Updated April 2014, next review April 2017
Premature labour - giving birth
If your baby is born prematurely, your experience of giving birth may be quicker than you might have expected as preterm labour is often slightly different to full-term labour.
What is premature labour like?
In most cases, premature labour starts by itself, but your labour could also be induced or the baby delivered by caesarean if the healthcare team feels that these would be safer options for you and/or the baby.
The main difference between preterm labour and full-term labour is that preterm labour is likely to be much faster. Babies may be born before the cervix is fully dilated, so you may move very quickly from stage 1 of labour to stage 2 (see below).
The healthcare team will also be monitoring you and the baby much more frequently and checking the baby's position (breech babies are more common before 34 weeks). They will also be ready to perform emergency procedures if necessary.
Changing your birth plan
Many women do not attend antenatal classes until around week 30, so if you have your baby unexpectedly before this you might not have even considered or heard about birth plans or gone to sessions to learn about labour and birth.
If you have written a birth plan, having your baby prematurely may disrupt many of your choices, including where you give birth:
- You will need to go to hospital rather than having the baby at home or in a midwife-led birthing unit.
- If your hospital of choice does not have specialist facilities for premature babies, you may need to be transferred to one that does.
Premature birth can be accompanied by complications for mothers and babies so it's important to be aware that there may be unexpected changes along the way.
Giving birth your way
If the birth is planned, then you will have time to prepare. This means you can still have some control over your birth experience, by:
- sharing any quiet moments with loved ones
- using music, low lighting or clothing that makes you feel comfortable
- asking questions of the professionals around you
- trying to focus on your baby, the little person at the centre of all this hubbub.
If your labour is induced
If there is a risk to your baby's health or your health, labour can be induced (started artificially). Common conditions that lead to premature inducing of labour include pre-eclampsia or fetal growth restriction where your baby is not developing as he should in the womb.
If the team needs to, the midwife or doctor will put a pessary or gel into your vagina, or a drip in your arm, or both. Once it starts, an induced labour may proceed naturally, though it might take 24 hours or more to get going.
If induction does not work, your doctor and midwife will assess your condition and your baby's wellbeing. You may be offered another induction, or a caesarean section – your midwife and doctor will discuss all the options with you.
The stages of labour
Labour is usually described in three separate stages:
- Stage 1 Contractions start softening and stretching out your cervix before it opens up (dilates) wide enough to let the baby through.
- Stage 2 This is the pushing stage and lasts from when your cervix is fully dilated until after the baby is born.
- Stage 3 The baby is born and you deliver the afterbirth (placenta).
You may also have a caesarean section..
Extra help for your baby
If you are exhausted or your baby is distressed, or if he is not moving out of the birth canal, you may need an assisted birth. This means either forceps (which gently cup the baby's head like spoons) or a ventouse (suction cap) to gently help him out. A ventouse can be used only at 34 weeks or more, once the baby's head is sufficiently developed for it.
Both these procedures are safe. They may leave short-term marks, bumps and bruising on your baby's head, but these will disappear over time.
Read more about pain relief options during preterm labour.
Macdonald S and Magill-Cuerden J, Mayes’ Midwifery, Fourteenth Edition (Edinburgh: Bailliere Tindall Elsevier, 2012).
London National Institute for Health and Care Excellence, ‘Intrapartum Care: Management and Delivery of Care to Women in Labour’, 2007, http://publications.nice.org.uk/intrapartum-care-cg55/key-priorities-for-implementation.
London Obstetric Anaesthetists’ Association, ‘Pain Relief in Labour’, 2013, http://www.labourpains.com/ui/content/content.aspx?ID=332.
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