Recognizing Preterm Labor: How Will I Know?
Author: Dr. Anna Kaplan
Once you visit your obstetrician for the first time, he or she will confirm your pregnancy and give you an EDC, an estimated due date. This is calculated from your last normal menstrual period, and is 40 weeks later. If you deliver anywhere from 37 to 42 weeks from your last period, it is considered a normal, full-term pregnancy. If there is any confusion because you have irregular periods or you had some early spotting, ultrasound examinations can help the doctor try and arrive at the correct age of the baby you are carrying.
Preterm labor is labor commencing before 37 weeks. If you have already had labor with a previous pregnancy, you may have a better idea of what contractions feel like. If you are at risk for premature labor (see http://www.planningfamily.com/pregnancy/premature-birth/risks-and-reasons-for-premature-birth/), you need to be even more aware of what you might experience.
Women experiencing premature labor often feel abdominal or pelvic symptoms similar to menstrual cramps. They can have diarrhea with the cramps. They may feel pressure in the pelvic area or lower abdomen. Some women have a low backache. There may be an increase or change in vaginal discharge; there may be mucous, spotting or bleeding. A liquid discharge can be amniotic fluid and can indicate that the membranes have ruptured (the water has broken). This can be anything from a large gush of liquid to a trickle
If you are in the second half of your pregnancy and you begin to experience any pelvic, lower abdominal or back discomfort, ache, or feeling of cramps, and this persists for at least an hour, you may be going into premature labor. While some or all of these symptoms may be normal in pregnancy, the fact that they continue for an hour or more suggests preterm labor. You need to see your obstetrician as quickly as possible.
You may or may not recognize uterine contractions. The menstrual-like cramps are actually uterine contractions. Some women do experience painful contractions; this makes it easier to realize what is happening. However, many do not have pain but feel a tightening. If you have been in labor before, you may recognize contractions more easily. Some women have back labor, and if it is preterm, they will have a backache that is associated with a tight feeling across the abdomen.
You can ask your doctor or nurse to show you how to recognize uterine contractions by feeling your abdomen. Most women have some contractions as they near the end of their pregnancies. These are called Braxton-Hicks contractions and do not lead to labor. These are usually not painful and not regular. Even if they are painful and regular, they should go away within an hour or so with rest. Some doctors will have women at risk for a premature delivery wear a uterine monitor to check for contractions at home; this has not proven to help detect premature labor but in some cases may be helpful.
Most doctors will say that if you feel regular contractions every ten minutes for an hour, and they don't stop, you should be evaluated immediately.
There are many tests a doctor can do to tell if you are in premature labor and to help decide what to do if you are.
What should make you the most suspicious is pain, contractions, pressure or other symptoms that do not go away but persist, becoming more regular or constant. If you are wondering if you are in preterm labor because you have any of these symptoms, the best choice is to go to the doctor. It is better to make the mistake of being checked and found to be fine, than to ignore warning signs and get to the doctor too late to attempt to stop preterm labor or prepare you and the baby. Do not be embarrassed to get yourself checked.
