Lifestyle and Environmental Risks

Some studies have found that certain lifestyle factors may put a woman at greater risk of preterm labor. These factors include:
· Late or no prenatal care
· Smoking
· Drinking alcohol
· Using illegal drugs
· Exposure to the medication DES
· Domestic violence, including physical, sexual or emotional abuse
· Lack of social support
· Stress
· Long working hours with long periods of standing[BACK TO TOP]

 

Medical Risks

Certain medical conditions during pregnancy may increase the likelihood that a woman will have preterm labor. These conditions include:

• Urinary tract infections, vaginal infections, sexually transmitted infections and possibly other infections
• Diabetes
• High blood pressure
• Clotting disorders (thrombophilia)
• Bleeding from the vagina
• Certain birth defects in the baby
• Being pregnant with a single fetus after in vitro fertilization (IVF)
• Being underweight before pregnancy
• Obesity
• Short time period between pregnancies (less than 6-9 months between birth and the beginning of the next pregnancy)

Researchers also have identified other risk factors. For instance, African-American women, women younger than 17 or older than 35, and poor women are at greater risk than other women. Experts do not fully understand why and how these factors increase the risk that a woman will have preterm labor or birth.[BACK TO TOP]

 

What Can Women Do?

Remember, though, even if you have one of these risk factors, it does not mean you will have preterm labor. It just means that you are at greater risk than a woman who does not have a risk factor. Still, knowing you're at risk is scary. That's why it's so important that you:

• Know the signs and symptoms of preterm labor
• Know what to do if you have any of them
• Take very good care of yourself and your baby while you're pregnant

This is the best way to protect yourself and your baby against preterm labor.[BACK TO TOP]

 

Signs and Symptoms of Preterm
Labor and What to Do

What Is Preterm Labor?

Preterm or premature labor happens when you go into labor before 37 completed weeks of pregnancy. This is too early for your baby to be born. Babies born too soon can have lifelong or life-threatening health problems.[BACK TO TOP]

 

Can Preterm Labor Be Stopped?

Many women are given drugs to try to delay or stop preterm labor. In some cases, birth can be delayed long enough to transport Mom to a hospital with a neonatal intensive care unit (NICU). Women may also be given medications that can improve the baby's health.
Here are the Warning Signs:

• Contractions (your abdomen tightens like a fist) every 10 minutes or more often
• Change in vaginal discharge (leaking fluid or bleeding from your vagina)
• Pelvic pressure—the feeling that your baby is pushing down
• Low, dull backache
• Cramps that feel like your period
• Abdominal cramps with or without diarrhea[BACK TO TOP]

 

What Should I Do If I Think I'm Having Preterm Labor?

Call your health care provider (nurse, doctor or midwife) or go to the hospital right away if you think you're having preterm labor, or if you have any of the warning signs. Call even if you have only one sign.
Your health care provider may tell you to:

• Come into the office or go to the hospital for a checkup.
• Stop what you're doing. Rest on your left side for one hour.
• Drink 2-3 glasses of water or juice (not coffee or soda).
• If the symptoms get worse or do not go away after one hour, call your provider again or go to the hospital. If the symptoms get better, relax for the rest of the day.[BACK TO TOP]

 

Treating Preterm Labor

What happens if a woman goes into preterm labor and it doesn't stop on its own? Even though a woman may carefully follow her health care provider's instructions, preterm labor sometimes continues. Drug therapy and restricted activity are two common treatments for preterm labor.[BACK TO TOP]

 

Drug Treatment

Women who develop preterm labor are often treated with one of several drugs (called tocolytics). The names of these drugs include calcium channel blockers, terbutaline, ritodrine, magnesium sulfate, indomethacin, ketorolac and sulindac. These drugs can stop contractions. They are given intravenously, orally or rectally depending upon the drug.

Tocolytics may delay delivery 2-7 days, buying some extra time to treat the pregnant women with steroid drugs. Steroids (such as betamethasone and dexamethasone) speed the growth of the baby's lungs and organs. These drugs reduce infant deaths by about 30 percent. They also reduce the two most serious complications of premature birth, respiratory distress syndrome (by about 50 percent) and bleeding in the brain (by about 70 percent). The extra time also makes it possible to treat the mother with antibiotics in case she has an infection or to transfer her to a better-equipped health care facility.[BACK TO TOP]

 

Restricted Activity

Some health care providers recommend that women restrict their activities to prevent preterm labor. Bedrest is often advised, despite conflicting research evidence about its effectiveness. While decreasing a hectic schedule may help a pregnant woman to relax, bedrest has not been shown to reduce the rate of preterm birth.

Recommendations vary. Some women are told to rest several times a day. Others are told to stay in bed. Some providers advise women to identify activities that appear to increase contractions and to avoid those activities.

Restricted activity affects the woman physically. The woman may lose muscle tone and become short of breath. After delivery, she will need to regain muscle strength. Extended periods of time in bed also increase the risk of blood clots. In some cases, the health care provider may recommend that the woman not have sex. While a woman is on bedrest, it's best for her not to stay completely still. With the guidance of her doctor, she can do some stretching and other relaxed movements.

With their activities restricted, some women feel bored, depressed or anxious; others feel isolated. It's not unusual for a woman or her partner to feel frustrated, angry or resentful. This is a time for the couple to support each other, get outside help if they need it and try to find the humor in the situation.

A woman may feel guilty during this time. Even if she did the best she could to have a healthy pregnancy, the woman may wonder, "What did I do wrong?" Talking to professional counselors, spiritual advisors or others who have been in the same situation can be helpful during this trying time.

Some women are unable to work when their activity is restricted, and the family may suffer financially. Within the family, roles and responsibilities may change. Childcare, meal preparation and other household tasks may need to be handled differently. Friends and relatives can run errands, provide meals and care for children. It helps to "spread the burden" across the woman's support network. Women who live alone need extra help during this time.

Some women may qualify for medical leave. Under the Family Medical Leave Act, a woman's job is protected for 12 weeks of unpaid medical leave. Check with the human resources department where you work to find out.[BACK TO TOP]

 

Staying Occupied

Even though activity may be restricted, it's helpful to stay occupied, under the guidance of a health care provider. Some women find this a good time to catch up on things they've been wanting to do. They may be able to work from home. Some women pay bills, read for themselves or to their children, sew, play games, keep a journal or use a computer to pass the time. Many women like to receive visits from friends. The woman should speak to her health care provider before undertaking any activities.

To minimize movement, it's helpful if the woman keeps what she needs nearby (for instance, medications, food and beverages, a telephone, reading materials, the computer, a radio or TV).[BACK TO TOP]

 

Hospitalization

Depending upon the circumstances, the health care provider may recommend that the woman enter a hospital. If she is hospitalized for weeks or months, the concerns and issues are similar to long periods of restricted activity at home.[BACK TO TOP]