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, 2014. Next review date July 1st, 2017.
By Anonymous (not verified) on 12 Oct 2017 - 21:35
I am 26+1 weeks pregnant, I already have 3 children, born at 34 weeks, 36 weeks and 38 weeks.
I was checked a week ago and had an internal scan, they told me that I had a short cervix of 23mm and flunneling. I have been advised not to run, jump or have sexual intercourse until I'm 34 weeks.
I am a little stressed at the moment and I struggle with my ribs, for the last 2 days my groin has been really hurting and at times I have struggled to walk.
I swim lengths underwater and use float boards in my sets at least 3 times per week, i swim 80 lengths in 40 minutes, is this still safe to do this amount of Exercise? Does the groin pain mean anything? Today I felt some very dull aching in the lower tummy and I look like I have changed shape slightly. Baby is head down. Is this something I should be concerned about before my consultant appointment next Tuesday??
By Midwife @Tommys on 16 Oct 2017 - 10:56
It sounds like you lead a very healthy lifestyle. If your doctor and midwife, who know you well and know your full medical history know that you exercise as often as you do, and are happy for you to continue to do so, then there is no reason why you should not.
A shortening cervix can mean that you are advised to avoid certain activities, as you are already, but it might also be a sensible idea to go into be seen if the pelvic/groin pain continues or has gotten worse recently. You may need another review.
Any abdominal pain too, dull, sharp or otherwise, at any gestation of pregnancy requires a medical review by a midwife and obstetric doctor at your local hospital, so i would recommend that you took yourself in for that too to be on the safe side. You may have a UTI that needs treatment with antibiotics. please do take good care of yourself and feel free to call us if you wish to speak in any further depth what i have recommended to you.
By Anonymous (not verified) on 19 Sep 2017 - 07:08
I've been getting a dull ache in stomach. For a couple of days and very bad lower back pain but some times a sharp pain in stomach, baby movements are fine it's like a period pain.
By Midwife @Tommys on 19 Sep 2017 - 10:34
I'm sorry that you're feeling so uncomfortable. You don't mention how many weeks pregnant you are and this will factor in the answer that I give you.
I'm glad that your baby is active. This is a good sign that your baby is well. Please get back in contact with a little more information about your pregnancy including how many weeks you are now, is this your first baby, if you have any health problems, have you been well in the pregnancy so far.
By Anonymous (not verified) on 19 Sep 2017 - 18:01
Hello this is my first pregnancy. I'm 21 weeks and 6 days. Baby is moving fine. Went for an hour walk today. I have ibs and don't know how to tell if I'm having Braxton hicks or ibs cramps/moving bowels. How can I tell the difference ? Also could the combination of spicy food and walking cause preterm labor ? Thank u
By Midwife @Tommys on 20 Sep 2017 - 10:01
IBS cramps and Braxton Hicks may feel similar to some women - and different to others- everyone experiences this differently. Abdominal pain at any gestation though, should be investigated urgently at your nearest maternity units labour ward/day assessment unit/triage. The doctors and midwives would always prefer to see you and make sure all is well with you and baby. Spicy food can irritate the bowels - pregnant or not- and walking can increase Braxton Hicks. However, the combination of all of these aspects together, could suggest that you should pop into your nearest unit for a review. The likelihood is that everything is fine, but it is sensible to get a review anyway. Please take good care of yourself!
By Anonymous (not verified) on 23 Aug 2017 - 20:03
Hi I Am 34 weeks and 4 days pregnany with my 2nd child. I have been experiencing a lot of pelvic pain and my vaginal pain feels like something is ripping down there...the pressure and back pain have been limiting me from sitting a long time and standing. I have been having urgent urination and having the need to rush to the restroom because of all the pressure. And these last few days i have been experiencing diarrhea and having the urge to go almost every hour...any advice?
