Premature labour (also called preterm or early labour) means going into labour before 37 weeks. After this, your pregnancy is classed as full term.

Call your Maternity Unit straight away if you think you may be going into premature labour. You're not a burden - they want to hear from you if there's a chance you're going into labour early. They'll usually tell you to go straight to hospital, and they may send an ambulance for you, if needed.

Signs of Premature Labour

If you have any of the following symptoms, you should call your Maternity Unit:

• regular contractions or ‘tightenings’
• period-type pains or pressure in your vaginal area
• a ‘show’ - this is when the plug of mucus that has sealed the cervix during pregnancy comes away and out of the vagina
• a gush or trickle of fluid from your vagina, as this could be your waters breaking
• persistant backache that's not usual for you.

This list isn't exhaustive, you can call your Maternity Unit if you're worried about anything at all, including your baby's movements. You must also call your Maternity Unit if you're experiencing bleeding, or your waters have broken and their coloured or smelly.

You may have some of these signs, but not others. For example, your waters may have broken but with no contractions, or you may have contractions but your waters haven’t broken. 

In 7 out of 10 cases, the symptoms of premature labour go away, and women give birth at full term. More than 9 out of 10 women have still not given birth 2 weeks after having these symptoms.

What happens at the hospital?

The doctor or midwife at the hospital will examine you and offer you tests to find out:

• if your waters have broken 
• if you're in labour
• if you have an infection.

These tests may include:

• a vaginal examination to check if your cervix is opening
• a check of your pulse, blood pressure and temperature
• feeling your bump to check the baby’s position 
• monitoring and recording any contractions
• a check of your baby’s heartbeat
• blood tests to check for infection
• swabs to check for infections
• urine tests to check for infection (or protein for pre-eclampsia)
• a vaginal swab to see if your body is preparing to give birth (called a ‘fetal fibronectin test’)

Your baby’s movements

Your healthcare team should also ask you about your baby’s movements in the last 24 hours.

Your baby's movements are an important sign of their wellbeing. You should continue to feel your baby move, in their normal pattern, right up to the time you go into and during labour. Call you Maternity Unit immediately if you think your baby’s movements have slowed down, stopped or changed.

What happens if my waters break early?

Normally your waters break shortly before or during labour. If your waters break before labour at less than 37 weeks of pregnancy, this is known as ‘preterm prelabour rupture of membranes’ (or PPROM). If this happens, it can (but doesn't always) trigger premature labour. You should contact your Maternity Unit immediately if you think your waters have broken.

How will I know if my waters have broken?

When your waters break, you may feel a mild popping sensation and/or a trickle or gush of fluid that you can’t stop, unlike when you wee. You may not have any sensation of the actual ‘breaking’, and then the only sign that your waters have broken is the trickle of fluid. 

What happens if I am in premature labour?

If you'e in premature labour, the midwife or doctor will talk to you about whether it's best for you to give birth now (either by vaginal delivery or caesarean section) or to try to slow down labour using medication.

They will consider:

• how many weeks pregnant you are
• you and your baby’s health     
• what special-care facilities are available and whether you need to be moved to another hospital
• what you want to do. 

You may need to be moved to a hospital that has special facilities for premature babies.

Medications

Babies that are born early are more likely to have some health problems. To help reduce the risks you may be offered medication either to delay the birth, or to improve the baby’s health before they are born. These depend on how many weeks pregnant you are. They may include:

• magnesium sulphate (to protect your baby’s brain)
• steroids (to help your baby’s lungs mature)
• antibiotics (to reduce the chance of infection)

What happens if I’m not in labour?

That's great news! If your labour hasn't started, your healthcare professional will investigate what may be causing your symptoms, and if you and your baby can benefit from further treatment. They may sometimes recommend that you stay in hospital so they can monitor you and your baby.

More Resources

NHS website

Bliss Charity

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