Delivery of your baby after week 20 and before week 37 of pregnancy is considered preterm or premature. In cases of very early preterm labor where fetal lung maturity hasn't been established, your provider will probably try to delay the delivery for as long as possible. Preemies can suffer from a wide range of physical, neurological, and developmental difficulties, so any extra time spent in the womb is beneficial.

Are You At Risk?

A number of environmental and physical factors have been associated with an increased chance of preterm delivery. These include but are not limited to:

• Previous premature labor

• Pregnant with multiples (twins or more)

• Brief period of time between pregnancies

• Previous uterine surgery

• Hypertension (high blood pressure)

• Cigarette smoking

• Diagnosed incompetent cervix

• Drug or alcohol abuse

• Vaginal or systemic infection

• Obesity

• Being underweight pre-pregnancy

• Blood clotting disorders

• Exposure to drug DES

• Domestic violence

• Lack of appropriate prenatal care

• Working more than 40 hours a week and/or standing more than six hours per day

Women at high risk for preterm birth (for example, those who have had a previous spontaneous preterm birth) may be given regular injections of the hormone progesterone administered in the second and third trimesters to cut the risk of preterm labor.

Warning Signs

If you experience any of the following warning signs of preterm labor, call your health care provider immediately. If you are out of town or unable to get in touch with her for any reason, go directly to the nearest hospital emergency room. With prompt action, it may be possible to delay your labor until your unborn child has adequate time to develop.

Symptoms include:

• Painful contractions at regular intervals

• Abdominal cramps

• Lower backache

• Bloody vaginal discharge

• Stomach pain

• Any type of fluid leak from the vagina, large or small.

Treatment

Preterm labor may be halted by bed rest, tocolytic medications (drugs that stop contractions), and intravenous hydration. Depending on your medical history and how far along your pregnancy is, you may be hospitalized. Home bed rest may also be prescribed, and you might be required to hook up to a fetal monitor on a regular basis. If preterm labor occurs between 24 and 34 weeks, corticosteroids may be administered to hasten fetal lung surfactant development as well.

If your cervix dilates to 4 or 5 centimeters or if your fetus is showing signs of distress, preterm delivery may be unavoidable.

A level-three neonatal intensive care unit (NICU) is the best place for your newborn to receive treatment if he is delivered preterm. These units are highly experienced in the care of high-risk newborns and preemies and have state-of-the-art technology and training. The American Academy of Pediatrics and the American College of Obstetricians and Gynecologists recommend that all deliveries that occur earlier than week 32 take place at these facilities.