If you go into labour earlier than you had expected, you'll have to think on your feet. However, fewer than 20 percent of cases of suspected premature labour actually result in the baby being born. In the remaining 80 percent, the symptoms turn out to be something else, or the contractions simply stop of their own accord and the baby is delivered later in the pregnancy, or at term.
If you're in any doubt, phone the hospital or midwife straight away for advice. If you are less than 37 weeks pregnant they will usually tell you to go straight to hospital, and they may send an ambulance for you.
What are the signs of premature labour?
If you have any of the following symptoms, phone the hospital or midwife straight away, as you could be in labour:
- either a slow trickle or a gush of clear or pinkish fluid from your vagina or any increase in vaginal discharge
- cramps like strong period pains
- a frequent need to urinate
- a feeling of pressure in your pelvis
- nausea, vomiting or diarrhoea.
Don't delay if you have strong pain, a smelly discharge or bleeding from your vagina, or if you are feeling feverish, sick or have a temperature, call immediately as you may need urgent medical attention.
What happens when you are showing signs of labour?
You may have some of the symptoms but not others. For example, your waters may have broken but with no contractions, or vice versa. Contractions don't always indicate that you're in labour, so the healthcare team will carry out checks to find out.
Many women experience Braxton Hicks, sometimes known as practice contractions. These can become quite strong and painful during the third trimester, and it's easy to mistake them for the real thing.
The healthcare team will check
- whether you are actually in labour
- if labour hasn't started, whether your symptoms are due to some other cause that needs treating
- if you are definitely in labour, whether this has been caused by something (such as an infection) that needs treating, and how far the labour is progressing, so they can line up the facilities you need, either to delay the birth or to deliver the baby.
If your waters have broken early (Preterm premature rupture of the membranes - PPROM)
It is possible for your waters to break without any contractions. Where this happens early, it is known as preterm premature rupture of the membranes (PPROM).
How will I know if my waters have broken?
You will notice either a gush or a slow trickle of watery fluid, which is often pinkish or clear in colour.
The healthcare team will examine you. If you are not having contractions, and if you and the baby are otherwise healthy, they may treat you with antibiotics to prevent infection and help you continue the pregnancy for as long as possible.
You may also have the following tests:
- Blood tests. These check for high levels of white blood cells (which can indicate that you're fighting off an infection) and haemoglobin levels (which could indicate haemorrhage), along with other tests for inflammation.
- Urine samples. These enable the healthcare team to check for urinary tract infections and conditions such as pre-eclampsia.
- Your baby's heart rate. This will be monitored regularly. If it is unusually fast, this may be a sign of chorioamnionitis, which can be life-threatening to you and the baby. In this case, your baby may need to be delivered as soon as possible, often by caesarean.
If your waters haven't broken
The healthcare team will examine you to see if they can feel the contractions. This will include an internal examination to check whether the cervix is changing. If they think you are having contractions, you may then have a fetal fibronectin test to see if your body is preparing to give birth and an ultrasound scan to check the length and shape of your cervix. Fibronectin is a substance found in the amniotic fluid and vaginal secretions. It is only present in the vaginas of women up to 20 weeks or over 35 weeks pregnant, or whose bodies are getting ready to give birth.
These can be good predictors that labour is imminent. The team will probably also do some blood and urine tests. If you have symptoms of infection, or are considered high risk, they may also take swabs for infections such as bacterial vaginosis and group B streptococcus.
Tests for your baby
As well as carrying out various tests on you, the healthcare team will need to assess how your baby is doing. They will check his heartbeat and may also:
- run a scan to check his weight
- carry out electronic fetal monitoting to check his heart rate
- perform a scan to check that the placenta is functioning normally.
In labour or not... what happens next
Even if it is a false alarm, the team may want to keep you in hospital to monitor you and your baby.
If you are in labour and less than 35 weeks pregnant, they may try to stop the contractions, or to slow down the birth enough to give you injections of steroids to help your baby breathe when he is born. Find out more here about what happens if you are definitely in labour.
If you are 35 weeks or over, the team will usually let the birth go ahead.
Removing a stitch (cerclage) if you have one
If you have had a cervical stitch (cerclage), you will need to have it removed before your baby is born, as there is a risk of it tearing if it is still in place while you are having contractions. If you don't go into labour early, the stitches will usually be removed at between 36 and 40 weeks.