By Midwife @Tommys on 25 Aug 2017 - 16:38
Hi, sorry to hear that you are feeling unwell and are in pain. Are you due to see your midwife soon? It is important to make sure that you do not have urine infection as you are needing to empty your bladder regularly and have back pain. If you are experiencing pelvic pain it is important to manage this, we have information which can help here: https://www.tommys.org/pregnancy-information/pregnancy-complications/symphysis-pubis-dysfunction-spd-or-pelvic-girdle-pain-pgp If you are feeling like you are opening your bowels often then try to keep hydrated and eating little and often. If your pain worsens or you experience at tightenings, bleeding or worries about baby's movements then please call your maternity unit straight away.
By Anonymous (not verified) on 4 Aug 2017 - 15:59
Hello i am currently 36+1 I've been losing my plug (just clear no blood) for about a week I've also had lose BM and vomiting on and off for a week I think my cervix is starting to thin as been feeling twinges and getting cramps front and back alsp an increase in pressure and my energy levels keep rising and dropping and an increase in watery discharge In your experience is there still a chance I can go another 4-6 weeks?
By Midwife @Tommys on 4 Aug 2017 - 17:01
It is very difficult to know if you will go into labour soon or not. If you have noted watery discharge it is important to monitor this and be sure that your waters have not broken, if you put on a pad and if it is damp after an hour or so then ring the maternity unit to go in to be checked. If you start to have regular tightenings, any bleeding or concerns about baby's movements then ring the maternity unit straight away.
By Anonymous (not verified) on 24 Jul 2017 - 14:43
Hiya for last couple days I have been getting lot pressure today I am in pain down below
Could this be sighn of labour
By Midwife @Tommys on 24 Jul 2017 - 15:42
Hi . Sharp pain in your groin is not usually a sign of labour but if this pain persists you should contact your midwife for advice. It is always best to be checked if you have concerns. Best wishes
By Anonymous (not verified) on 28 Jun 2017 - 14:17
I'm 34 weeks&3days with my third, I have a lot of nasty pressure in my bum and front parts , I keep getting sharp stabbing pains in my sides, abdomen and I have been suffering from nasty cramps in my thighs and legs for a few days now, I also have had quite an increase in discharge which is clear and had had no smell , but midwife keeps on telling me that its normal because my body is left with few weeks for delivery.im in a serious pain ,please advice
By Midwife @Tommys on 29 Jun 2017 - 14:24
Hi, Thank you for your comment. If you are in serious pain then we would advice that you call your local maternity unit so that you can be seen. Pain can happen for a number of reasons like urine infections or pelvic gurdle pain but as you are describing this pain as serious, then we can only assume that you are very uncomfortable. At 34 +3 weeks, you need to be assessed to rule out that you are not going into premature labour. Please call you local maternity unit or antenatal day unit so that you can be seen. Hope this help and all goes well in your pregnancy. Tommy's Midwives x
By Anonymous (not verified) on 16 Jun 2017 - 19:33
Am 35weeks +3days ,Am feeling sharp pain around my abdomen,back pain and regular contraction that last for 2-3hours.Do u know if that is a sign of labour?
By Midwife @Tommys on 19 Jun 2017 - 09:54
Hello, I hope that you have been able to access help and support for your pain. We always recommend that if you have any abdominal pain in your pregnancy that you seek medical advice straight away. Please note that we are available for non urgent advice between the hours of 9am and 5pm Monday to Friday. You will find telephone numbers for your maternity department on your notes and your local midwives are available 24 hours a day to support you. Best wishes and I hope all is well.
By Anonymous (not verified) on 15 Jun 2017 - 19:33
I have been having occasional lower back pains, having to pee and poop more frequent but nothing, today after I wiped I had a gigantic peice of mucus come out ,as well as I self checked and I'm able to put almost two fingers in my whowhooo.
By Midwife @Tommys on 16 Jun 2017 - 16:08
If you have noticed these symptoms then we would advise you to contact your midwife and be reviewed to make sure you are not showing signs of labour at all. The number of fingers that you can insert into your vagina does not mean whether you are or are not in labour, therefore it is important that you see a midwife. Take care.
