Preterm Labor

Preterm labour is labour that starts before 37 completed weeks of pregnancy. Babies born early — particularly before 34 weeks — face higher risks from immature lungs, feeding difficulties, infections, bleeding in the brain, and long-term developmental issues. Preterm birth is the single biggest cause of newborn death in India — recognising early warning signs saves lives.

Signs of preterm labour — go to hospital immediately

• Regular contractions before 37 weeks — every 10 minutes or sooner, lasting at least 30 seconds.
• Period-like cramping.
• Low backache, pelvic pressure — persistent.
• Change in vaginal discharge — watery, bloody, mucousy.
• Water breaking — gush or trickle of clear fluid.
• Vaginal bleeding.
• Reduced baby movements — always deserves check.

Risk factors

• Previous preterm birth.
• Short cervix (may be found on ultrasound).
• Twins/triplets.
• Infections — urinary, genital, gum disease.
• Very young or older (>35) mothers.
• Very short interval between pregnancies.
• Smoking, substance use.
• Severe stress, physical abuse.
• Inadequate antenatal care.
• Certain maternal conditions — high BP, diabetes, heart/kidney disease.
• Uterine anomalies, cervical incompetence.

What a Health Expert may do

• Assess how far labour has progressed.
• Steroid injections for the mother — help the baby's lungs mature; most valuable between 24 and 34 weeks.
• Magnesium sulfate — protects baby's brain if very early delivery is expected.
• Medicines to slow contractions (tocolytics) — to buy time for steroids to work.
• Antibiotics if infection present.
• Transfer to a hospital with a NICU before delivery when possible — outcomes are much better.

Prevention

• Attend antenatal visits, eat well, treat anaemia aggressively.
• Stop smoking, alcohol, and any substance use.
• Treat urinary infections promptly.
• Dental hygiene — gum disease is a known preterm birth risk.
• Cervical length scan in women with previous preterm birth or risk factors.
• Progesterone support, cervical stitch in select women with clear indications.
• Space pregnancies at least 18 months apart.