Frequently asked questions about premature labour and birth
Moving you both to a specialist neonatal unit may be the safest option if your baby is likely to be born very prematurely. This is known as 'in utero transfer' as they are effectively making sure your baby is in the best place for her care while she is still in your womb.
Giving birth is one of the most life-changing experiences you'll ever have, but it doesn't always go as planned, especially when your baby is premature.
- BAPM (2008) Management of acute in-utero transfers: a framework for practice. London, British Association of Perinatal Medicine
- Giraldo-Isaza MA BV (2011) Cervical cerclage and preterm PPROM, Clinical Obstetrics and Gynecology, Vol 54, No 2, p313-20
ℹLast reviewed on July 1st, 2017. Next review date July 1st, 2020.
By Carrie (not verified) on 6 Aug 2018 - 23:03
Hi. I'm 32 first pregnancy, I have gestational diabetes. Experiencing pain & pressure around my vigana along w severe hip pain, & side of my belly/ligaments I assume. I feel pressure while I urinate & now have diarrhea along w shortness of breath. I was told 3 or 4 weeks ago the baby had already turned down. Any advice is appreciated, thank you, just worried. The babies movement have still been normal, no discharge I can tell but 2 times today I've felt like I was leaking.
By Midwife @Tommys on 7 Aug 2018 - 16:54
As you are experiencing symptoms such as pain, diarrhoea, shortness of breath, think that you might be leaking fluid and also have a pregnancy complicated by diabetes, I would advise you to contact your maternity unit as soon as possible for urgent advice-you may be asked to go the unit for further assessment
By Carrie (not verified) on 12 Aug 2018 - 02:35
Thank you for your respond. I went in to be checked out at the birthing center where I live, I had been having contractions & had a UTI. Everything is good with the baby, I was given medication for the infection & 2 bags of fluids... still having contraction & now back pain, I will most likely deliver early, Thanks again.
By Anon (not verified) on 2 Aug 2018 - 22:34
I'm 32 +4 today. Was admitted for monitoring 2 nights ago due to slowly leaking fluid and cramping. 3mins apart for cpl hours. Was told not suspected labour as cervix still long/ closed.
Tonight I've been having cramping again 3mins apart. Headache. Feel sick. Back pain. Pain in inner thighs. Peeing loads. Big painful movements from baby. Sometimes to left. The right. Even middle. Lots pres sure in vagina inc stabbing pains.
I've rested all afternoon. Currently laid on bed.
I just don't feel 'right'.
Could this be early labour???
By Midwife @Tommys on 3 Aug 2018 - 15:08
Sorry this is a urgent service, I am not sure how you are at the moment, however if you don't 'feel right' and are getting regular cramps that aren't stopping then I would advise for you to call the maternity unit for another review.
By Stacey (not verified) on 21 Jul 2018 - 18:14
Since the last week very bad lower back pain I'm 26+2days
By Midwife @Tommys on 23 Jul 2018 - 16:43
Stacey. As you have read from this page there can be many reasons for lower back pain at 26 weeks. Please see your GP or midwife to exclude anything serious. If all is well with your pregnancy you may need to see a physiotherapist or osteopath to help you to move around better. Please take care x
By Abiola (not verified) on 17 Jul 2018 - 11:29
I am pregnant woman of 17month,am a mother of two,have been feeling like my baby want to fall out whenever am urinating and am pee light red fluid.Pls what should I do.
By Midwife @Tommys on 18 Jul 2018 - 10:15
You need to go to hospital to be reviewed as soon as possible. It sounds like either you have a very bad urine infection (passing blood stained urine) or your waters may have broken prematurely. Both need to reviewed by a midwife and doctor at the hospital urgently. Please get seen as soon as possible.
All the best
By Tamyra (not verified) on 15 Jul 2018 - 01:22
I'm 36 weeks pregnant baby #3. I have been having strong contractions that take my breath away. They come every 5 minutes and last 30-40 seconds. This continues for 2 hours every evening for the last 3 days. During the day I'll have several strong contractions but they are sporadic. With all of these contractions I can feel the baby's head squishing down hard on my cervix. It is exausting me. I also have a constant feeling of fullness and pressure in my pelvis and everytime I stand up I have to urinate. Also when I strain on the toilet or during a contraction it feels like the baby bulges out of me. Oh and constant achey lower back. Is this prelabor? Will I be going into labor soon?
