Tommy's PregnancyHub

How to reduce your risk of premature birth

We don’t always know why some babies are born prematurely. But there are things you can do to try and reduce your risk of having a premature birth.

It's not always easy for the healthcare team to know why some babies are born prematurely, but there are steps that can be taken to reduce your risk of premature birth. There are some risk factors for premature birth, such as your age, that you cannot do anything about. But there are some things you can do to try and reduce the risk of giving birth early.

Premature birth and antenatal care

It’s very important to go to all your antenatal care appointments throughout your pregnancy. This will help your midwife to:

Antenatal care starts with a booking appointment. This gives the antenatal team a chance to identify any risks you and the baby may have and the care you will need throughout your pregnancy. 

Anything you say to your midwife or doctor is in confidence. That means they can't tell anyone else without your permission. But if they have concerns about your safety or your baby's safety, they might need to tell other people, such as a social worker, about your pregnancy. If this happens, they will tell you, and explain the reason. 

If you suffer from an eating disorder, have mental health problems or are worried about money, housing, domestic abuse or anything else at all, tell your midwife or doctor. They may be able to help you and, if not, they can advise you where to go for more help and support.

Having continuity of care

At the moment, most women see a number of different healthcare professionals throughout their pregnancy and appointments. Having continuity of care means having the same healthcare professionals (often a team) involved in your care throughout your pregnancy, labour and the postnatal period. Research has shown that a long-term relationship with a midwife and other professionals can help reduce complications such as pre-term births and baby loss.   

In 2019, the NHS increased its funding to improve maternity services and to ensure the majority of women have the same midwife throughout their pregnancy.

Depending on the services in your area, this may not always be possible. But if you have been told that you are at risk of giving birth early, it is worth asking your midwife or doctor if you can see the same healthcare professional throughout your pregnancy. 

Premature birth and complications

You may have a long-term condition or complications in pregnancy that increase your risk of premature birth. If so, you’ll likely have extra antenatal care throughout your pregnancy. Working with your healthcare team to manage your condition effectively may help reduce your risk of premature birth. 

If you have any questions about managing health conditions or complications in pregnancy, you can also call our pregnancy line on 0800 014 7800 (Monday to Friday, 9am to 5pm), or email us at [email protected]

Premature birth, eating well and staying active

Eating a healthy, balanced diet and staying active during pregnancy has many benefits. For example, it can help you maintain a healthy weight may also reduce your risk of gestational diabetes (and therefore reduce your risk of premature birth). Maintaining healthy habits can also help manage mental health problems, such as anxiety or depression in pregnancy. 

Exercise is not thought to result in higher risk for preterm birth, but talk to your midwife or doctor if you have been told you are at risk of premature birth. They will be able to advise how much activity is safe for you and your baby. Find out more about safe exercise in pregnancy.

Premature birth and your mental health

Some research suggests that severe stress or depression during pregnancy is linked to premature birth, although it’s not clear why. If you are struggling with your mental health, you are not alone.

Up to 1 in 5 women develop mental health problems during pregnancy or in the first year after childbirth. Midwives and doctors are aware of this and will be ready to support you, not judge you. 

Find out more about your mental health before, during and after pregnancy

Premature birth and alcohol

Drinking large amounts of alcohol in pregnancy increases the risk of premature birth. When you drink, alcohol passes from your blood through the placenta and to your baby. There is no known safe level for drinking during pregnancy, so the safest approach is not to drink at all while you're pregnant.  

Find out more about alcohol in pregnancy and where you can access more support.

Premature birth and recreational and illegal drugs

Using illegal drugs such as cannabis can increase the risk of premature birth. It can be extremely difficult to quit something you may be addicted to. But it’s very important to tell your midwife or doctor about what is happening. 

You may be offered a referral to a specialist midwife or doctor who can give you dedicated advice and offer you regular appointments. They will also be able to tell you about local services that could also help.

Premature birth and smoking

Protecting your baby from cigarette smoke is one of the best things you can to protect your baby’s health. When you (and the people you live with) stop smoking you will reduce the risk of premature birth, as well as other complications including stillbirth, low birth weight and sudden infant death syndrome (SIDs). 

Stopping smoking can be difficult, but there is plenty of support available

Premature birth and infections

There are many types of infections are associated with premature birth. For example, sexually transmitted infections (STIs), which are passed from one person to another through sex or genital contact. They are sometimes referred to as sexually transmitted diseases (STDs). All pregnant women are offered blood tests to check for as STIs such syphilis and HIV as part of their routine antenatal care.  

However, you will not be offered tests for all other sexually transmitted infections that can cause pregnancy complications. For example, chlamydia and gonorrhoea can both cause premature birth. These are two of the most common STIs in the UK and many people don’t have any symptoms.

