Preterm labor is defined as regular contractions resulting in an opening of the cervix after 20 weeks of pregnancy but before 37 weeks. Not all premature labor results in premature birth, but it can if it does not stop. The most significant health risk of premature labor is premature birth. The earlier the premature birth, the greater the chances of health risks.
Premature labor is not always controllable. Sometimes, it just happens, and there are no objective reasons. However, even though we do not always know the cause of premature labor, some things put someone at higher risk for premature labor.
Risk Factors For Preterm Labor:
- Previous preterm labor or births, especially in more than one previous pregnancy.
- Pregnancy of multiples.
- Shortened cervix.
- Problems with the uterus or placenta.
- Smoking cigarettes or using illicit drugs.
- Infections of the amniotic fluid or urinary tract.
- High blood pressure, diabetes, autoimmune diseases, and depression.
- Living in a Black or Brown body with everyday exposure to racism.
- Stressful events.
- IVF pregnancies.
- Diabetes and Gestational Diabetes.
- Domestic violence, including physical, sexual, or emotional abuse.
- Polyhydramnios or too much amniotic fluid.
- Vaginal bleeding during pregnancy.
- Fetal congenital disabilities.
- Less than twelve months between pregnancies or greater than fifty-nine months between pregnancies.
- Young or older birthing parents.
Some of these risk factors are unavoidable – things that birthing individuals cannot change – and others are things we can control. Doing one's best to avoid risk factors is a great way to prevent preterm labor.
Braxton Hicks or Preterm Labor?
The most common symptoms reported with preterm labor are:
- More than four contractions in one hour with or without menstrual-like cramping.
- Pressure in the lower belly or a constant dull backache.
- Diarrhea accompanies other symptoms.
- Watery, blood-tinged, or mucus-like discharge.
- A gush or trickle of fluid from the vagina.
If you are experiencing any of these symptoms, it is a good idea to contact your care provider immediately and let them know.
If your provider has you come in, different things may occur to confirm that you are indeed in preterm labor.
Tests to Confirm Preterm Labor:
- Monitoring contractions. At a hospital, a device called a Tocodynamometer attaches to one's belly to monitor the frequency of contractions. This can give a good idea of the timing of each contraction visually.
- Urine test. UTIs can cause premature labor or a lot of premature labor symptoms. Because of this, a urine test will be taken. When a UTI is treated, the signs of preterm labor often go with it.
- Fetal Fibronectin Screening. This screening is often done if premature labor occurs before thirty-four weeks of pregnancy. This swab tests the cervical secretions for Fetal Fibronectin, a protein that helps the amniotic sac. The lack of Fetal Fibronectin in the vagina is a good sign that premature labor is unlikely.
- Transvaginal Ultrasound. This ultrasound can measure the length of the cervix, check the placenta, and check the baby.
- Pelvic Exam. A pelvic exam may be considered to check for uterine firmness or softness, baby positioning, cervical ripening and opening, and amniotic fluid.
After confirming preterm labor, different options might be given to you for keeping labor at bay and your baby in the womb.
Options to Delay Labor:
Bed rest. Some individuals need to do bed rest for a few weeks, and others need to practice it for the rest of their pregnancy. This can either be done at home or in the hospital setting.
- Tocolytic Medications. These medications can work with the body to stop labor and contractions. However, each medication has a list of risks and benefits that should be weighed before administration.
- Corticosteroids. These are steroids that aid in rapidly growing the fetal lungs. This can be a reasonable precaution or a great option if preterm birth is imminent.
- Antibiotics. If an infection is causing preterm labor, antibiotics treating the infection can cause the preterm labor to stop.
If nothing works to stop the preterm labor, birthing the baby is the last option.
Complications of Preterm Labor
Because of modern-day technology, infants as young as 24 weeks gestation have a 60-70 percent chance of survival. These survival rates increase weekly, and a person can continue with pregnancy. Unfortunately, about 40 percent of preterm infants will suffer from life-long health complications due to being born early. Some of these complications look like this:
- Trouble maintaining body temperature.
- Breathing problems.
- Heart problems.
- Blood problems.
- Kidney problems.
- Digestive problems.
- Nervous system problems.
- Infections.
Takeaway
Although preterm birth only occurs in about 1 of every 10 pregnancies in the United States, it is essential to know what it is and what it might look like. Catching early preterm labor can be an effective way to stop it. However, premature labor can be an extremely stressful event that puts birthing individuals in impossible situations. Although, for the most part, statistical survival rates are good, premature birth is a scary thing that can lead to infant mortality rates and should be taken seriously.