By Midwife @Tommys on 18 Jul 2018 - 09:32
It could be that you are in the latent (early phase) of labour. But i would go and be checked over at your local maternity unit asap if you haven't already done so- because it is baby number 3, it could come incredibly quickly once regular contractions come and then stay. It is possible that your cervix is already partially dilated with such strong contractions which is common in 3rd time mums.
I also want the midwife to check your urine, the heaviness you are feeling could be a uti and you may need antibiotics for that as a UTI can also cause uterine irritation and for you to go into early labour (since you are 36 weeks you are not quite "term"
So please take good care of yourself
Sophie, Tommy's Midwife
By Mutane (not verified) on 10 Jul 2018 - 11:22
Hi, i am 30+5days gone.. Had period like cramps 28/6/18 that made me unable to walk, sits or lie...ws admitted fr 2days, candida ws seen in my urine though scanning showed baby is fine. Ws given antibiotics n pcm which i took the last tab on 8/7/18. Couldnt sleep last night because of pains i have each time baby moves... I feel pains like something wants to com out through my V. The pressure down there is so tight n the pain intense especially at my left hip bone region. I am feeling tired n sleepy but cant lie for long...when i appy pressure to my anus n V, i dont feel the pain but only the babys movement: when i press my upper belly against the cushion foam, the pelvic pains is severe. Its my second baby after 7 long awaiting years. No show, water or blood, no diarrhoa or vommiting.
Any advise is welcomed. Tx in anticipation
By Midwife @Tommys on 12 Jul 2018 - 13:36
Sorry to hear that you are in so much pain. It is reassuring that you are not experiencing any bleeding, or vaginal loss. It is important that you are also monitoring your baby's movements closely, any concerns you must see someone straight away. If you are still having a lot of pains then it is important to be reviewed again to make sure the antibiotics have been effective and there is nothing else going on.
By Lyndsay (not verified) on 7 Jul 2018 - 23:52
I am experiencing really bad pelvic pains and have been told at last appointment baby is head down. Sometimes I can hardly walk pains are so bad baby is moving normally. This is my first baby. Is this normal or should I get checked out? Thanks
By Midwife @Tommys on 9 Jul 2018 - 16:15
It is always sensible to ask advice from your midwife. If it is nothing serious you may be referred to the physiotherapy team for some pelvic support and exercises. This can really help to make you comfortable and stop it from getting any worse. Don't be afraid to ask. Midwives are there to help you. Take good care of yourself.
By Sophia (not verified) on 7 Jul 2018 - 16:49
Hi am 35 weeks, and having small small back and abdomen pains, always peeing and can go to toilet also
By Midwife @Tommys on 9 Jul 2018 - 16:09
It would be sensible to call your maternity unit and arrange to be seen. Any abdominal pain at 35 weeks should be assessed. Please don't worry that it is a waste of anyone's time. If all is well you will be reassured and can go home. Take care
By Shana (not verified) on 23 Jun 2018 - 13:52
Hi im 31 weeks 4 days went to hospital 4 days ago after almost colliding with another car turned out I was dilated to 2 then closed uo the 2 days ago dilated to 1 and last night had period like cramps and back pain and strong braxton hicks all night I couldn't sleep I pee alot and keep getting constipated or diarrhea.
By Midwife @Tommys on 25 Jun 2018 - 15:03
Hi Shana, I hope you are not too shaken up by the near collision in your car. Please make sure you are aware of your baby's movements and remember that you can go in to hospital for advice at any time if you are worried. .
By Yenmi (not verified) on 21 Jun 2018 - 20:35
Hi I'm 37 weeks and 4 days and I went to the hospital and was having contracions every 2 to 3 minutes and was 3 dialated so they stoped my contractions and gave me 2 shots for bby lungs was there for 3 days and they send me home with a very high sugar of 200 doctor say is cuz of the shots I got but I have never had sugar in my pregnancy so this mo tmi g i woke up and don't feel my bby moved at all I checke my sugar and is 176 my heart is betting So hard and im itchi all over my body don't know what to do in scared going back to the hospital and then send me bk can some one tell me please
By Midwife @Tommys on 22 Jun 2018 - 15:22
I am sorry to hear that you are feeling scared and not very well. I understand that you are worried about going back to hospital but if your heart is beating so fast and hard and you are itching all over then it is important that you are reviewed by a doctor.
