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Before you can determine how to avoid pre-term labor, you must understand what it is, and what causes the condition. Pre-term labor is diagnosed when labor begins before 37 weeks gestation; 3 or more weeks prior to the due date. Unfortunately, in most cases, the actual cause of pre-term labor is unknown. However, there are instances when certain conditions are identified, and act as a warning sign that early (pre-term) labor is a possibility.
Some known causes of pre-term labor include:
- A prior history of premature labor.
- A prior history of habitual miscarriage.
- Incompetent cervix (the inability of the cervix to hold the pregnancy can be seen in some cases of second and third trimester losses).
- Premature rupture of membranes.
- Carrying more than one fetus (twins, triplets, etc.).
- Smoking.
- Alcohol.
- Drugs/substance abuse.
- Uterine infection.
- High blood pressure during pregnancy or chronic hypertension.
- Hyperthyroidism.
- Gestational diabetes or pre-gestational diabetes.
It is important to understand what labor is, and when it is actually occurring. There are certain "guidelines" that most midwives and health care providers follow and these will be discussed with you. Make sure you understand what these mean, and when to call your midwife or health care provider. Usually, these guidelines include the following:
Call Your Midwife If:
- You have four or more contractions in a one-hour period. If you live more than 30 minutes away from your midwife, you may be instructed to call her if you have 3 or more contractions in an hour. The contraction intensity should be uncomfortable (more than a cramping sensation). Your abdomen should get hard during a contraction and you may have difficulty speaking. You may have to stop and concentrate on breathing while having a contraction. In addition, a contraction can last anywhere from a few seconds to a few minutes. Labor contractions are often felt in the lower back and the sensations may travel around to the front of the belly.
- You suspect your water has broken. Each woman experiences this differently. You may feel a sudden gush, or possibly just a trickle. If you feel that your water has broken, call your midwife immediately. The fluid is usually clear (but can be bloody, or yellow- or green-tinged) and have a sweet smell to it. It will not smell like urine. Ask your midwife if she would be willing to give you a small strip of litmus paper (nitrazine test) to take home. Urine is usually acidic with a pH below 7, whereas amniotic fluid is mildly alkaline with pH of 7.2. It's easy to use and read, and can prevent unnecessary worry. A fern test may be done where a sample of fluid is taken from the back of the vagina with a swab and examined under a microscope. Dried amniotic fluid creates a fern pattern, visible under a microscope.
- ANY vaginal bleeding warrants an immediate call to your midwife. This may be caused by a placenta previa (placenta partially or fully over the cervix opening) or a placental abruption (a partial or fully detached placenta). This can be an emergency. This also may be bloody show (a tinge of blood mixed with gobs of mucous), which is seen in active labor as the cervix is dilating and effacing.
- An odd sense of "pressure" can also be a sign of labor. You may feel a sensation if pressure in you abdomen, thighs, rectum, or vagina. You may also have the feeling that the baby is "falling out" or that you have a "watermelon between your legs" feeling.
- Any change in vaginal discharge. As the cervix dilates and effaces, you will loose your mucous plug from the cervix. This mucous plug is often a creamy color with possibly a slight tinge of blood (very slight).
- A constant pain in the lower back, which radiates towards the uterus, can also be a sign that labor has begun. Many labors are felt in the lower back as a nagging back ache that comes and goes with regular intervals.
- Often, the most reliable sign that labor is beginning, is a woman's intuition that things are not "right" or "normal." Do not hesitate to call your midwife. Remember that they are there to care for you, and your unborn baby. Never feel that you are "pestering" your midwife. They understand your concerns, and expect that you will call with questions.
Although there is no sure-fire way to prevent pre-term labor, there are precautions that you can take to give you and your baby the best chance possible of going to full term.
Among these are:
- Don't smoke, drink, or use other harmful substances.
- Avoid stress and strenuous work.
- Keep the lines of communication open with your midwife or health care provider.
- Rest as much as you can.
- Learn to recognize the signs of pre-term labor.
- Pay attention to the signs that your body (and your baby) are giving you.
Pre-term labor can be treated with various medications, restrictions, and monitoring. If you feel, at any time, that labor is beginning, call your midwife or health care provider immediately. If the condition is caught early on, your baby will have a much better chance of survival.
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