HealthONE - November 01, 2017

At about 40 weeks, your pregnancy is considered full term. Full-term pregnancies increase the odds that your baby will be able to develop important organs, such as the lungs and brain. A baby born before 37 weeks of pregnancy is considered premature and may have long-lasting health and developmental problems.

"Thirty-seven weeks is full term, so only before that would labor be concerning," said Andrew Ross, MD, FACOG, Mountain Vista OB/GYN and Midwifery. "Most baby's lungs are mature after 34 weeks, so 34-37 is a gray area where babies continue to benefit from pregnancy, but interventions to slow or prevent labor are not strongly proven to provide benefits that outweigh the risks"

Preventing premature birth

Women who have an unusually short or weak cervix, or who have already delivered a premature baby, are more likely to experience early labor. Women at an increased risk may be able to delay labor with one of the following treatment options:

  • ProgesteroneA hormone that can be received as an injection or placed in the vagina, progesterone can help prevent early labor in women with a short cervix or who have already delivered a premature baby. Talk to your doctor about progesterone, or brand names Makena® or 17P, to help prevent premature labor. 
  • Cervical cerclage: Cervical cerclage is a procedure that helps prevent labor by stitching closed a woman's cervix. Your doctor may recommend cervical cerclage if you have already had a premature baby, have had a miscarriage, have a short cervix or have a cervix that dilates early.

While women carrying twins are at an increased risk of preterm labor, these treatment options cannot prevent premature birth in women carrying multiple babies.

Starting labor early

If you start having contractions, or think you are going into labor, contact your doctor or midwife. If your water breaks or you start bleeding, go to the hospital right away. While it is normal to have sporadic leaking, a constant leak or a large gush of fluid, breaking your water is a clear sign of labor that indicates you should get to the hospital.

"Depending on the circumstances, some early labor patients between 34-37 weeks should be treated. A pregnant woman dealing with premature labor symptoms should let her doctor know about them," said Dr. Ross. "If it's 3 a.m. and you're not sure you want to wake someone up, call the hospital where you're planning to deliver and ask to speak to a nurse on the labor and delivery unit. If it sounds important enough, you'll be instructed to wake up your provider."

If you experience signs of labor before 40 weeks, go to a hospital with a neonatal intensive care unit (NICU) that specializes in the treatment of preterm babies. If you go into preterm labor, your care plan may include: 

  • Steroids: Steroids speed up lung growth and decrease the risk of the baby being born with breathing problems.
  • Antibiotics: Antibiotics treat or prevent infections in both baby and mother.
  • Other medications: Your doctor may prescribe other medications to temporarily slow or stop contractions. Medicine to delay labor can give steroids enough time to help your baby's lungs develop further and give hospital staff enough time to transfer pregnant women to a hospital with a NICU, if necessary. 

If the doctor has concerns about the health of you or your baby, and the baby has developed lungs, contractions will not be stopped after 34 weeks.

Carrying your baby full term

"Preterm labor risk has many factors, many of which are outside a woman's control," said Dr. Ross. "Generally, anything that causes inflammation can cause labor."

While preventing premature birth may not be possible, moms-to-be can take the following steps to help ensure a full-term pregnancy: 

  • Get regular prenatal care starting early in your pregnancy, including if you plan to become pregnant.
  • Manage any preexisting conditions, like depression, high blood pressure or diabetes.
  • Avoid smoking, consuming alcohol or using illegal drugs.
  • Properly manage stress.
  • Include a variety of healthy foods in your diet.
  • Monitor your weight to ensure you aren't gaining too much, or too little.
  • Protect yourself and your unborn baby by washing your hands frequently; avoiding raw meat, fish or unpasteurized cheese; avoiding changing cat litter; and using condoms during intercourse. 

"The number one patient-controlled risk factor is smoking; it's a risk for almost everything bad in pregnancy. Otherwise, poor dental hygiene is a surprising risk for premature birth, so making sure you're up to date with your dental checkups before you get pregnant can lower your risk," said Dr. Ross. "Additionally, making sure you're not dehydrated, and alerting your doctor to any signs of a bladder infection, can help prevent contractions."

Talk to your doctor if you are already pregnant or plan to become pregnant. Women who seek medical care early and often increase the odds of having a healthy pregnancy and baby.

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