By Danielle (not verified) on 21 Jun 2018 - 14:56
Hi so for a couple of weeks I have really bad pressure this week I have lost lots of green snotty discharge last night at 11:30 dull ace in back coming and going at about 8 this morning they stopped and it's coming and going every so often no blood or nothing in discharge, now feeling cramps in the front of belly
By Midwife @Tommys on 22 Jun 2018 - 15:20
If you lost a lot of green discharge then I would advise for you to contact your maternity unit to be review. It is good that you are not having any bleeding and the aches have calmed down but the discharge would still be a good reason to go be checked out.
By Laura (not verified) on 16 Jun 2018 - 09:37
For the last few days I have been having cramping like period pains, terrible inner hip pains, back pain over my hips and diarrhoea. Baby is still moving as per normal, but get weird tightenings over bump too. Is this the start? As had previous c section so never laboured naturally?
By Midwife @Tommys on 18 Jun 2018 - 15:03
Yes it is possible that your body is getting ready for labour. We call the tightenings Braxton hicks and this is nothing to worry about, however, if they become painful and/or regular you should contact your maternity unit for assessment as you are still a little early for delivery.
By kerry (not verified) on 16 Jun 2018 - 06:14
hi i am 28weeks preg had cerclarge put in at 24 weeks today had loose bowls keep going to toilet haveing lower back pain and on right side of tummy around back i am getting sharp pains getting shorter and more pain ful
By Midwife @Tommys on 18 Jun 2018 - 14:50
Please call your maternity unit for advice. We always advise that women are seen and assessed if they have abdominal pain in pregnancy.
By Kaay ramzan (not verified) on 12 Jun 2018 - 12:53
So I will be 34 weeks tomorrow but today in the morning when I woke up I had a blob of green snot like discharge and after that I have been getting period like cramps not painful just like before a period is due I have had this 4/5 times so far since 9.30 this morning I feel a bit nauseas I can still feel him moving and I can feel a bit of pressure on my bladder
By Midwife @Tommys on 12 Jun 2018 - 14:00
Please call your maternity unit now and get their advice now.
The following symptoms before 37 weeks of pregnancy could indicate premature labour:
•either a slow trickle or a gush of clear or pinkish fluid from the vagina or any increase in vaginal discharge
•cramps like strong period pains
•a frequent need to urinate
•a feeling of pressure in the pelvis
•nausea, vomiting or diarrhoea.
As you can see from these symptoms listed above you have mentioned cramps, nausea, discharge and pressure on your bladder (4 of the 6 symptoms).
Please let us know how you get on.
By Chantelle Swan (not verified) on 7 Jun 2018 - 17:19
Hello, for last few days I’ve experienced cramps and the urge like you get before a period is due, my hips hurt this comes in waves and goes, I’ve been urinating so much more than usual, and I have been swtiching between constipated and diorhea (vice Versa) I’ve had a pain tht was in my bum today like sharp stabbing needles in my bum hole (sorry for the TMI) and shortly after I lost a big clump of a tingy snot/gung (whilst laying down) baby’s movements are fine but painful when he does move. I’ve had headaches but put it down to normal pregnancy related, this morning I seen stars. And I’ve just been so over dramatic and hormonal today and crying (unusual even up till now) and so anxious and on edge! My hips and lower back/bum pain come and go in waves then my belly hurts like a nervous feeling..
By Midwife @Tommys on 8 Jun 2018 - 13:02
It sounds like a lot is going on at the moment, it is difficult to know why. It maybe that you have a bit of a bug and feeling unwell or could be pregnancy related. Especially as you are feeling anxious, it would be a good idea to contact your maternity unit or midwife to be reviewed just to make sure everything is ok.
By Miller (not verified) on 6 Jun 2018 - 14:47
So for 2 days today is day 2 I been having pains like I'm going to start my period I have diarieha or how ever u spell it frequent peeing my baby belly hurts pressure in my vagina my inner right side hurts like kidney lower back pain baby is breech what do I do
By Midwife @Tommys on 7 Jun 2018 - 13:33
Hi Miller, Thank you for your comment.
