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Preterm Labour: Care Instructions

Overview

Preterm labour is the start of labour between 20 and 36 weeks of pregnancy. Most babies are born at 37 to 42 weeks of pregnancy. In labour, the uterus contracts to open the cervix. This is the first stage of childbirth.

The cause of preterm labour is often unknown, but certain factors can increase the chance of preterm labour. These include if you:

Have had a preterm baby before.
Are less than age 17 years or more than 35 years.
Have a short cervical length.
Are carrying twins or triplets.
Have a lot of stress, if you smoke, or use substances.
Have a health condition such as high blood pressure or diabetes.
You’ve had pregnancy complications such as bleeding, infection, or have an abnormal uterus.

Sometimes a pregnant person may have preterm labour for no apparent reason. It’s important for all pregnant people to learn:

The normal response of their own bodies to pregnancy.
About preterm labour and what to watch for.

Signs of preterm labour - what to watch for

Pay attention to the signals your body gives you during your day. Watch for:

Menstrual-like cramps (may be constant or come and go).
Low, dull backache.
Pelvic pressure or fullness (like the baby is pushing down).
Abdominal cramps (with or without diarrhea, nausea or vomiting).
Vaginal discharge (change or increase).
Contractions of your uterus with or without pain (6 or more in 1 hour).

Never ignore these symptoms or assume that they mean nothing. It’s better to go to the hospital for an assessment than to wait too long.

How to check for contractions
It is important to know how to feel your belly for contractions of your uterus in case you go into preterm labour. To feel for contractions:

While lying down, rest your fingertips on the top of your uterus. If your uterus contracts, you’ll feel your belly get tight or hard, then relax and soften when the contraction is over.
To tell how often the contractions are, count the minutes that go by from the beginning of 1 contraction to the beginning of the next. You may find it helpful to write the times down on paper.
If you have a clock with a second hand, you can also note how long each contraction lasts. There are also apps available for your smartphone to count contractions.
Keep doing this for 1 hour. If you feel more than 6 contractions in 1 hour, go now to the labour and delivery unit where you plan to have your baby.

How is preterm labour treated?

In some cases, doctors use medicines to try to delay labour until 34 or more weeks of pregnancy. By this time, a baby has grown enough so that problems are not likely. In some cases—such as with a serious infection—it is healthier for the baby to be born early. Your treatment will depend on how far along you are in your pregnancy and on your health and your baby's health.

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your healthcare provider or nurse advice line (811 in most provinces and territories) if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.

How can you care for yourself at home?

If your healthcare provider prescribed medicines, take them exactly as directed. Call your healthcare provider, midwife, or nurse advice line if you think you are having a problem with your medicine.
Rest until your healthcare provider advises you about activity.
Do not have sexual intercourse unless your doctor says it is safe.
Watch for signs of preterm labour.
Follow your healthcare provider’s instruction about how often to count your baby’s movements. For information on counting your baby’s movements, go to: Fetal Movement Count Chart (albertahealthservices.ca).
Do not use tobacco or tobacco-like products, including cannabis, and other substances. They can harm your health. They also affect your baby’s growth, health, and the development of their brain and lungs. If you need help to use less or quit, talk to your healthcare provider or go to the Alberta Quits website.
Do not drink alcohol. Alcohol affects everyone differently and may be a risk to your health. Alcohol passes through the placenta to your baby and can cause problems with their growth, health, and development.
Pregnancy can be an emotional and unpredictable time. When you have complications in your pregnancy you may have more stress. This may lead to other concerns for you and your family. Talk to your healthcare provider about how you’re feeling and any concerns you have.

When should you call for help?

Call 911 anytime you think you may need emergency care. For example, call if:

You passed out (lost consciousness).
You have a seizure.
You have severe vaginal bleeding.
You have severe pain in your belly or pelvis that doesn't get better between contractions.
You have had fluid gushing or leaking from your vagina and you know or think the umbilical cord is bulging into your vagina. If this happens, immediately get down on your knees so your rear end (buttocks) is higher than your head. This will decrease the pressure on the cord until help arrives.

Call your healthcare provider, midwife, or nurse advice line now or seek immediate medical care if:

You have signs of pre-eclampsia, such as:
- Sudden swelling of your face, hands, or feet.
- New vision problems (such as dimness, blurring, or seeing spots).
- A severe headache.
You have any vaginal bleeding.
You have a change or more vaginal discharge.
You have belly pain or cramping.
You have a fever.
You have had regular contractions (with or without pain) for an hour. This means that you have 6 or more within 1 hour after you change your position and drink fluids.
You have a sudden release of fluid from your vagina.
You have low back pain or pelvic pressure that does not go away.
You notice that your baby has stopped moving or is moving much less than normal.

Watch closely for changes in your health, and be sure to contact your doctor, midwife, or nurse advice line if you have any questions or concerns.

Where can you learn more?

Go to https://www.healthwise.net/patientEd

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