Options for Preventing Preterm Labor

by Bette G. Rinehart

Preterm labor and delivery can happen to any pregnant woman. It occurs in about 12% of all pregnancies.

Whether you're currently pregnant or planning a pregnancy after a preemie, knowing the symptoms and avoiding particular risk factors can keep your baby cooking longer and offer the best chance for a healthy beginning.

Preventing Preterm Labor

Although the specific causes aren't known, certain factors appear to increase a woman's risk of having premature labor. Women can take steps to help prolong their pregnancies.

Stay Hydrated

Being dehydrated can cause contractions. Be sure to drink plenty of water or other caffeine-free beverages each day. Drink even more during hot or very cold weather, even if you're indoors. How can you know how much is enough? You should be drinking enough that it makes your urine looks pale colored.

The downside? A full bladder can cause contractions, so schedule regular trips to the bathroom.

Keep Your Prenatal Visits

What seems to you a normal pregnancy symptoms can indicate of premature labor. Your doctor or midwife can help screen you for risk of preterm labor at each appointment and treat it as early as possible if you do develop signs of premature labor.

Know Your Numbers

The length of your cervix is expected to shorten as a pregnancy progresses.

• At 16 to 20 weeks, normal cervical length is 4.0 to 4.5 cm
• At 24 to 28 weeks, normal cervical length is 3.5 to 4.0 cm
• At 32 to 36 weeks, normal cervical length is 3.0 to 3.5 cm

Most doctors schedule an ultrasound around 20 weeks. Ask the sonographer for your cervical length at that time. If the length is below 4 cm and you experience ANY signs of preterm labor in the weeks that follow, your provider will request another ultrasound and compare the cervical length to the previous measurement.

Cerclage

Cerclages (a stitch placed in the cervix to help hold it closed) have been used over fifty years to prevent preterm birth. A cerclage doesn't stop labor once it has begun, but it can prevent preterm birth in some women.

Recognizing Preterm Labor

Preterm labor is no different from "real" labor. It just happens earlier in your pregnancy. If you feel that you're in labor, call your caregiver's office and describe what's happening. Most providers suggest you let them know if you have any of these signs of pre-eclampsia or preterm labor:

• More than five contraction per hour
• Bright red blood from your vagina
• Swelling or puffiness of the face or hands, a sign of preeclampsia
• Painful urination
• A sharp or prolonged pain in your stomach
• Acute or continuous vomiting
• A sudden gush of clear, watery fluid from your vagina
• Low, dull backache
• Intense pelvic pressure

Managing Preterm Labor

Your provider will work with you to map out a plan to manage your preterm labor. Possible interventions include:

Getting Hydrated

Often your treatment at the hospital begins with IV fluids. This is because when you're dehydrated, your blood volume decreases. As blood volume decreases, the concentration of the hormone that causes contractions oxytocin increases.

Bed Rest

Although providers still suggest bed rest, especially to moms carrying multiples, studies indicate that bed rest alone doesn't prevent preterm birth. Routine bed rest might actually increase the rate of preterm birth in some women.

Health Coaching

Many insurance plans offer home-health monitoring and coaching. Usually a registered nurse works with your doctor and meets with you. Most prescribed treatments can be arranged to be done in the comfort of your own home.