Premature Labor: Signs, Risks, and What to Do

Premature labor is the onset of regular uterine contractions with cervical change before 37 weeks. Recognizing signs early allows interventions that may delay delivery and improve outcomes.

Warning Signs

• Regular contractions (every 10 min or more) — abdomen tightens rhythmically.
• Constant low backache, often radiating to the front.
• Pelvic pressure or heaviness.
• Menstrual-like cramps or abdominal cramping with/without diarrhea.
• Change in vaginal discharge: increase, watery, mucus, or bloody.
• Rupture of membranes (water breaking) — gush or trickle.

What to Do

Contact your provider immediately if you notice any of these. Do not wait. Evaluation may include:

• Fetal fibronectin test (predicts preterm delivery risk).
• Cervical length ultrasound.
• Monitoring contractions and fetal heart rate.

Possible Interventions

• Corticosteroids (betamethasone) to accelerate fetal lung maturity (most effective 24–34 weeks).
• Tocolytics (e.g., nifedipine, indomethacin) to temporarily suppress contractions.
• Antibiotics if infection suspected or PPROM.
• Magnesium sulfate for neuroprotection if delivery <32 weeks.

Not all preterm labor leads to immediate delivery; sometimes it can be halted for days to weeks, buying critical time for fetal development.