It sounds like you may have a urine infection as this can cause abdominal pain and frequent urination. As you are 34 + 5 it would be advisable that you call your local antenatal day unit at the hospital, with any abdominal pain this needs to be assessed so please give them a call and they will check you over and give you treatment if needed. Hope this helps, Take Care, Tommy's Midwives x
By Jasmine Gross (not verified) on 28 May 2018 - 03:48
Hey, I'm 30 weeks pregnant today. And this is my third child, I lost my second to a miscarriage. And I had a DNC. I'm already feeling pressure in my area. After I sit and rest then stand up to get something I feel pressure there, and feels like somethings trying to come out. Also I had the urge to pee and it slowly came on an went away so fast. So I don't know if this is normal or not.
By Midwife @Tommys on 29 May 2018 - 12:10
I would like you to go into your local maternity unit to be seen asap if you have not already done so since you sent this message yesterday.
You could be at risk of preterm birth and i want you to be reviewed by a midwife/obstetric doctor in labour ward triage asap.
They will check you and baby over and may want to do a speculum examination to have a look at your cervix. Feeling pressure can be caused by the cervix dilating, but it can be as simple as a UTI which may require antibiotics. But either way, it's best to get checked over.
All the best
By Natalie Marsden (not verified) on 27 May 2018 - 09:27
Has a premie birth already (31 weeks) now 24+3 with my second had severe lower back pain, light abdominal cramping & nausea for 2.5 days now - had paracetamol & hot water bottles but not shifting - should I be concerned. No pink discharge or fluid leaks. Prone to infections. Any advice welcome. Xx
By Midwife @Tommys on 29 May 2018 - 14:42
If you have not already, please go to your local maternity unit as soon as you can for review in triage today.
Abdominal pain or cramping, at any gestation needs to be reviewed as soon as possible. I am glad to hear that you've not had any bleeding or discharge, but with a history of having a premature birth, you are at risk of another one, and so id like you to get yourself reviewed today if you have not already been. The midwives at the hospital will check you and baby over and the Dr's may want to do a speculum examination on your to check that your cervix is still tightly closed and not gradually dilating.
Don't forget your pregnancy notes
All the best
By Natalie Marsden (not verified) on 30 May 2018 - 09:26
Thank you for your reply. I went up to triage on 26/05/18 and had a speculum (they had to try 3 times) they said that they could not completely see my cervix but it didn’t look dilating. My urine test was clear and they did a vaginal swab. They said however if the problem persists or gets worse to come back. I’m still having the lower back pain and cramping but am due to see my midwife tomorrow. Is there anything I can do in the meantime and do you think it’s safe for me to go to work (in a legal secretary so desk based) thank you
By Midwife @Tommys on 30 May 2018 - 16:20
Glad you got a review in the hospital. Their advice is 100% right. If you are comfortable enough to go to work (and also do the work commute) then that is fine, especially as you can stay seated for most of the day. But don;t overdo it if you don't feel well enough.) Please always take your pregnancy notes with you wherever you go in case your nearest hospital is not your local one. If you need to contact us again, please send us an email to our inbox [email protected]
All the best
By Rachel Faith (not verified) on 15 May 2018 - 22:47
All my prayers to the mamas and midwives on this thread. On the morning of May 5th my waters broke. I was rushed to the hospital by ambulance with contractions every two mins, only to find baby had no heartbeat. I delivered naturally 20 mins after arriving. Birthed baby and placenta without doctor intervening and released from hospital that evening. Heard baby's heart beat a week before, and all genetic testing came back fine a few weeks ago. I have a 19 year old, had an abortion due to rape about 17 years ago, had a miscarriage last year at about 4 weeks along and now this. I'm not sure if they checked for bacteria at the hospital, however a few days later I got a urinary tract Infection and was given antibiotics. Baby looked perfect. I felt fine until except for contractions leading up to birth and later when my milk came in two days after birthing him and the physical and mental pain associated with that. I will have doctor's test for CMV, since I work with some children who were exposed in utero. Any other suggestions to test for. I did have what i thought might be the stomach flu a month and a half ago with fever and vomiting. Just trying to pinpoint something that may help give some explanation, thank you in advance. My prayers are with all of the mothers out there and to be mother's, and those that are still trying, you are not alone.