Ideally, it’s a good idea for you and your partner to have a check-up before you start thinking about starting a family. But if you didn’t or if you have a new partner, have any symptoms or are worried about STIs, it is important to get tested.

The best places to go are a genito-urinary medicine (GUM) clinic, sexual health clinic, your GP or a young people’s clinic.

All information given will be kept confidential, and the tests are only done with your permission.

You can find details of local GUM clinics by contacting the Sexual Health Line on 0300 123 7123 or the Family Planning Association’s website.

Bacterial vaginosis and pregnancy 

Bacterial vaginosis (BV) doesn’t cause any problems in most pregnancies. But there is a small chance of complications, such as premature birth and miscarriage. 50% of women with bacterial vaginosis do not have any symptoms. 

You can prevent BV by following this guidance. Do not:

  • use perfumed soaps, bubble bath, shampoo or shower gel in the bath
  • use vaginal deodorants, washes or douches
  • put antiseptic liquids in the bath
  • use strong detergents to wash your underwear
  • smoke.

You are more likely to get BV if you are sexually active. It is not a sexually transmitted infection but you are more likely to get it if you are sexually active with men or women. Find out more about staying safe when having sex in pregnancy.

You may get more vaginal discharge than usual while you’re pregnant. But talk to your GP or midwife if you notice any of the following as this could be a sign of BV:

  • unusual vaginal discharge that has a strong fishy small, particularly after sex
  • a change to the colour and consistency of your discharge – for example, if it becomes greyish-white, thin and watery. 

Find out more about how to avoid infections in pregnancy

Premature birth and your weight

Women who are not at a healthy weight when they get pregnant are more likely to have premature birth. If you are underweight or overweight, there are things you can do to make sure you have a healthy pregnancy. These include:

  • going to all your antenatal appointments, scans and make sure you have any recommended tests
  • eating well and staying active
  • taking all the recommended supplements
  • follow any specialist advice from a dietitian or anyone else involved in your care.

Find out more about weight management in pregnancy.

Looking after your teeth and gums

It may sound a bit odd, but research has suggested that there is a relationship between gum disease and premature birth. This does not mean that gum disease is proved to be a direct cause of premature birth, but it is a good idea to take extra care of your teeth during pregnancy.

Some women get swollen and sore gums during pregnancy because of hormone changes. This can make your gums more open to plaque, leading to inflammation and bleeding (gum disease).

It will help to:

  • clean your teeth twice a day with a fluoride toothpaste
  • floss once a day
  • avoid fizzy drinks and sugary foods
  • avoid mouthwashes that contain alcohol
  • stop smoking (smoking can also harm your baby’s health).

If you have morning sickness, rinse your mouth with plain water after being sick. This will help prevent the acid in your vomit from damaging your teeth.

Visiting your dentist

Your dentist will also be able to help you keep your teeth healthy during pregnancy. Just make sure you tell them that you are pregnant because there are some things, such as X-rays, that are better to leave until after you’ve had your baby.

Dental care is free during pregnancy and for 1 year after your due date. Ask your doctor, nurse or midwife for form FW8, which you can use to apply for a maternity exemption certificate. This also entitles you to free prescriptions.

Find out more about maternity exemption certificates.

Call your midwife if you have any concerns

If you have any worrying symptoms, you do not have to wait until your next antenatal care appointment. Do not worry about wasting anyone’s time. Call your midwife, nearest early pregnancy unit or labour ward if you have symptoms such as vaginal bleeding, stomach pain, severe headache, or you are worried about your baby’s movements

It is always best to get checked out
 

NICE (2010). Pregnancy and complex social factors: a model for service provision for pregnant women with complex social factors. National Institute for health and care excellence. https://www.nice.org.uk/guidance/cg110

NHS England. Targeted and enhanced midwifery-led continuity of carer. https://www.england.nhs.uk/ltphimenu/maternity/targeted-and-enhanced-midwifery-led-continuity-of-carer/
 
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NHS. Chlamydia complications. https://www.nhs.uk/conditions/chlamydia/complications/ (Page last reviewed: 4 June 2018 Next review due: 4 June 2021)  

NHS. Gonorrhoea complications. www.nhs.uk/conditions/gonorrhoea/complications/ (Page last reviewed: 29 June 2018  Next review due: 29 June 2021)  

NHS. Bacterial vaginosis. Bacterial vaginosis - NHS (www.nhs.uk) (Page last reviewed: 22 November 2018 Next review due: 22 November 2021)    

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Clinical Knowledge Summaries (March 2021) Pre-conception advice and management. https://cks.nice.org.uk/pre-conception-advice-and-management 

Royal College of Obstetricians and Gynaecologists. (2011) Why your weight matters during pregnancy and after birth. www.rcog.org.uk/globalassets/documents/patients/patient-information-leaflets/pregnancy/pi-why-your-weight-matters-during-pregnancy-and-after-birth.pdf

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