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Recognizing Premature Labor | Patient Education

What is Premature Labor?

A term pregnancy takes about 40 weeks to complete. Babies born before 37 weeks may have problems breathing, eating and keeping warm. Premature labor occurs between the 20th and 37th week of pregnancy, when uterine contractions cause the cervix, the mouth of the uterus or womb, to open earlier than normal. This can result in premature birth.

Certain factors may increase a woman's chances of having premature labor, such as carrying twins. However, the specific cause or causes of premature labor are not known. Sometimes a woman may have premature labor for no apparent reason.

Warning Signs of Premature Labor

It may be possible to prevent a premature birth by knowing the warning signs of premature labor and by seeking care early if these signs occur. Warning signs and symptoms for premature labor include:

• Uterine contractions that happen six or more times in an hour, with or without any other warning signs.
• Menstrual-like cramps felt in the lower abdomen that may come and go or be constant.
• Low dull backache felt below the waistline that may come and go or be constant.
• Pelvic pressure that feels like your baby is pushing down. This pressure comes and goes.
• Abdominal cramping with or without diarrhea.
• Increase or change in vaginal discharge such as change into a mucousy, watery or bloody discharge.

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Uterine Contractions: How to Tell What's Normal

It is normal to have some uterine contractions throughout the day. They often occur when you change positions, such as from sitting to lying down. It is not normal to have frequent uterine contractions, such as six or more in one hour. Frequent uterine contractions or tightenings may cause your cervix to begin to open.

Since the onset of premature labor is very subtle and often hard to recognize, it is important to know how to feel your abdomen for uterine contractions. You can feel for contractions in this way:

• While lying down, place your fingertips on the top of your uterus
• A contraction is a periodic tightening or hardening of your uterus. If your uterus is contracting, you will actually feel your abdomen get tight or hard, and then feel it relax or soften when the contraction is over.

What To Do If You Think You May Have Symptoms of Premature Labor

If you think you are having uterine contractions or any other signs and symptoms of premature labor:

1. Lie down tilted towards your side. Place a pillow at your back for support.

• Sometimes lying down for an hour may slow down or stop the signs and symptoms.
• Do not lie flat on your back, because lying flat may cause the contractions to occur more often.
• Do not turn completely on your side, because you may not be able to feel the contractions.
• Hydrate yourself by drinking several large glasses of water. Sometimes being dehydrated can cause contractions.

• To tell how often contractions are occurring, check the minutes that elapse from the beginning of one contraction to the beginning of the next.

• You have six or more uterine contractions in one hour
• You have any of the other signs and symptoms for one hour
• You have any spotting or leaking of fluid from your vagina

With acknowledgement to Dr. Robert K. Creasy for his assistance and to the March of Dimes Birth Defects Foundation for their support.

Braxton-Hicks contractions or false labor contractions are irregular contractions and relaxation of the muscles of the uterus as a way of preparing for true labor. They are thought to start around 6 weeks of gestation but are not usually felt until the 2nd or 3rd trimester.

False contractions are a normal part of pregnancy. They may be uncomfortable, but not painful. Women describe them as a feeling that feels like mild menstrual cramps or tightness in a specific area of ​​the abdomen that quickly resolves. nine0003

They are also irregular in duration and intensity, occur infrequently, are unpredictable and not rhythmic, and are more uncomfortable than painful.

Braxton Hicks contractions tend to increase in frequency and intensity towards the end of pregnancy. Women often mistake Braxton Hicks contractions for real labor. However, unlike real contractions, they do not dilate the cervix and result in the birth of a baby.

Braxton Hicks contractions occur when the muscle fibers of the uterus contract and relax. The exact etiology of Braxton Hicks contractions is unknown. However, there are circumstances that can cause them:

• when the woman is very active,
• when the bladder is full,
• after sexual activity,
• when the woman is dehydrated.

Common among all these circumstances is the potential stress on the fetus and the need for increased blood flow to the placenta to provide oxygen to the fetus.

• Change position or activity level: if you were very active, lie down; if you have been sitting for a long time, go for a walk. nine0014
• Relax: take a warm bath, massage, read a book, listen to music or take a nap.

If you have Braxton Hicks contractions or if they continue and become more frequent and intense, you should see your doctor.