By Anonymous (not verified) on 14 Jun 2017 - 22:04
Am 35weeks +3days ,Am feeling sharp pain around my abdomen,back pain and regular contraction that last for 2-3hours.Do u know if that is a sign of labour?
By Midwife @Tommys on 15 Jun 2017 - 14:47
Hi, it is difficult to say what these pains are without examining you so we would advice that as you are 35 +3 days, it would be best if you contact your local maternity unit so that they can check you over. It could be that these pains may be caused by a urine infection and if you need treatment then they can prescribe this for you. If you are going into labour then again if you are at the hospital you will be well looked after, but please go and be checked by a midwife. We wish you all the best for your pregnancy and beyond, take care, Tommy's Midwives xx
By Anonymous (not verified) on 9 Jun 2017 - 20:22
Hi iv been having pains that last about 1 min and every 15mins for about 2 hrs on and off through the last 2 days it feels like i have a lot of pelvic pressure and its painful to walk around any advice as to what this could be
By Midwife @Tommys on 12 Jun 2017 - 11:53
Please be aware that this is not an urgent pregnancy service. Our office hours are Monday to Friday 9-5pm. If you have any concerns about pain in pregnancy please contact your maternity department for advice. The phone number is usually on the front of your maternity notes. I hope all is well today. Best wishes
By Anonymous (not verified) on 30 May 2017 - 12:31
I really hope you can help me? Ive been to my local clinic for check up just the other day, the nurse said baby is breech and that im a possible high risk?? I know that baby has a lot of time to turn. Other than that, ive been experiencing pains in my front and lower area.. its almost like period pains but brings tears to my eyes... started again over the weekend and this morning its been coming and going. I do however experience a whitish discharge that has been coming along more often. Please can you help me?? I don't know what to do...
By Midwife @Tommys on 31 May 2017 - 09:45
Abdominal pains, at any gestation of pregnancy need to be reviewed urgently at your local hospital labour ward or triage by a midwife/obstetric doctor. Although it is possible that you are experiencing Braxton hicks contractions, it is vital that you are checked over to ensure that your body is not trying to go into premature labour.
The baby being breech now at this gestation 29-33 weeks is not uncommon. It has got plenty of time to turn, but your midwife can discuss this with you at your next appointment too if the baby still hasn't turned naturally, then you would be offered ECV to try to turn the baby into a head down position.
By Anonymous (not verified) on 29 May 2017 - 10:54
Am due between 2nd and 12th of june as said in the hospital but I have strong back pain,abdominal and waist clamps that I can't walk when it comes also I have strong milky discharge and the bones of my private part hurts when I walk..it's my first pregnancy and I want to know if am in labour
By Anonymous (not verified) on 28 May 2017 - 20:45
I am 32 weeks pregnant with my second I felt as baby had dropped a couple of days ago and started experiencing dull lower back pain that comes an goes very irregular but today I think i may have lost some of my mucus plug and have been feeling nausea since what could this mean
By Midwife @Tommys on 31 May 2017 - 11:04
It is normal to feel nervous in pregnancy, especially as your due date nears. Having abdominal pain, at any gestation of pregnancy, whether it is a dull ache, or sharp pain or any other type of pain in your bump area, it is vital that you take yourself into your local triage/labour ward/ day assessment unit. If you are feeling nauseous and your mucous plug or SHOW has happened, then it is possible that you are going into labour a little earlier than planned. Please do take good care of yourself!
By Anonymous (not verified) on 19 Apr 2017 - 10:53
I been having alot of werid pressure like pains in my cervix I'm dialted to a 5 and effaced to 75% and been feeling like I have to pee all the time and been having pink discharge with burst of pink thick water and having really bad potty problems what could it meen
By Midwife @Tommys on 19 Apr 2017 - 10:59
It sounds as if your body is trying to go into labour earlier than planned and so if you are not already in the hospital, you should make your way in urgently to the labour ward to be reviewed by a midwife and obstetric doctor.
