Premature labour: signs and what to do

Premature (preterm) labour is labour that starts before 37 weeks of pregnancy. It’s not common, but knowing the warning signs matters, because getting help quickly can make a real difference for your baby. This is one worth reading so you know what to watch for and to act on your instincts.

What “premature” means. A pregnancy is considered full term from 37 weeks. Labour or birth before that is premature, and the earlier it happens, the more support a baby is likely to need, since they’ve had less time to develop. The good news is that modern neonatal care helps many premature babies do well — and prompt action gives your baby the best start.

The warning signs to know. Contact your maternity unit straight away if, before 37 weeks, you have any of these:

• Regular or painful contractions or tightenings (more than a few in an hour), or period-like cramping
• Persistent lower back ache or pelvic pressure, or a feeling that your baby is “pushing down”
• Your waters breaking — a gush or a trickle of fluid
• A change in vaginal discharge, especially more discharge, or it becoming watery, mucousy or blood-tinged
• Any vaginal bleeding
• Reduced or changed baby movements

Don’t wait to see if symptoms settle — it’s always better to be checked.

Trust your instincts and call. If something just doesn’t feel right, or you’re not sure whether what you’re feeling is normal, call your maternity unit at any hour. They would far rather assess you and reassure you than have you sit at home wondering. You will never be a nuisance for checking.

What happens if you go in. Your team will assess you and your baby — checking your contractions, your baby’s heartbeat, sometimes examining your cervix or doing a swab or scan — to work out whether labour is really starting. If it is, and you’re preterm, there are treatments that can help: steroid injections to speed up your baby’s lung development, medication that may delay the birth to buy time, and sometimes transfer to a hospital with the right neonatal (special care) unit. Acting early is what makes these possible.

Who’s more at risk. Premature labour can happen to anyone, but the chance is higher with a previous premature birth, a multiple pregnancy (twins or more), certain infections, problems with the cervix or placenta, or some health conditions. If you have risk factors, your team will watch you more closely — but the warning signs matter for everyone.

Reducing your risk where you can. You can’t prevent all premature births, but looking after yourself helps: attend your antenatal appointments, don’t smoke, treat infections promptly (see your GP for burning when weeing or unusual discharge), and manage any conditions with your team. Report anything that worries you rather than pushing through.

If your baby does come early. Premature babies are cared for in a special care nursery or NICU, and how much support they need depends on how early they are. It can be frightening, but you’ll be surrounded by expert staff, and you remain central to your baby’s care — including skin-to-skin (kangaroo care) and expressing milk, which are hugely valuable for preterm babies.

It’s not always labour — and that’s okay. Sometimes what feels like it could be premature labour turns out to be Braxton Hicks, a urine infection, or a false alarm — and that’s a good outcome, not a wasted trip. Being assessed and reassured is exactly what the service is for, so never talk yourself out of calling because you’re worried it might be “nothing”. A false alarm is always better than a missed one.

The key message: from any point before 37 weeks, take contractions, waters breaking, unusual discharge or bleeding, back pressure, or reduced movements seriously and call your maternity unit straight away. Quick action opens the door to treatments that protect your baby — so trust yourself, and never hesitate to make that call.