What Are the Warning Signs of Premature Labor?

signs of premature labor
Know the signs of preterm labor and what to do if you notice them

A typical pregnancy lasts for about 40 weeks. Occasionally, however, labor begins prematurely because uterine contractions can cause the cervix to open earlier than normal. Babies born before week 37 of pregnancy are considered premature: 

  • Premature: Between 32-37 weeks
  • Very premature: Between 28-32 weeks
  • Extremely premature: Between 23-28 weeks

Doctors usually try to delay or stop preterm labor to let the pregnancy continue so that the fetus has more time to grow and develop. Premature babies are at higher risk of health complications. While some preterm babies do very well, others need medical intervention and intensive care unit (ICU) care. 

Signs of preterm labor include:

  • Regular painful contractions
  • Painful or hard uterus
  • Contractions that occur more than 6 times an hour
  • Contractions that occur less than 10 minutes apart
  • Severe cramping in the lower abdominal area
  • Stomach cramps that feel like period pain
  • Crescendo pattern of pain
  • Pain that does not go away by changing positions
  • Dull to severe ache in the lower back
  • Blood or fluid coming from the vagina
  • Increasing pressure in the vagina
  • Pressure in the pelvis as if the baby is pushing down
  • Swelling of hands, feet or face
  • Nausea, vomiting or diarrhea
  • Troubles with the eyesight, such as blurred or double vision
  • Water breaking
  • Baby stops moving or moves less

If your water breaks or contractions start before you have reached week 37 of pregnancy, you should contact a doctor or go to the hospital immediately for prompt medical assistance.

What are Braxton Hicks contractions?

Braxton Hicks contractions are a type of uterine contraction that can happen throughout pregnancy and are not the same as the contractions that occur during labor. They prepare your body for giving birth. But these contractions can cause false alarm and worry, especially if it is your first pregnancy. 

Braxton Hicks contractions feel like a tightness in the uterus. They are usually irregular, infrequent and relatively less painful or painless. For women who are in their first pregnancy, however, the contractions can feel quite strong and even painful. 

As your pregnancy progresses, Braxton Hicks contractions may occur more frequently and may become more regular. It can feel like labor for many women.

Unlike labor contractions, Braxton Hicks contractions usually stop on their own or go away with a change in position, walking, or resting. Labor contractions increase in length, typically occur at regular intervals, and are much more painful.

What causes preterm labor?

Most preterm labor cases are unexpected, and the causes aren’t always clear. Some factors that may increase the risk of premature birth include:

  • Previous preterm labor in another pregnancy
  • Urinary tract infection (UTI) or other infections
  • Poor diet or poor health
  • Underlying medical conditions before or during pregnancy
  • Smoking or using recreational drugs
  • Stress
  • Carrying twins or more babies
  • Trauma to the mother
  • Bleeding from the placenta
  • Problems with the cervix
  • Problems with the uterus, such as fibroids

Sometimes, labor may need to be induced if: 

  • The mother’s blood pressure is too high (preeclampsia) or she has other health conditions
  • There is bleeding from the placenta
  • The baby is not growing or there are other health concerns


Conception: The Amazing Journey from Egg to Embryo See Slideshow

What are potential health problems in premature babies?

It’s common for premature babies to be slightly behind their peers in meeting developmental milestones, such as crawling, walking, and talking, but most often they catch up within the first couple of years.

Premature babies, however, are at higher risk of health complications than full-term babies, and these complications may be short-term, long-term, or permanent:

  • Lack of surfactant in the lungs (a substance that helps the lungs stay inflated), leading to lung collapse
  • Respiratory distress syndrome (RDS), a condition caused by immature lungs that makes breathing difficult
  • Difficulty controlling body temperature
  • Difficulty eating and digesting food
  • Infection
  • Jaundice
  • Bleeding in the brain
  • Hearing and vision problems
  • Difficulty making sounds, crying, or communicating
  • Cerebral palsy and other neurological disorders
Ross MG. Preterm Labor. Medscape. https://emedicine.medscape.com/article/260998-overview

Furdon SA. Prematurity. Medscape. https://emedicine.medscape.com/article/975909-overview

Lockwood CJ. Preterm Labor: Clinical Findings, Diagnostic Evaluation, and Initial Treatment. UpToDate. https://www.uptodate.com/contents/preterm-labor-clinical-findings-diagnostic-evaluation-and-initial-treatment

Robinson JN, Norwitz ER. Preterm Birth: Risk Factors, Interventions for Risk Reduction, and Maternal Prognosis. UpToDate. https://www.uptodate.com/contents/preterm-birth-risk-factors-interventions-for-risk-reduction-and-maternal-prognosis