Feeling pressure, passing pink liquid (could be your waters breaking) and having an upset stomach are usually signs of early labour. So please take yourself in urgently with your pregnancy notes! Take care of yourself
By Anonymous (not verified) on 18 Apr 2017 - 07:30
Hi, I'm 30 +5 weeks pregnant with my first baby.
I am feeling very uncomfortable cramping like pains in my ribs and down my back. Also my stomach feels like it's contracting but I'm not sure, I get a achy and heavy sensation all over my lower abdomen and then it goes. What could this be?
By Midwife @Tommys on 18 Apr 2017 - 10:21
Any abdominal pain or cramping in pregnancy should be reported and checked by a midwife or doctor. Please urgently contact your local maternity unit (either triage or the delivery suite) so that you can be seen and assessed.
By Anonymous (not verified) on 24 Mar 2017 - 01:20
35 weeks having a lot of pains in back no leakage but lots of diarrhea and stomach has became soft and I was having contractions 8 mins apart last week I'm high risk and baby much more active than usual please any advice
By Midwife @Tommys on 24 Mar 2017 - 08:58
Hi Worried Mom.
Having contractions, abdominal pain and an upset stomach can be signs that your body is starting to go into labour.
Being that you are a high risk pregnancy and you seem concerened by the change in your babies pattern of movement, I would advise that you take yourself in to your local labour ward as soon as you possibly can to be reviewed.
If you are reviewed and there is no concern, then they will send you home. Otherwise they may admit you and monitor you more closely. Please good care of yourself.
By Anonymous (not verified) on 26 May 2017 - 08:13
I am 34 weeks and 2 days I have a lot of back pain and pelvic pressure should I go to the hospital
By Midwife @Tommys on 26 May 2017 - 09:15
Thank you for your comment.
I would strongly advise you to go to( or contact your maternity unit) as soon as possible for further advice about your back pain and pelvic pressure-they should ask you to come in for further assessment and tests.
Mild back pain is common in pregnancy but if it has started suddenly and is very painful, it is important to have this checked as soon as possible as this can be a sign of labour starting.
I have attached some links with further information for you if needed
Hope this helps. Please contact us or call our helpline
0800 0147 800 for any further advice
By Anonymous (not verified) on 16 Mar 2017 - 18:12
Hi my wife has been experiencing lower abdomen and lower back pains all afternoon she said they are sharp pains reducing her to tears but refusing to go hospital I'm very worried please help
By Midwife @Tommys on 20 Mar 2017 - 09:02
Hi Luke, I am hopeful that as I reply to your message now, you have already become parents as it sounds like your wife was going into labour on friday last week. Please feel free to contact us again if this is not the case. I would recommend that you take her in to be reviewed asap if you have not already done so and she has not given birth already. Abdo pain, at any gestation of pregnancy needs to be investigated.
By Anonymous (not verified) on 7 Mar 2017 - 15:20
Im38+2 today and I had my midwife today I wished I had asked this when there but I was told my outside cervix is open but internal closed I have been getting sharp pains in my back amd the feel like I need to go to bathroom constantly and pushing I'm just confused now as to what is happening and if labour will start soon
By Midwife @Tommys on 7 Mar 2017 - 16:58
It sounds like your midwife examined you today and found there are some changes happening to your cervix, however it is very difficult to be able to predict when you are going to go into labour. If this is your first baby then it can be a long time and less predictable. It may have been that the baby is lower down now and pushing which is creating some pressure. If the midwife did a membrane sweep then often you will feel some period type pains and back ache. You may also experience some 'show' which is mucousy discharge that can have some streaks of blood in it which is a sign of your cervix is changing. It is important that if the pain worsens, your waters breaking or you get any bleeding or worries about baby's movements then do ring your maternity unit to be reviewed.
