarean delivery may be recommended in certain cases.
Prevention of prematurity:
- Cervical cerclage (cervical stitch), is a treatment for cervical incompetence or insufficiency. If the cervix starts to shorten and open too early during a pregnancy it results in either a late miscarriage or preterm birth. Usually, the treatment is done in the first or second trimester of pregnancy, for a woman who has had one or more late miscarriages in the past or has a history of preterm birth.
It is done if the mother has a short cervix and previous preterm birth.
- Progesterone vaginal or shots help your uterus (womb) grow during pregnancy and keeps it from having contractions thus help to avoid preterm labor. It is not used if you are pregnant with multiple (2/3) babies.
Tips for mothers
- Avoid heavy or repetitive work or standing for long periods of time which may increase the risk of preterm labor.
- Get to a healthy weight before pregnancy and gain the right amount of weight during pregnancy with the help from a nutritionist.
- Identify the chronic disease (thyroid, high blood pressure, diabetes, etc) you may be suffering from and get the treatment done before conceiving.
- Don’t smoke, consume alcohol or street drugs.
- Protect yourself from infections. Get required vaccinations done.
- If you observe any vaginal discomfort or infection, don’t ignore it. Get it treated by the doctor.
- Go for timely routine check-ups and ultrasound scans.
- Get a good prenatal care.
- Don’t stress. Eat healthy food and remain active during pregnancy.