HealthPartners - Preparing for childbirth

Preterm Labor Labor usually begins sometime after 37 weeks of pregnancy (40 weeks is full term). A baby born before 37 weeks is considered premature. These infants may need special care in the NICU or special care nursery to breathe and keep themselves warm. Premature birth can be a serious risk to your newborn. The earlier that preterm labor occurs, the greater the risk to your baby. Premature babies can have organs that are not fully developed, leading to breathing, hearing, and vision problems. They may also have long-term learning or behavioral disabilities. Many risk factors have been linked to preterm birth. But not everyone who experiences preterm labor has risk factors. You are at the highest risk if you have already had at least 1 preterm birth. Other high-risk factors include twins, a fetal birth defect, problems with the cervix, uterus and placenta, and others. Feeling contractions does not always mean you are in labor. See “Braxton Hicks Contractions” on page 46. Your contractions must be strong enough to dilate the cervix. Your health care provider may do a pelvic exam to see if your cervix is thinning and opening, then decide how to manage your preterm labor based on how far along you are and what is best for the health of both you and your baby. Warning signs of preterm labor may include: • Uterine contractions (4 in 20 minutes or more than 8 per hour) • Abdominal cramps with or without diarrhea • Low backache that comes and goes or is constant • Pelvic pressure that feels like the baby is pushing down • A sudden increase in vaginal discharge — watery, mucuslike, or slightly bloody • Water breaks (either a small trickle or a gush) WARNING

Tracking Baby’s Movement As you get closer to your due date, your health care provider may ask you to start tracking your baby’s movement. This process is sometimes called “counting kicks,” although you’ll also count other movements (jabs, pokes, rolls, punches, and swooshes). Tracking these movements helps you know what’s normal for your baby. It can also alert you to call your provider if something changes. How to track your baby’s movement • Choose a time of day when the baby tends to be active • Make sure you’ve recently had a snack and a cold drink of water • Sit quietly or lie on your side and don’t let yourself become distracted • Time how long it takes to feel 10 distinct movements by your baby

NEED TO KNOW

Call your health care provider immediately if you have 1 or more of these warning signs. You may be in premature labor!

The American College of Obstetricians and Gynecologists (ACOG) considers 10 movements in 2 hours to be a reassuring number. If you feel fewer than 10, talk to your health care provider. Your baby’s activity level will vary throughout the day, but you should feel them moving inside you every day.

28 Your Guide to Labor and Birth