Labour that starts before 37 weeks is called preterm labour. Although nine months of pregnancy feels like a lifetime, this doesn’t mean you want to go into early labour or have a premature baby.
Dr Trudy Smith, an obstetrician at the Charlotte Maxeke Johannesburg Academic Hospital, stresses the importance of good antenatal care and recognising the signs of early labour so that women can get help.
“Although we can’t always identify the cause of premature labour, we know which mothers are at risk, so we can monitor them carefully throughout the pregnancy, in an effort to prevent or minimise complications,” says Dr Smith.
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One of the biggest problems with premature labour is that baby’s lungs don’t have time to develop properly. “Sometimes spontaneous labour can be stopped or controlled long enough to mature the baby’s lungs, to minimise complications,” she says.
“But when the mother’s life is at risk because there is no way of stopping vaginal bleeding or controlling pregnancy induced hypertension (high blood pressure), we have no choice but to deliver the baby early.”
Premature labour may be caused by complications with the baby, the womb, hormones or other circumstances.
For example, a big baby (either because of genetics or gestational diabetes) can overstretch the womb, as does a multiple pregnancy or polyhydramnios (too much amniotic fluid).
The cervix (mouth of the womb) may be weak and unable to “hold” the baby beyond six months. Infections, leaking amniotic fluid and vaginal bleeding are all associated with early labour. “Women with pregnancy induced hypertension may also need to deliver early,” says Dr Smith.
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So what can women do to minimise risks? “It’s important for a woman to go to her doctor or clinic regularly during pregnancy and to report anything abnormal,” says Dr Smith.
Signs of early labour include regular contractions with low abdominal cramping (like period pain) or constant backache. Women often instinctively feel that something is wrong, especially if there is diarrhoea and a pink or blood stained vaginal discharge.
Once assessed, the woman may be admitted to hospital and put on a drip in an effort to stop or delay labour long enough to help the baby’s lungs mature. If labour is stopped, the woman may be allowed to go home, providing that she rests and reports any changes or signs of labour.
Once the womb has started to open (when the cervix starts to dilate) and the waters have broken, labour is inevitable. Then a paediatrician and the hospital High Care unit will be alerted to be on standby for when the baby is born.
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Signs of early labour
Premature labour should not be confused with Braxton Hicks contractions. These are irregular, painless, “practice” contractions that come and go throughout pregnancy. True premature labour contractions are constant.
Because it’s not practical (and stressful) if you’re always phoning your doctor/midwife or rushing off to the hospital, try monitor contractions for at least an hour or have a relaxing bath before you panic. If you’re feeling worse after the hour, get medical help. If symptoms disappear with rest, it was a false alarm.