Early labour means going into labour before 37 weeks. After this point your pregnancy is classed as full term.
If you go into labour earlier than you had expected, you'll have to think on your feet. Do not panic however, only 2 in 10 cases of suspected premature labour actually result in the baby being born. In the other 8 in 10, 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 full 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 Sharly (not verified) on 15 Mar 2019 - 03:22
I am 18 weeks pregnant close to 19, I was feeling braxton hicks and pelvic pains and tummy pains and back pains around 40 mins ago now. I wad laying down and I figured id get up to see if anything changed I walked around and it feels like I just finished doing a work out.
By Tietiana (not verified) on 11 Mar 2019 - 07:15
I was told I could be induced or wait it out 12 more days to recieve the steroid shot for her lungs.
By Paige (not verified) on 4 Mar 2019 - 11:13
Hi I am 36 weeks pregnant. I am experiencing dull cramps and cervix pain. I’m also experiencing diarrhoea too. I generally feel unwell and unable to sleep as I can’t get comfy. Is this a early sign of labour?
By Midwife @Tommys on 4 Mar 2019 - 16:23
Hi Paige, Yes this may be a sign of labour but as you are not yet 37 weeks I would advise that you go to your maternity unit to be checked.
By Chelsea (not verified) on 22 Feb 2019 - 20:30
I am 34 weeks tomorrow and for the past 2/3 days I have had cramps in my lower part of the stomach. Today I’ve had back pain, groin pain and pelvic pain which has been quite painful whenever I stand up. I’ve not been sleeping for days due to baby being extremely active. He just won’t rest and is always kicking and moving. I’ve had tight feelings in my stomach and then some kind of release: I have woken up today feeling sick and a tight chest Even after I have tried to eat something. Is this normal. First baby also.
By Midwife @Tommys on 25 Feb 2019 - 15:53
Hi Chelsea, It is always worth calling your maternity unit when you have these symptoms. While it may be normal, any abdominal pain at 34 weeks should be assessed. It is our job as midwives to be alert to any possible complications but also to reassure you if all is well. Please don't worry about asking. #Alwaysask
By Anie (not verified) on 21 Feb 2019 - 10:59
Hi my water broke on Tuesday at the doctor said it's not all broken the is some little that I have ever sinse Tuesday I have a pain in my back that come and go and I fell the pain I'm my vigina they said must come on Tuesday to che
By Midwife @Tommys on 22 Feb 2019 - 13:20
If you continue to have pains that are coming and going, then I would suggest for you to contact your doctor for a review. Additionally, if you feel unwell, feverish or your waters change colour from clear then it is important that you are reviewed. Do also keep an eye on baby's movements, any changes then to contact the hospital.
By Ana (not verified) on 16 Feb 2019 - 23:23
I'm having really painful pelvic pain in only 34 weeks
By Midwife @Tommys on 20 Feb 2019 - 15:30
Hi Ana - please go into your local maternity unit for review by a midwife and doctor as soon as you can. Take care, Tommy's Midwife
By Natasia (not verified) on 16 Feb 2019 - 22:24
Good day. I'm 34 weeks and 4 days pregnant. Got up this morning with flu/cold like symptoms. Through out the day it just got worst. Now I'm having a fever and low back pains, and rough pelvic pain. My feet and ankles are severely swollen. Baby is kicking regularly and seems happy. Should I call my dr?
By Midwife @Tommys on 20 Feb 2019 - 15:28
If you have not already been into hospital to see a midwife/doctor since you sent this message, please do so urgently. They will need to review you to rule out infection and pre-eclampsia. Take care, Tommy's Midwife
By Micka (not verified) on 18 Jan 2019 - 00:26
Hi, for the last few days I have been feeling light menatrual like pains on and off. I have had them for a few weeks now, but they seem to be getting more frequent. They don’t have any pattern to them, and come on randomly a few times a day. I was checked last week and my cervix was completely closed and firm. Should I be concerned?
By Midwife @Tommys on 18 Jan 2019 - 15:00
It sounds like it is something to just keep an eye on, but not something to worry about at the moment. If you start to having some regular tightenings that are in a pattern and/or you have any bleeding or noticed any reduction in your baby's movements then do ring the maternity unit for a review.
By Ashley minard (not verified) on 17 Jan 2019 - 11:55
I am 36 and 1 day pregnant...I have had diarrhea for the last two days and last night /this morning I am having contractions (not really sure how to time them)nausea,diarrhea and vomiting...am I in labor
By Midwife @Tommys on 17 Jan 2019 - 12:50
Hi - Thank you for your message.
