To date, I’ve had one personal run-in with preterm labor and two with preterm births. The preterm labor was due to an underlying medical problem. I was given a shot to stop it, and she was able to stay in there until 41 weeks. As for the preterm births, both my children were born before 37 weeks, no hospital stays or NICU required.

As a doula, I’ve had clients experience preterm labor; again, doctors were able to stop it with a shot, so the babies stayed in longer and continued developing and growing. The medications given to babies when the mothers are experiencing preterm labor help stop the delivery progress, allow the babies’ organs to develop faster, and reduce the risk of certain complications.

What is preterm labor?

A typical pregnancy lasts for at least 40 weeks. Of course, every birth is different, and some women go into labor before the 40 weeks are up. According to a study covering 184 countries, 5% to 18% of babies are born preterm. These rates continue to rise all over the world. As with any global issue, education remains a key component of prevention efforts.

So, what happens when your baby comes early, and not just a little early, but way too early?

ACOG defines preterm labor as labor that occurs before 37 weeks, which is the viable gestational age. A premature baby (preemie or preterm baby) is one born before the 37th week.

It’s important to note that preterm labor doesn’t always equal preterm birth. Preterm labor shouldn’t be a constant fear, but a little awareness and basic education have never hurt anyone. Educating yourself helps with early intervention and even prevention in some cases.

Risk factors for preterm labor

What causes preterm birth? The reasons are often unclear, but there are risk factors that increase the likelihood of preterm labor and preterm birth. These include:

1. A previous experience with preterm birth. If you have a history of preterm birth, it can increase your chances of having another.
2. Early cervical dilation: If your cervix starts to experience changes early, this can lead to a higher risk of preterm labor.
3. Shortened cervix: If your cervix is shorter than the average, changes can happen faster.
4. Age: Pregnant women under 17 or over 35 are at greater risk of preterm birth.
5. Carrying more than one fetus: Multiple babies increase the chances of preterm labor overall.
6. Extra stressful life events: This is something out of your control for the most part. Seeking healthy coping mechanisms is a great way to deal with any extra everyday stress that you can’t control.

These are just some of the risk factors. Remember to consult with your doctor about how much you personally are at risk. Having one or more of these doesn’t necessarily lead to preterm labor or birth.

Signs of preterm labor

Now that you know what can cause preterm labor, how can you tell that it’s actually happening?

• Mild abdominal cramps: This can seem like period cramps. They don’t lessen with pain relief measures such as having a warm bath, drinking water, or resting.
• Pelvic or lower abdominal pressure: Pressure is felt as the baby descends further down into the birth canal, preparing for departure.
• A change in the type and amount of vaginal fluid: If your vaginal fluid becomes bloody or brown in color, this can signal the next symptom.
• Ruptured membranes: Also referred to as your water breaking, this gush of fluid or maybe even an ongoing trickle can signal the beginning of labor.

The first and best thing to do when you suspect preterm labor is to call your ob-gyn or midwife and speak to them. Let them know all symptoms so you can explore your options for the next step. They may suggest some at-home remedies that can calm your body or a visit to their facility for a checkup.

Preterm birth complications

There are common issues for preemies. Preterm birth can lead to problems such as:

• Low birth weight: Most infants weigh at least 7 pounds at full term, while many preterm babies can weigh less than 5 pounds, 8 ounces.
• Vision problems: Abnormal blood vessels can grow on a premature baby’s retina, resulting in a disorder called retinopathy of prematurity (ROP), which could cause eye and vision problems such as blindness.
• Breathing issues: The lungs aren’t done developing until week 37. There is medication doctors use to help speed this development along.
• Short-term conditions: These include but are not limited to jaundice, respiratory distress syndrome, and heart problems. Many of these conditions clear up with time and proper care.
• Developmental delays: Sometimes, premature babies can experience issues such as delays in walking and/or speech.

Not every preterm baby will experience one or all of these problems. They will vary and can be detected using regular developmental screening and medical checkups through your local pediatrician. If you’ve had a preterm baby, keeping an eye on their growth and development is a good way to stay on top of things.

