How do I spot signs of preterm labour?

Preterm labour, also known as preterm birth, is defined as a birth that occurs before week 37 of pregnancy. It can be a scary experience to discover signs that your body might be going into labour prematurely.

Knowing what symptoms to look out for can help you react quickly and seek the help you need. In this blog post, we take a closer look at the typical signs of preterm labour and what you should do if you experience them.

1. Regular and frequent contractions
One of the most obvious signs that labour may be on its way – even prematurely – is contractions. While many pregnant women experience contractions that are irregular and not painful, it’s important to be aware if you are experiencing them:

• Regular contractions: If you have contractions that come at regular intervals, such as every 10 minutes or more often.
• Contractions that don’t stop: If you lie down or change position and the contractions continue and become more intense or frequent, this could be a sign that your body is going into labour.

If you’re unsure if your contractions are severe, you can contact your midwife or labour ward who can help you assess them.

2. Back pain, especially in the lower back
Back pain, especially in the lower back, can be another sign of premature labour. This is often constant pain that doesn’t go away, and can feel like a deep, grinding pain similar to menstrual pain. For many women, labour starts with this type of back pain, which later becomes stronger.

If the back pain gets worse and is combined with other signs such as contractions or pressure in the pelvis, you should contact your doctor or midwife.

3. Pressure in the pelvis or abdomen
Many women describe a feeling of pressure or heaviness in the pelvic area as an early sign of premature labour. It can feel like the baby is pressing downwards, and sometimes it can also feel like you need to pee all the time. This sensation is due to the baby moving further down in the pelvis, which can happen early if the body is preparing for premature labour.

4. Changes in vaginal discharge
Changes in your vaginal discharge can also be an indicator of preterm labour. It is important to be aware of:

• Increased amount of discharge: If you suddenly notice more discharge than usual, especially if it is watery or mucus-like.
• Blood-tinged vaginal discharge: If there is blood in your vaginal discharge (even in small amounts), it could be a sign that your cervix is starting to change or dilate. Watery discharge in particular can be a sign that amniotic fluid is leaking. If you experience this, contact your midwife or labour ward immediately.

5. Leakage of water
Leaking is one of the most obvious signs that labour has started, and it can also happen prematurely. If you experience oozing or leaking amniotic fluid, you should contact the hospital immediately.

Amniotic fluid is usually clear or slightly whitish in colour, but it can also be pink if there is a little blood. Even a small leakage of amniotic fluid is a sign that you should get in touch, as watering can lead to infections if labour doesn’t start immediately afterwards.

6. Menstrual-like cramps
Menstrual-like cramps or abdominal cramping can also be a sign that your body is preparing for premature labour. These cramps can feel like strong menstrual pains and may come and go in intervals.

If these cramps are constant or accompanied by other symptoms such as back pain, contractions or pelvic pressure, you should pay extra attention.

7. Diarrhoea or digestive problems
Some women experience digestive problems such as diarrhoea shortly before giving birth – and this can also happen with premature birth. If you suddenly experience diarrhoea or nausea for no apparent reason and it’s combined with other signs of labour, it could be that your body is going into labour.

8. General feeling that something is not right
Many women have an intuitive feeling that something is different or wrong. If you feel that something is not as it should be or if you just feel “off”, it’s a good idea to listen to your body and contact your healthcare professional. It’s better to be safe than sorry and get everything checked out.

What should you do if you experience signs of preterm labour?
If you experience any of the above symptoms, especially if you’re before 37 weeks, you should act quickly. Here are some steps you can take:

• Contact your midwife or labour ward: tell them exactly what you’re experiencing, including how frequent your contractions are and if you’ve had any changes in your discharge or pain. They can help assess whether you should come in for a check-up.
• Rest: If you are having contractions, try to lie down on your side and rest. Sometimes contractions can subside if you change position or relax. If they continue or get stronger, it’s likely that they are real contractions.
• Watch for amniotic fluid: If you suspect your water has broken, contact the hospital immediately as amniocentesis requires prompt follow-up.
• Note the frequency of contractions: If you are experiencing contractions, try to measure how often they come and how long they last. This will be useful information for the healthcare professional.
• Lie down flat: Pregnant women are often advised to lie down if preterm labour is suspected, especially in the case of water breaking. This is due to the risk that the amniotic fluid may continue to flow and complications such as umbilical cord prolapse may occur. Note: Lying down is a temporary measure and it is important to get professional help as soon as possible if preterm labour is suspected.

Treatment of preterm labour
If you go to the hospital and it is determined that you are going into labour prematurely, doctors will often try to delay the birth to give the baby more time to develop. This can be done with medication that stops or delays labour.

To best help babies in early labour, they will often be treated with celeston, which is a lung maturation medication to promote the development of the baby’s lungs. The effect occurs 6 hours after injection and lasts for a maximum of 24 hours after injection.

Termination of labour
Preterm labour is a serious situation, but the earlier you recognise the signs, the better your chances of getting help and potentially delaying labour. By knowing the key symptoms such as contractions, back pain, water breaking and changes in vaginal discharge, you can act quickly and get the necessary medical attention. Always remember that it’s better to seek help once too often than once too little.

Have you delivered your twins prematurely and want to share your story? – Feel free to write it in the comments section below so that other mums-to-be can read about your experience leading up to the early birth.