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My Pregnancy

Premature Labor and Birth

First Trimester | Second Trimester | Third Trimester | Postpartum 

A premature baby is one who is born too early, before 37 weeks. Premature babies may have more health problems and may need to stay in the hospital longer than babies born later.

What are the signs and symptoms of preterm labor?

Call your doctor right away if you have any of these signs and symptoms of preterm labor:

  • Change in your vaginal discharge (watery, mucus or bloody) or more vaginal discharge than usual
  • Pressure in your pelvis or lower belly, like your baby is pushing down
  • Constant low, dull backache
  • Belly cramps with or without diarrhea
  • Regular or frequent contractions that make your belly tighten like a fist (the contractions may or may not be painful)
  • Water breaks


Your physician may do a pelvic exam or a transvaginal ultrasound to see if your cervix has started to thin out and open for labor. Your cervix is the opening to the uterus (womb) that sits at the top of the vagina (birth canal). A transvaginal ultrasound is done in the vagina instead of on the outside of your belly. Like a regular ultrasound, it uses sound waves and a computer to create a picture of your baby. If you're having contractions, your doctor monitors them to see how strong and far apart they are. Other may be needed to help your doctor determine whether you're really in labor.

If you're experiencing preterm labor, your doctor may provide treatment to help stop it. Or, you may get treatment to help improve your baby's health before birth. Talk to your doctor about which treatments may be right for you.

Are you at risk for preterm labor and premature birth?

We don't always know for sure what causes preterm labor and premature birth. Sometimes labor starts on its own without warning. Even if you do everything right during pregnancy, you can still give birth early.

These three risk factors make you more likely to have preterm labor and give birth early:

  1. You've had a premature baby in the past. 
  2. You're pregnant with multiples (twins, triplets or more). 
  3. You have problems with your uterus or cervix now or in the past.


Medical risk factors before pregnancy for preterm labor and premature birth include:

  • Being underweight or overweight before pregnancy. This can include having an eating disorder, such as anorexia or bulimia.
  • Having a family history of premature birth. This means someone in your family (mother, grandmother or sister) had a premature baby. If you were born prematurely, you're more likely than others to give birth early. 
  • Getting pregnant again too soon after having a baby. For most women it's best to wait at least 18 months before getting pregnant again. Talk to your provider about the right amount of time for you.

Medical risk factors during pregnancy for preterm labor and premature birth

Having certain health conditions during pregnancy can increase your risk for preterm labor and premature birth including:

  • Connective tissue disorders, such as Ehlers-Danlos syndrome (also called EDS) and vascular Ehlers-Danlos syndrome (also called vEDS). Connective tissue surrounds and supports other tissues and organs. EDS can cause joints to be loose and easy to dislocate; skin to be thin and easily stretched and bruised; and blood vessels to be fragile and small. It also can affect your uterus and intestines. vEDS is the most serious type of EDS because it can cause arteries and organs (like the uterus) to rupture (burst). EDS and vEDS are genetic conditions that can be passed from parent to child through genes. 
  • Diabetes. Diabetes is when your body has too much sugar (called glucose) in your blood. 
  • High blood pressure and preeclampsia. High blood pressure (also called hypertension) is when the force of blood against the walls of the blood vessels is too high. This can stress your heart and cause problems during pregnancy. Preeclampsia is a kind of high blood pressure experienced by some women during or right after pregnancy. If not treated, it can cause serious problems and even death.
  • Infections, including sexually transmitted infections (also called STIs) and infections of the uterus, urinary tract or vagina.
  • Intrahepatic cholestasis of pregnancy (also called ICP) is a liver disorder that occurs during pregnancy.
  • Thrombophilias. These are conditions that increase your risk of making abnormal blood clots.


Other medical risk factors during pregnancy include: 

  • Late or no prenatal care.
  • Not gaining enough weight during pregnancy. This can include having an eating disorder, such as anorexia or bulimia.
  • Bleeding from the vagina in the second or third trimester. 
  • Preterm premature rupture of the membranes (also called PPROM). Premature rupture of membranes (also called PROM) is when the amniotic sac around your baby breaks (your water breaks) before labor starts. PPROM is when this happens before 37 weeks of pregnancy. If you have any fluid leaking from your vagina, call your provider and go to the hospital.   
  • Being pregnant after in vitro fertilization (also called IVF). IVF is a fertility treatment used to help women get pregnant.    
  • Being pregnant with a baby who has certain birth defects, such as heart defects or spina bifida. Birth defects are health conditions that are present at birth. They change the shape or function of one or more parts of the body. Birth defects can cause problems in overall health, how the body develops or how the body works. Spina bifida is a birth defect of the spine.


Risk factors in your everyday life for preterm labor and premature birth:

  • Smoking, drinking alcohol, using street drugs or abusing prescription drugs
  • Stress
  • Low socioeconomic status (SES), which includes education, job, and income.  
  • Domestic violence, including physical, sexual, and emotional abuse
  • Working long hours or having to stand a lot
  • Exposure to air pollution, lead, radiation and chemicals in things like paint, plastics and second-hand smoke. Secondhand smoke is smoke from someone else's cigarette, cigar, or pipe.


Age and race as risk factors for preterm labor and premature birth

Being younger than 17 or older than 35 makes you more likely than other women to give birth early. In the United States, black women are more likely to give birth early. Almost 17 percent of black babies are born prematurely each year. Approximately 10 percent of American Indian/Alaska Native and Hispanic babies are born early, and less than 10 percent of white and Asian babies. We don't know why race plays a role in premature birth; researchers are working to learn more.  

Can you reduce your risk for preterm labor and premature birth?

Yes, you may be able to reduce your risk for early labor and birth. Some risk factors you can't change, like having a premature birth in a previous pregnancy. Others you can do something about, like quitting smoking.

According to the March of Dimes, here's what you can do to reduce your risk for preterm labor and premature birth:

  • Get to a healthy weight before pregnancy and gain the right amount of weight during pregnancy. Talk to your doctor about the right amount of weight for you before and during pregnancy.
  • Don't smoke, drink alcohol, use street drugs, or abuse prescription drugs. Ask your doctor about programs that can help you quit. 
  • Go to your first prenatal care checkup as soon as you think you're pregnant. During pregnancy, go to all your prenatal care checkups, even if you're feeling fine. Prenatal care helps your doctor make sure you and your baby are healthy.
  • Get treated for chronic health conditions, like high blood pressure, diabetes, depression, and thyroid problems.
  • Protect yourself from infections. Talk to your provider about vaccinations that can help protect you from certain infections. Wash your hands with soap and water after using the bathroom or blowing your nose. Don't eat raw meat, fish, or eggs. Have safe sex. Don't touch cat poop.
  • Reduce your stress. Eat healthy foods and do something active every day. Ask family and friends for help around the house or taking care of other children. Get help if your partner abuses you. Talk to your boss about how to lower your stress at work.
  • Wait at least 18 months between giving birth and getting pregnant again. Use birth control until you're ready to get pregnant again. If you're older than 35 or you've had a miscarriage or stillbirth, talk to your doctor about how long to wait between pregnancies.