Understanding Preterm Labor and Delivery

Dr. Paul MacKoul, MD

April 27, 2023


Preterm birth is a serious medical problem that can lead to a wide range of health problems for your baby. These include low birth weight, breathing difficulties, and developmental disabilities.

Understanding preterm labor and delivery can help you prepare for the situation. Ask your doctor and nurses for more information.

What is Preterm Labor?

Preterm labor is when your uterus or womb starts to get ready for childbirth before it’s expected. This happens in about half of all women who have symptoms of labor before their 37 weeks’ due date.

Symptoms of preterm labor include regular or frequent contractions that make your belly tighten like a fist. Your cervix may also start to open.

Doctors may use medications to help your baby’s development more quickly in the womb, especially if you are less than 32 weeks pregnant and have signs of labor that won’t stop. This can speed up your baby’s lungs and brain development, reduce breathing difficulties after birth and decrease the risk of problems later in life such as cerebral palsy.

What is the Treatment for Preterm Labor?

Preterm labor is a serious medical problem that can cause problems for both you and your baby. You need to follow your healthcare provider’s instructions carefully so that you and your baby can have a safe, healthy delivery.

At NYU Langone, doctors manage preterm labor based on your health and your baby’s health. They may use bed rest, intravenous (IV) fluids and medicines to relax your uterus.

If you are at high risk for preterm labor, your doctor may recommend a surgical procedure called cervical cerclage to strengthen your cervix and prevent it from opening too soon. The surgery is usually done when you’re about 24 weeks pregnant, but can be performed earlier if necessary.

To help lower your risk of premature labor, talk with your healthcare provider about avoiding smoking and drinking alcohol, getting adequate prenatal care, staying hydrated and eating nutritious food. Other healthy habits, such as regular exercise and getting 8 to 10 hours of sleep each night, can also help lower your risk.

Are You at Risk for Preterm Labor?

Preterm labor can happen to anyone, often without warning. Knowing the signs and symptoms of preterm labor can help you get medical care quickly and start to deliver your baby as early as possible.

The risk for having a baby born prematurely depends on a number of things, including how many previous pregnancies you have had. If you have had a pregnancy that was very early (less than 40 weeks), the chances of having another preterm birth increase by 2.5 times.

Women who are pregnant with multiples, have been a smoker, or have had a history of abortion, also have higher risks for having a baby that is delivered before it is due. In addition, pregnancy complications such as uterine infections or cervical insufficiency can cause premature labor.

Your doctor can screen for premature delivery by measuring the length of your cervix using a vaginal ultrasound at around 18-20 weeks. If your cervix is shorter than normal, this can be treated with bed rest, cerclage or medication to prevent early labor.

What is the Treatment for Preterm Birth?

Preterm birth can lead to lifelong health problems for babies and their mothers. They can have breathing problems, infections, fetal growth retardation and brain damage.

Medications, such as antenatal steroids and tocolytics, can help protect the baby from future problems. Antenatal steroids speed up the development of a baby’s lungs, digestive organs and brain before delivery.

Tocolytics stop contractions for up to 48 hours to delay preterm labor. During that time, your provider can give you magnesium sulfate or corticosteroids to develop the fetus’s lungs and other body parts before it is born.

These medications may also give you time to be transferred to a hospital with a neonatal intensive care unit (NICU) that can provide specialized care for your premature baby.

If you’ve been diagnosed with a risk factor for preterm birth, your doctor will talk to you about treatment options. These include taking a test to measure the length of your cervix. Measuring your cervix with a special vaginal ultrasound probe can help predict the risk of delivering early.