By Midwife @Tommys on 17 May 2018 - 12:41
We are so sorry to hear about your loss and what you have been through, we cannot even begin to imagine what you must be feeling at this time. The Drs and midwives at the hospital should of taken all the necessary tests that are needed to be done in these circumstances so that they can try and find a cause or explanation to what happened. You should also have a debrief at the hospital once at the results have come back and then be talked through them and given a full explanation. We understand that this will be difficult for you and if you feel that you need more support then please contact the Tommy's Midwives on email [email protected] or you can call us on 0800 0147 800 Monday to Friday 9am-5pm. Hope this helps, take care, Tommy's Midwives x
By Z (not verified) on 8 May 2018 - 14:29
34 weeks in two days - last night had v sharp pains right under my belly making me feel breathless - lasted about 20 mins or so then baby was gg crazy for about 20 mins once i got into bed. Pains gone today and baby movements normal but keep feeling sick and dizzy. Second baby and don't remember it feeling like this last time.
By Midwife @Tommys on 8 May 2018 - 15:09
thank you for your post. I'm sorry that you have had this sharp pain that really took your breath away. It is great that your baby is moving normally and the pain has gone.
The sickness and dizziness could be unrelated to the pain overnight. Has anyone in the family had similar symptoms? You may have picked up a bug so it would be good to rest and remain well hydrated in this hot weather.
If however the pain returns, you have any rib pain, blurred vision or a headache call your Maternity Assessment Unit or labour ward. Abdominal pain or bleeding should always be followed up on.
I hope you have an antenatal appointment soon Z. If the symptoms return though get seen as soon as possible, don't wait until the appointment if you are concerned.
By Gemma Rogers (not verified) on 4 May 2018 - 17:11
Hi, I’m 30 weeks today.
11th Pregnancy- 1 live birth at 25 weeks and 4 days, 9 miscarriages under 12 weeks.
For the past 24 hours I’ve been having period like pains in my lower abdomen, having tightenings along with increased movements of the baby, I have been up & about today, drank plenty of fluids and taken analgesia, yet I still feel the same.
I’ve recently (past 2 weeks) been discharged from the Tommy’s Rainbow clinic at st Marys for pre term labour checks, all my check ups have been fine.
By Midwife @Tommys on 8 May 2018 - 16:04
please get back in touch with the Rainbow clinic today or your local hospital. I am aware that you posted this on May 4th so I really hope that you have been seen and that your symptoms have settled.
By Georgina (not verified) on 20 Mar 2018 - 17:25
I am 29+3 and I was admitted last week with bleeding and tightening. I have been discharged and only get irregular Braxton hicks now but keep passing pieces of greenish/pink mucus the size of 5p about 2 a day for 5 days. The hospital didnt seem concerned as there was no fresh blood. Am I just being overly paranoid??
By Midwife @Tommys on 21 Mar 2018 - 12:18
Your not being paranoid, it is important to notice any new symptoms and ask someone about them if in any doubt. If you are sure that it is mucus and not your waters then this is more reassuring. The pink mucus maybe just the end of the bleeding that you experienced when you went into hospital, and it does not sound like you are needing to wear a pad. You do not mention any pain or any concerns about baby's movements, if this is the case then again this is reassuring. Do you have an appointment booked to follow up? If you are not due to see someone soon then do ring the day assessment unit at the hospital and ask to be review if you are worried or things are on going. If there is an increase in loss or you get any pain or concerns about baby's movements then do go in straight away.
Best wishes, Tommy's midwives.
By Kamo (not verified) on 15 Mar 2018 - 15:59
My girlfriend friend is pregnant and she feel something like urine and back pain
By Midwife @Tommys on 15 Mar 2018 - 16:50
If she is having on going back pain and pain when she passes urine then she may have a urine infection which is very common in pregnancy, she needs to see her midwife or GP for a review. Best wishes, Tommy's midwives.
By Tawanna (not verified) on 15 Mar 2018 - 03:14
Hi I am 32 weeks and been having so much pain when I walk and pressure and lots of BH pain off and on he pain is so bad I can barely move or turn over in bed it's all in my back area....