If you’re expecting, understanding what preterm labor is and the signs of preterm labor can help you avoid health complications for yourself and your baby.

First of all, preterm labor is when you go into labor before you reach 37 weeks of pregnancy. Why is that number significant?

The typical pregnancy lasts 40 weeks from conception to delivery. However, your baby should be developed enough to survive outside the womb by 37 weeks.

Born before 37 weeks, a preterm baby will likely require some level of care in a neonatal intensive care unit until they grow strong enough to survive without 24/7 care from specialists. This could take days or weeks.

Preterm labor or false labor?

If you know the signs of labor, you’ll be able to tell the difference between real labor and false labor. This knowledge can make a difference if you go into preterm labor.

If you recognize the signs of labor before you reach 37 weeks, call your provider right away. You may need immediate medical attention to delay the delivery, if possible.

Signs of preterm labor include lower abdominal pain, lower back pain, cramping and bloody discharge.

One thing to keep in mind about telling the difference between true labor from false labor is that not all contractions are created equal. There are true labor contractions and there are false labor contractions, also known as Braxton-Hicks contractions.

So, how can you tell the difference?

Labor contractions

“Your contractions when you are in or going into labor – you’ll feel them in your back, and they will go to the front, so it will be like a rounding pain from the back to the front,” said Gina Demas, a supervisor of nursing and patient care in Labor and Delivery Services for OSF HealthCare.

“When early labor begins your contractions may feel like menstrual cramps,” Gina said. “They may be as far apart as every 30 minutes. As your labor progresses, your contractions will become more intense, more consistent and closer together.”

A first-time mother should start heading to the hospital for labor and delivery when contractions are three to four minutes apart for at least two hours.

You could have milder contractions for quite a while, but when they become closer together and last longer, even though they feel mild, contact your provider and see when they want you to go to the hospital.

False labor contractions

False labor pains can include a dull achiness in your lower back or Braxton-Hicks contractions that you feel in the front of your upper stomach, rather than lower on your abdomen. These contractions may feel more like period cramping and are usually not as severe as true labor contractions, which you’ll feel throughout your entire core.

If your contractions occur irregularly, stop when you’re up and about or when you’re laying down, those are Braxton-Hicks contractions. These are believed to be caused by your body getting ready for labor, and are not a sign that you’re going into labor.

You can have false labor contractions for weeks or even months before labor. So talk to your provider about any Braxton-Hicks contractions to find out what they recommend.

Losing your mucus plug

Your mucus plug is a layer of mucus in your cervical canal. This mucus is released when your cervix dilates in preparation for delivery, in what is often called a “bloody show.”

“Your mucous plug is a different kind of discharge then your normal pregnancy discharge,” Gina said. “It can be stringy in appearance, like mucuos, and may contain streaks of blood in it.”

Losing your mucus plug doesn’t necessarily mean you’re going into labor. Labor could begin within a few hours or within a few days. And sometimes losing your mucus plug is not necessarily related to labor at all.

So, notify your provider that you lost your mucus plug, and they may give you instructions.

Did your water break?

If your water breaks, you’re in labor and should get care for yourself and your baby as soon as possible, so your provider or delivery team can monitor your labor and make sure everything’s going well.

When your water breaks, you will have a discharge that is more watery than your normal vaginal discharge. And you won’t be able to stop the leakage, like you could with urine. 

“When your water breaks, depending on what is going on in the womb with your baby, the color of the fluid could be clear, yellow, brown or red-tinged,” Gina said. “Let your provider know your water broke and also let them know the color of the fluid. You’ll probably be heading to the hospital.”

‘I’m in preterm labor. What should I do?’

“You should contact your provider or go to the hospital to be checked out,” Gina said. “Some preterm labor cannot be stopped, but there are a few things that we can do to help to stop preterm labor.”

Depending on the health of your baby, your provider may try medications to delay birth, speed up organ development or reduce other complication risks. Your provider could also start IV fluids, put you on bedrest or give you a medication to help slow the contractions, so they can give you steroids to strengthen your baby’s lungs. 

Risk factors for preterm labor and birth

According to the American College of Obstetricians and Gynecologists, there are several risk factors that can contribute to having a premature birth. These risk factors include:

• Having a past preterm birth or past delivery injury
• Having a short cervix
• Early dilation
• Carrying more than one baby at a time
• Suffering infections during pregnancy
• Smoking during pregnancy
• Poor nutrition and diet
• Being younger than 17 or older than 35