Preventing preterm birth

Preterm labor doesn’t have a specific cause, but there are some tested ways to lessen the risk.

Make sure regular prenatal care is a part of your pregnancy journey. Any risk factors or early symptoms can be caught and addressed if you’re receiving regular medical care.

Leading a healthy lifestyle, which includes limiting stress, is helpful during pregnancy. Pregnant women should also eliminate any risky substances that could cause problems, obvious examples being hard drugs, smoking, and alcohol consumption.

Lastly, if your doctor has determined that you are at risk of preterm labor, there are preventative medical measures, such as progesterone shots. The hormone can be administered via a regular or a vaginal injection and can help prevent preterm birth.

Cervical cerclage can be used on pregnant women whose cervix starts to shorten and open too early. This procedure involves the doctor putting in 1 or 2 stitches to close up the cervix.

Characteristics of preterm babies

What does a premature baby look like?

Small size: When a baby is born early, they are smaller in size. A lot of weight gain happens in the last few weeks before birth, so missing them would mean low weight.

More pinkish or jaundiced skin tone: Babies who are born earlier can appear pinker in color. Jaundice, or yellow discoloration of the skin due to a build-up of bilirubin in the body, is a common issue with preemies. The skin and the white of the eye (sclera) may be stained yellow.

Sharper features: As babies continue to gain weight until full term, their features round out to the chunkiness we’re used to seeing. Since preterm babies are underweight, their features appear sharper and less rounded due to less fat.

Low body temperature: A lack of stored body fat may mean your baby’s skin is cooler than normal.

Caring for a premature baby

When your baby is born premature, they will require extra attention, skill, and support. Caring for a preterm infant might look different in certain areas given that the baby hasn’t had time to develop fully.

Your newborn may be required to stay at the hospital a little longer even after you are discharged. This can be extremely hard to deal with. Postpartum support, lots of hospital visits, and care for yourself are 3 essential tips for getting through the NICU period. When it’s time to take your infant home, things can still look a little different for you when it comes to feeding and aiding their development.

Doctor care, both in the NICU and after discharge, becomes an even larger part of your life when you have a preemie. The jaundice some preemies suffer from requires being under special lights or under special blankets.

Other conditions and complications that premature babies come home with and can affect their eyesight, breathing, and/or heart are handled through frequent postnatal appointments and monitoring the issue as your child continues to develop. Frequent doctor visits are a normal part of care for a preterm baby.

With regard to breastfeeding, latching took some time as my children developed, but we got there, taking it one day at a time and using resources. When it comes to lactation, the reflexes needed to suckle may not be fully developed. The pressure to make sure they were meeting milestones and gaining enough weight was hard to bear, but having support along with realistic expectations helped tremendously. Reaching out to your local lactation consultants and breastfeeding peer support groups is a great way to stay educated and receive help during your breastfeeding journey. Other feeding methods include pumping and giving the milk through a tube or a syringe.

Making sure your baby is getting enough to eat and growing is something you’ll have to deal with constantly. This can come with pressure to formula-feed or supplement as needed. Stay in regular contact with your pediatrician and lactation consultant to make sure you and your baby are on track with feeding and maintaining realistic goals. Keeping in mind that a baby’s stomach is about the size of a walnut even at full term can relieve the worry of whether they’re getting enough or not.

Milestone tracking takes on a whole new dimension when you have a preterm baby. Making sure any issues are caught early and support promptly provided can be a heavy burden to carry. Always have realistic expectations, give your little one wiggle room to grow and learn, and, as much as possible, avoid stress.

Conclusion

Preterm labor is a pregnancy complication that can lead to preterm birth. Not every instance of preterm labor turns into a preterm birth. Regular medical care and adherence to professional pregnancy advice can help minimize the risk of preterm labor and preterm birth.

When it comes to premature babies, there are obvious differences in birth and infant care. The challenges can be unpredictable for each family. As preterm birth rates rise, it’s important to stay educated on these issues so that prevention efforts can continue and truly make a difference.