Pregnancy is normally a time of happiness and anticipation, but it can also be a time of unknowns. Many women have concerns about what is happening with their baby. Is everything okay? Some women wonder about going into labor early. Premature labor occurs in about 12% of all pregnancies. However, knowing the symptoms and avoiding particular risk factors can lower a woman's chance of premature labor.

What is premature labor?

A normal pregnancy should last about 40 weeks. Occasionally, labor may begin prematurely before the 37th week of pregnancy because uterine contractions cause the cervix to open earlier than normal. When this happens, the baby is born premature and can be at risk for health problems. Fortunately, due to research, technology and medicine, the health of premature babies is improving.

What risk factors place me at a high risk for premature labor?

Certain factors may increase a woman's risk of having premature labor, although the specific causes of premature labor are not known. However, having a specific risk factor does not mean a woman is predetermined to have premature labor. A woman may have premature labor for no apparent reason. If you have any of these risk factors, it's important to know the symptoms of premature labor and what you should do if they occur.

• Women are at greatest risk for premature labor if:
• They are pregnant with multiples
• They have had a previous premature birth
• They have certain uterine or cervical abnormalities


• Medical risk factors include:
• Recurring bladder and/or kidney infections
• Urinary tract infections, vaginal infections, and sexually transmitted infections
• Infection with fever (greater than 101 degrees F) during pregnancy
• Unexplained vaginal bleeding after 20 weeks of pregnancy
• Chronic illness such as high blood pressure, kidney disease or diabetes
• Multiple first trimester abortions or one or more second trimester abortions
• Underweight or overweight before pregnancy
• Clotting Disorder (thrombophilia)
• Being Pregnant with a single fetus after in vitro fertilization (IVF)
• Short time between pregnancies (less than 6-9 months between birth and beginning of the next pregnancy)


• Lifestyle risks for premature labor include:
• Little or no prenatal care
• Smoking
• Drinking alcohol
• Using illegal drugs
• Domestic violence, including physical, sexual or emotional abuse
• Lack of social support
• High levels of stress
• Low income
• Long working hours with long periods of standing

What are warning signs of premature labor?

It may be possible to prevent a premature birth by knowing the warning signs and calling your health care provider if you suspect you are having premature labor. Warning signs and symptoms of premature labor include:

• A contraction every 10 minutes, or more frequently within one hour (five or more uterine contractions in an hour)
• Watery fluid leaking from your vagina (this could indicate that your bag of water is broken)
• Menstrual-like cramps felt in the lower abdomen that may come and go or be constant
• Low, dull backache felt below the waistline that may come and go or be constant
• Pelvic pressure that feels like your baby is pushing down
• Abdominal cramps that may occur with or without diarrhea
• Increase or change in vaginal discharge

What does a contraction feel like?

As the muscles of your uterus contract, you will feel your abdomen harden. As the contraction goes away, your uterus becomes soft. Throughout pregnancy, the layers of your uterus will tighten irregularly which are usually not painful. These are known as Braxton-Hicks contractions and are usually irregular and do not open the cervix. If these contractions become regular or more frequent (one every 10-12 minutes for at least an hour) they may be premature labor contractions which can cause the cervix to open. It is important to contact your health care provider immediately.