Warning Signs for Premature Labor-Pregnancy

When to Call Your Physician or Midwife

Painful menstrual-like cramps.

Dull ache in the lower back(If you have had a dull backache throughout the pregnancy, then this symptom is only a danger sign if it is different from the backache you've had before.)

Pain or pressure above the pubic bone(in the area of the pubic hair.)

Sensation of pressure or heaviness in the pelvic region.

Increase in vaginal secretions, including loss of the mucous plug.

Change in the type of vaginal secretion(for example, from thick to thin or watery.)

Bloody discharge from the vagina.

Diarrhea.

Uterine contractions occurring 10 minutes apart or more frequently for more than 1 hour; even if they are not painful(a contraction is palpated when the top of your uterus-the fundus-gets hard, softens, and hardens again). If these disappear when you lie down, they are probably not labor:

Symptoms of urinary tract infection-pain or burning on urination, especially at the end of urination; urgency-an unusually strong feel of the need to urinate, especially if you actually urinate very small amounts; frequency-needing to urinate very often(although this may be difficult for pregnant women to differentiate from the usual increased frequency of late pregnancy).

Any leakage of fluid from the vagina.This can be a big gush or a continuous dripping of watery fluid. This may indicate rupture of the membranes.

If your work involves heavy physical labor, rotating or night shifts, long periods of standing, or makes you excessively tired, consider changing or reducing your workload. Unfortunately, women in the United States are not uniformly guaranteed paid maternity leave.

As sexually transmitted infections may be implicated in premature rupture of the membranes and preterm labor, you should use a condom if you are at risk for such an infection. Being at risk means that either you or your partner has more than one sexual partner. If you have any doubt about whether this is the case for your partner, or you have had a pre term birth, you should use condoms. In fact, because semen contains prostaglandins-body chemicals that cause uterine contractions-use of a condom from midpregnancy to 37 weeks gestation is a good idea for any woman who has had a previous preterm birth. The condoms provide a barrier between your body and your partner's semen.

If you have a history of pre term labor or signs of preterm labor, avoid nipple or breast stimulation in the third trimester, before 37 weeks gestation, as this initiates uterine contractions. Abstain from orgasm if there is any question of threatened preterm labor, as it can lead to contractions.
There is some evidence, although not conclusive, that calcium supplementation may help prevent preterm labor. Routine calcium supplementation is not currently advised in pregnancy, but you should certainly maintain an adequate dietary intake of calcium sources. Except for sometimes causing constipation, a calcium supplement is not dangerous in pregnancy. If you have had a preterm birth, discuss with your physician or midwife whether or not they advise calcium supplementation as a possible preventive measure.

In the 1980s, some promising studies showed that preterm birth might be prevented with frequent prenatal visits and vaginal examinations for women at risk for preterm labor. A number of "Prevention of Preterm" birth programs were funded by various governmental and private agencies. Unfortunately, these did not demonstrate that such measures were uniformly valuable in preventing preterm birth. Whether or not to do weekly or biweekly vaginal examinations or ultrasounds to check the cervix in the third trimester for women with a previous preterm birth remains controversial.