When assessing for Braxton Hicks contractions, there are a few key questions to ask yourself. We have prepared a table for you with questions, the answers to which will help you understand what kind of contractions you have:

	Braxton Higgs contractions	Real labor pains
How often do contractions occur?	Irregular and do not increase over time.	Occurs at regular intervals and gets stronger over time.
How long do contractions last?	Unpredictable. They can last less than 30 seconds or up to 2 minutes. nine0048	Lasts 30 to 90 seconds and gets longer over time.
How strong are the contractions?	Usually weak and either stay the same or get weaker and then disappear.	Increase over time.
Where do contractions feel?	Often only felt in the front of the abdomen or in one specific area.	Begin in the middle of the back and wrap around the belly towards the midline. nine0048
Do abbreviations change with movement?	May stop if activity level changes or if woman's position changes.	Continue and may even get worse with movement or change of position.

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How to distinguish real contractions from training ones?

Shemyakina Natalya Nikolaevna, head of the obstetric department 9 will help you figure it out0094 maternity hospital "Leleka" .

Training contractions, or as they are also called, fake, or Braxton-Hicks contractions, are irregular contractions that do not have increasing intensity. The uterus may tone up, but normally, it should pass quickly.

For example, the tone appeared once in half an hour and the uterus relaxed rather quickly. Then the tone reappeared only after two hours and again passed. These are training contractions, they do not increase in intensity and do not become more frequent. nine0003

Training bouts are physiologically provided by our body. So the uterus is preparing to do the hard work in the process of childbirth. Normally, training contractions appear in terms of pregnancy close to childbirth - from the 37th week of pregnancy.

The appearance of training contractions in the early stages of pregnancy is not the norm

The uterus can tone up with an active lifestyle, physical activity, with a change in body position, but this tone should quickly pass. Normally, the uterus should not often come into tone. And even more so, contractions, as such, should not be until the 37th week of pregnancy. nine0106 Braxton Hicks contractions in the early stages are a threat of premature birth. If a woman has contractions periodically during the day: after an hour, after 2, then again after an hour, (even if they are not regular), for periods up to 37 weeks, such a tone should alert the expectant mother.
Because this is not the norm, but the threat of premature birth. This is an occasion to contact a specialist and change your rhythm of life, put on a bandage. The causes of premature birth are most often internal, caused by hormonal disorders and a violation of the physical health of a woman. But significant physical activity and stress can also cause premature birth. nine0003

Labor pains

Unlike training pains, labor pains are regular. The uterus comes to tone first once every 15 minutes, and after a while - once every 7-10 minutes. Contractions gradually become more frequent, longer and stronger. And already occur every 5 minutes, then 3 and finally every 2 minutes.

True labor pains are contractions every 2 minutes, 40 seconds. If within an hour or two the contractions intensify - pains that begin in the lower abdomen or in the lower back and spread to the stomach - most likely, these are real labor pains. nine0003

Training contractions are NOT so much painful as unusual for a woman. When the expectant mother sees how the stomach comes into tone, its shape changes and it becomes dense, like an inflated ball. This might scare you a little. But a woman must understand that in real, labor pains, there must be a clear periodicity, intensification and acceleration over a certain period of time. Real fights never stop, but practice fights do. The uterus then comes to tone, then relaxes. nine0106 Women often confuse contractions with tone, which is caused by other physiological processes in the body. For example, increased intestinal peristalsis, intestinal infections, colic, etc.

What else should alert a woman?! If within an hour or two the uterus periodically comes into tone and mucous, bloody (streaked with blood or brown) discharge appears, then most likely there are structural changes in the cervix - it opens. Also an important sign to seek help is the discharge of the mucous plug long before childbirth. Her departure in terms of childbirth, a week or two before childbirth is normal. nine0003

Tracking labor pains

There are several methods for determining the types of contractions. A woman can do this herself, writing down the frequency and duration of contractions on paper or tracking them using special programs for a computer and phone. Or you can contact a doctor at antenatal clinic or at the maternity hospital, where a specialist will conduct fetal monitoring (fetal CTG). With the help of 2 sensors, the fetal heartbeat, uterine contractions are monitored and it is determined whether these are training contractions or labor. nine0003

When should I go to the maternity hospital?

If within an hour or two there is an increase and intensification of pain, its intensity increases, the frequency of contractions is clear and regular, you can go to the maternity hospital. A woman can make a mistake, but it’s better to come and make sure for sure whether these are labor or training contractions.

If the amniotic fluid breaks, you can slowly pack up and go to the maternity hospital. Since, normally, after this labor activity should begin.

The main thing is that a woman should not panic.

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