If you are having painful contractions at 36+1, it is important you are seen at your maternity unit and assessed urgently.
By Carley Neale (not verified) on 3 Jan 2019 - 13:08
Hi I am 23 weeks pregnant with my first baby I am having loads of back pains and I feel very unwell should I contact my midwife
By Midwife @Tommys on 9 Jan 2019 - 16:02
If you have not already been since you sent this message, please do urgently go to your maternity unit for review by midwife and doctor. All the best, Tommy's Midwife
By Leah (not verified) on 22 Dec 2018 - 09:01
I’m 35 weeks pregnant and a first time mom and went for my check up on Tuesday and she had told me the baby has dropped, I am now experiencing very bad lower back pain, period pain types, my vagina area seems to be getting wetter, I can bearly walk, and I now have the flu as in diareah and sweating and then freezing cold. Can someone please recommend me what to do thanks in advance x
By Midwife @Tommys on 3 Jan 2019 - 16:36
I hope by now that you have been seen by a midwife or doctor. If not and these symptoms are continuing then please do call your maternity unit today.
By lia (not verified) on 20 Dec 2018 - 06:03
Am 35weeks n 1day pregnant,this is my first pregnancy I want for my weekly appointment yesterday and the doctor say I can go into labour any time soon..I haven't had any sleep da whole night my back really hurt and having Braxton hicks and my baby seems to be kicking so hard that my stomach really hurt..Pls is there something I should be worried about
By Midwife @Tommys on 20 Dec 2018 - 16:39
Lia, This is quite normal and nothing to worry about. Just try to get as much rest as you feel you need. Your baby sounds to be very happy kicking around.
By Kerry (not verified) on 17 Oct 2018 - 20:15
I am 33 weeks and 6 days, I’ve had belly tightening all day which has now calmed down but now I’ve got lower back ache. I also vomited this morning which I haven’t done in months. When I went to my doctors appointment yesterday they took a urine sample and said it looks like I have white blood cells but they were going to test it and let me know by Friday the results. Could this be early labour or the symptoms could just be from a Urine infection? My next midwife appointment is Friday. I don’t know if I should leave it until midwifes appointment this Friday or check sooner?
By Midwife @Tommys on 22 Oct 2018 - 15:59
I expect that you have already got your answer. Sorry we are not able to answer these messages urgently. If you are still concerned, please speak to your midwife.
By Tanya (not verified) on 9 Oct 2018 - 21:53
Hi I am 20 weeks into my pregnancy I had severe back & tummy pains went to the local materinety the doctor check me out said I had a high white blood count they taught I maybe in early labour they gave me a scan & internal & sent me home with antibiotics paracetamol & buscopan & an hour or two later the doctor rang & asked would I come in tomorrow morning she wants to check & scan my cervix what would be the reason for this please & thank you
By Midwife @Tommys on 11 Oct 2018 - 11:45
Hi Tanya, Thank you for your comment.
The Dr may want to check to see if your cervix is shortening at all due to the pains that you have been having. This could be one of the reasons but it may be more advisable to call your maternity unit directly, so that they will be able to give you a more accurate answer to your question. Take Care, Tommy's Midwives x
By Anonymous (not verified) on 30 Sep 2018 - 16:30
I am 36 weeks and 1 day. My OB told me last check-up (Tuesday) that my cervix is already open. I have a pelvic pressure. My stomach tigthens sometime and have a mild lower back pain. When could be my labor starts?
By Midwife @Tommys on 1 Oct 2018 - 15:42
Hi, Your labour could start at any time. Sometimes, women having their first baby can take a long while to get into labour. The contractions seem to come and go, start and stop. Once your contractions become regular and five minutes apart you should call your midwife or doctor.
By Susan (not verified) on 18 Sep 2018 - 01:43
Hi im 32 weeks today. Since Saturday having tightness in my belly but today at about 5pm its really bad. Lower back pain as well and pressure thinking i need to pee.
By Midwife @Tommys on 20 Sep 2018 - 13:51
Hi Susan, Thank you for your comment.
If you haven't already been to your local maternity hospital because of these pains then we would recommend that you call your labour ward and be seen. Having pain that is really bad could be a sign of early labour so please call the labour ward to be seen. It could be that you have a urine infection that is causing the pain but it is best to be checked over and reassured. Hope this helps, take care, Tommy's Midwives x
By Joanne Goodman (not verified) on 8 Sep 2018 - 16:42
31 weeks pregnant feeling really agitated sick cant eàt feeling full and cant be bothered talking to anyone baby no5
By Midwife @Tommys on 12 Sep 2018 - 10:29
If you are feeling unwell or concerned about the baby please contact your maternity unit as soon as possible for urgent advice regarding your symptoms and the way you are feeling. Do you have support at home or a health professional such as your GP or midwife that you can talk to about your feelings of agitation and not wanting to talk to anyone?
