Signs of Preterm Labor

Signs of Preterm Labor


When I was 28 weeks pregnant I started contracting regularly. Up until that point I had something called ‘uterine irritability’, meaning I would have occasional cramping throughout the day, but it never progressed into anything more.

At 28 weeks it changed. I started to have regular painless contractions for a few hours every day that did not resolve with rest and hydration. Sometimes the contractions felt strong and other times they were there, but barely noticeable. 

If a patient called me with those complaints I’d tell them they need to come to the hospital to rule out preterm labor. But, for me, it was hard to get my mind around the fact that something could be happening. I really wanted to pretend it was just gas or that I was overreacting to some mild uterine activity. I tend to have a hard time differentiating between my own anxiety and real physical symptoms. I vacillate between wondering if I’m over or under reacting to what’s going on in my body. Most of the time I’d rather push through it than give into my anxiety, but when there’s a baby on the line, that just seems like a silly thought. I needed to figure out what was going on, and with preterm labor you can’t do that by just looking at the symptoms.

I eventually called a fellow midwife and asked her to speak to me like a patient- she told me what I would have told anyone else- go to the hospital!

I had multiple hospital visits over the course of my pregnancy to rule out preterm labor. I contracted daily and slowly kept dilating and thinning out my cervix, but it never happened quickly enough to be admitted for an in-patient stay. I ended up giving birth on my due date (and had her in 4 hours!), but waiting to see if I would make it to term was very anxiety provoking. 

Here are the signs for preterm labor and when to call your provider.

It can be really difficult to distinguish between normal discomforts of pregnancy (who doesn’t have back pain when pregnant?!) and warning signs (if you have back pain call your provider!).

So, if you feel confused, or if something that once felt normal feels a little bit different, call your provider and ask all the questions. It’s best to get their input and advice-- you don’t need to figure it out on your own! Even midwives need help figuring out what’s going on sometimes!

 Preterm labor is labor that occurs before 37 weeks. It is different than preterm birth (when you actually deliver). 

Some women have preterm labor in pregnancy and make it to term, while others do not. There’s no way of truly knowing which direction you’ll go if you have preterm labor. It’s best to rest, be gentle to your body, work closely with your medical team, and practice all the anxiety coping skills you have to help out your mind while you wait!

As you’ll see many signs of preterm labor are also common discomforts that happen during pregnancy, which makes it difficult to determine what is going on without a full assessment by a provider.  If you have questions, ask away!

If you think you might be having signs of preterm labor drink water, sit down and place your hand on your belly. Sometimes when you’re really active your uterus contracts, but if the symptoms don’t resolve with a bit of hydration and rest, you should be evaluated by a provider. Either way, give them a call to touch base.

Signs of preterm labor:

-      Change in vaginal discharge

-      Back pain

-      Pressure in your pelvis

-      Constant, low backache

-      Leaking of fluid

-      Belly cramps with or without diarrhea

-      Frequent, regular contractions- they can be painless or painful. Place a hand on your belly if you’re not sure what’s going on. Gently press into your belly to see how firm it is or if it changes when you think you might be having a contraction. 

Pro tip: if you place a finger on your forehead and then on your nose you can feel the difference in firmness. When you’re having a strong contraction your belly will feel like your forehead- you can’t push into it. At baseline your belly will feel more like your nose- firm, but malleable. This can help you distinguish how tight your belly gets during contractions. 


Advanced Maternal Age

Advanced Maternal Age

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