By Anonymous (not verified) on 1 Mar 2017 - 14:24
am 26 weeks pregnant today my baby is too much active since yesterday and am experiencing back pain since yesterday feeling tired the pain is still there even if i lay on my left side am starting to get nevours about this please help me on what to do
By Midwife @Tommys on 3 Mar 2017 - 12:07
Hi and apologies for the late reply to this post. With any pain at 26 weeks pregnant we would advise that you contact your maternity unit. It may be nothing to worry about but it would be sensible to check. Alternatively if you have more details you would be welcome to contact us on 0800 0147 800. There is a midwife here Monday to Friday 9-5pm for advice and support.
By Anonymous (not verified) on 19 Feb 2017 - 17:24
For a couple of days now I have had a dull ache at the bottom of my back along with belly ache that comes and goes, had a constant need to go to toilet #2 but nothing happens, heart burn has gotten much worse and with it all together I'm hardly getting any sleep because I just can't get comfortable with it, is it all part of pregnancy or should I phone the midwife? X
By Midwife @Tommys on 20 Feb 2017 - 09:24
Any abdominal pain should be reported to your midwife/maternity unit. Please contact the your local maternity unit to discuss your symptoms and for advice.
By Anonymous (not verified) on 12 Feb 2017 - 08:38
Hi I'm 30 +2 weeks pregnant I'm getting sharp pains and it feels like something is stabbing me and I have been dripping for about 2 weeks now what does it mean
By Midwife @Tommys on 13 Feb 2017 - 09:10
As a matter of urgency, you need to be seen at your local labour ward/ triage to be reviewed by a midwife and an obstetric doctor. Sharp abdominal pains at any stage of pregnancy needs to be reviewed urgently. In addition, you say you have been "dripping for about two weeks now", if your waters have broken or you are bleeding and you have not been seen in this time, you really do need to get yourself into hospital with your pregnancy notes very urgently.
Take care of yourself!
By Anonymous (not verified) on 6 Feb 2017 - 20:08
Hi bit gross but have some serious pains in my bottom. Only 23 weeks pregnant but not sure if its contractions or constipation. Can anyone advise. Feel the need to push but scared incase it's the baby
By Midwife @Tommys on 7 Feb 2017 - 15:11
Congratulations on your pregnancy!
It does sound like you may have constipation which is causing you the pain in your bottom. You can become constipated very early on in your pregnancy due to the hormonal changes in your body.
there are ways for you to safely treat constipation without harming you or your baby. Your GP will first advise you to change your diet by increasing fibre and fluid intake. You'll also be advised to do gentle exercise.
If dietary and lifestyle changes don't work, you may be prescribed a laxative safe to take in pregnancy to help you pass stools more regularly.
If however the pain becomes severe or changes, or you begin to experience any other symptoms such as bleeding or cramps, please contact you local maternity unit urgently.
By Anonymous (not verified) on 3 Feb 2017 - 21:48
Hi i am 33 + 6 and I have been so unwell I have had a swab done for infection as u have loads of discharge but nothing has come back over it but I'm now at the point where I have constant lower back ache every now and then it's a sharp pain. I have Braxtons hicks alot that don't stop when changing what I'm doing. But still really irregular. And now I'm feeling like my skin is extremely irritable and have been sick. I haven't really had morning sickness at all but last couple of days have been really bad and just not wanting to eat just drinking loads of ice cold water. I just don't know what to do.
By Midwife @Tommys on 6 Feb 2017 - 10:27
It really does sound as if you need to take yourself (and your pregnancy book)into your local labour ward/triage/day assessment unit for review by a midwife and/or obstetric doctor.
Discharge can be normal in pregnancy, but paired with your extreme nausea, back pain, feeling irritable and generally unwell, it sounds as if you need to be checked over to ensure that there isn't something more serious underlying.
They may need to take some blood tests and monitor your baby on CTG.
Please take care of yourself.
By Anonymous (not verified) on 30 Jan 2017 - 00:20
I've been getting dull period pains for the past couple of days and have felt nauseated a lot. I have constant pressure in my pelvis/vagina area which sometimes makes it hard to walk. My heartburn and restless leg syndrome has gotten worse and I have been getting sharp pains in my side. I have a midwife appointment on the 2nd so not sure whether to just wait till then or to call the triage ward today?