Please contact us via Tommy's Pregnancy Line 0800 0147 800 or email [email protected]
By Meg (not verified) on 1 Sep 2018 - 13:25
This is my 2nd pregnancy but its the polar opposite of my first so im having trouble telling whats normal and whats not.. Im currently experiencing lower back pain.. Ive had diarrhea for the last 2 days.. Period like cramping.. A LOT of pressure in my pelvic and vaginal area as well as when i urinate which has become a lot more frequent.. Is this normal or should i go see my doctor??
By Midwife @Tommys on 7 Sep 2018 - 15:04
If you haven't already it sounds like it would be best to speak with your doctor for a review.
By Lorraine (not verified) on 31 Aug 2018 - 15:57
I am 31 weeks and 3days I’ve been havin pains in my stomach all day I had pains in my right side last night and couldn’t sleep due to it and every time I feel baby kick it gets worse, I’ve also started gettin pain in my lower back? My stomach also seems to be tender to touch which seems to come and go I don’t want to keep pestering the midwife but I never had any of this with my 1st child?
By Midwife @Tommys on 31 Aug 2018 - 16:17
If you are having on going pains then we would advise for you to contact your midwife or maternity unit just to have a review to make sure everything is ok. Please do not worry about 'pestering' at all.
By Zoe (not verified) on 27 Aug 2018 - 19:14
Hi there, I am 40+6 and for the last 3 days have been loosing my plug and had really bad diarreah, the diarreah has passed now thank god but I keep getting period type pains, lower back pain and feel like I constantly need to pee but they don't seem painful enough to be contractions and there isn't any rhythm to them, my last midwife app at 40 weeks they said baby was fully engaged and head down but back to back, am I in early labour? And if so how long is this going to take until it ramps up to real labour, getting fed up now and wanting to stick with my home birth plan! Thanks x
By Midwife @Tommys on 29 Aug 2018 - 16:21
Yes, it does sound as if you are in early labour. It would be a good idea to call your hospitals labour ward/ birth centre to discuss your symptoms and ask them if they advise that you are assessed soon. Good luck - perhaps you have already given birth to your baby by now! Tommy's Midwife
By Saniatta (not verified) on 23 Aug 2018 - 06:30
Tonight I have been having back pain, hip pain, and my vagina feels heavy when I stand. I have had diarrhea a few days ago for 2 days.. I’ve been sleeping a lot due to being super exhausted as well. My pains started happening at 9pm til now (12:30am) and still on going..
By Midwife @Tommys on 23 Aug 2018 - 14:05
Hi Saniatta, Thank you for your comment.
If you are having abdominal pain then we would recommend that you call your local maternity unit so that you can be checked over, they will be able to give you advice over the phone and if they think that you may be in labour then they will ask you to come in. Hope this helps, Take care, Tommy's Midwives x
By Stacey (not verified) on 21 Aug 2018 - 09:44
I’m 32 weeks 6 days pregnant with my 3rd baby. I started with backache last night which has gotten worse. This morning I woke up with lower abdominal pain that radiates round the sides and back. I have tried going to the toilet, moving about and lying in my side. None of these things help. Baby is moving normally and when he does move it hurts. Any advice is much appreciated thank you
By Midwife @Tommys on 22 Aug 2018 - 11:19
You need to go to your Maternity Unit as soon as possible to be reviewed with your pregnancy notes.
Abdo pain at any gestation before 37 weeks is not normal and needs investigation. You may have something as simple as a UTI which may need antibiotic treatment, but it is best to rule out more serious problems too.
All the best
By Cimeron Worrell (not verified) on 17 Aug 2018 - 17:15
I’ve had really bad pains in my stomach not just lower. My back has been killing me. I can’t eat bc the acid reflex is so bad, but I’m not even hungry. I have been really nauseous and had diarrhea for a few days now. Everyone just keeps saying your fine it’s normal but is it? I’m a ftm and I don’t want to call doctors and waste there time.
By Midwife @Tommys on 20 Aug 2018 - 14:38
Hi Cimeron, Most doctors or midwives would prefer to have their time wasted 100 times than to miss 1 problem. If you have abdominal pain at 35 weeks please go to your labour ward for assessment and advice. I can't give advice and reassurance without examining you. Take care, Tommy's midwives
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