Tommy's PregnancyHub

Pregnancy after a premature birth

If you’ve had a premature birth before, there are things that you and your healthcare team can do to try and reduce the risk.

If you’ve had a premature birth before, it’s natural to worry about it happening again. There is nothing you can do to guarantee you won’t give birth early again, but there are things that you and your healthcare professionals can do to try and reduce the risk. 

If I’ve had a premature birth before, will it happen again?

It may do. If you’ve had a premature baby before you are more likely to go into early labour again. This risk increases every time you have a premature baby. 

How premature your previous baby was will also have an effect. The earlier you gave birth to your previous baby, the higher the risk of giving birth early again. 

But this doesn’t mean that you will definitely give birth early again. Many women who have a preterm baby may go on to have another birth at full-term (between 37 and 41 weeks).

What can be done to reduce the risk of another premature birth?

Your healthcare team can sometimes take steps to make sure that you avoid another premature birth. Any treatment or care you may have will likely depend on why you have had a premature birth before (if your doctors were able to identify why you gave birth early).

For example, if you had a premature birth because of a weak cervix you may be offered a cervical stitch or hormone treatment. Find out more about preventing a premature birth (treatment).

If you had any other complications, such as gestational diabetes in your last pregnancy, you’ll likely be offered extra care to make sure any issues get picked up as soon as possible and any risks can be reduced.  

The best thing you can do is talk to your GP or other healthcare professional before you start trying for another baby. They will be able to tell you what can be done before and during your pregnancy to reduce your risk of complications. 

Your antenatal care may be led by an obstetrician (a doctor who specialises in pregnancy and childbirth) as well as a midwife in your next pregnancy. You’ll also be monitored for signs of early labour. Make sure you know how to contact your midwife or hospital if this happens. 

What can I do to reduce the risk of another premature birth?

There are things you can do to try and reduce your risk of a premature birth next time, even before you get pregnant again. These include:

  • Stop drinking alcohol, smoking or taking recreational or illegal drugs, ideally before you start trying to get pregnant (although it's never too late to stop). All these things can increase the risk of premature birth during pregnancy. There is a lot of support available if you need help. Find out more about 12 things to do when trying for a baby.
  • Try to maintain a healthy weight by eating a healthy, balanced diet and staying active before (and during) pregnancy. Women who are not at a healthy weight when they get pregnant are more likely to have premature birth.  
  • Try to take care of your mental wellbeing before and during pregnancy as best you can.
  • Some research suggests that severe stress or depression during pregnancy is linked to premature birth, although it’s not clear why. If you have or had a mental health problem in the past and you’re planning to have a baby, try to talk to your doctor before you become pregnant. Find out more about planning a pregnancy if you have a mental health condition
  • f you have a new partner, or you have any symptoms or are worried about STIs, it is important to get tested before pregnancy (or during, if you have a new partner). Some sexually transmitted infections, such as chlamydia and gonorrhoea, can cause premature birth.   
  • Make sure any long-term health conditions, such as diabetes or high blood pressure are well managed before you get pregnant.
  • Go to all your antenatal appointments during your pregnancy. 
  • Protect yourself from infections during pregnancy and make sure you talk to your midwife about any worrying symptoms. This includes vaginal bleeding or pain when you wee – this this can be a sign of a urinary tract infection, which can cause premature labour if left untreated. 

There are more things you can do before pregnancy to make a difference to the health of your pregnancy and baby. Find out more about planning a pregnancy.

Find out more about reducing your risk of a premature birth while you are pregnant

Your mental health

A preterm birth can impact on how you and your partner feel during a next pregnancy. Be kind to yourself. It’s natural to feel some anxiety about how this pregnancy will progress.

If you are struggling with negative feelings, you may need help. Tell your GP and midwife how you feel. They will help you access the support you need.

You can also talk to a Tommy’s midwife free of charge from 9am–5pm, Monday to Friday on 0800 0147 800 or email them at [email protected]

Macdonald, Sue (2017) Mayes’ Midwifery. London, Elsevier Health Sciences UK

BMJ Best Practise. Premature labour. https://bestpractice.bmj.com/

NICE (2015). Preterm labour and birth. National Institute for health and care excellence https://www.nice.org.uk/guidance/ng25

The Royal College of obstetricians and gynaecologists (2018) Alcohol and pregnancy. https://www.rcog.org.uk/en/patients/patient-leaflets/alcohol-and-pregnancy/

Clinical Knowledge Summaries (Aug 2017) Pre-conception advice and management. https://cks.nice.org.uk/topics/pre-conception-advice-management/

Forray A. (2016). Substance use during pregnancy. F1000Research, 5, F1000 Faculty Rev-887. https://doi.org/10.12688/f1000research.7645.1
 
Royal College of Obstetricians and Gynaecologists 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 (Page last reviewed: Nov 2011) 

Wadhwa, Pathik D et al. (2001) The contribution of maternal stress to preterm birth: issues and considerations.” Clinics in perinatology vol. 38,3 (2011): 351-84. doi:10.1016/j.clp.2011.06.007

NHS. Chlamydia complications. https://www.nhs.uk/conditions/chlamydia/complications/ (Page last reviewed: 

NHS. Gonorrhoea complications. www.nhs.uk/conditions/gonorrhoea/complications/ (Page last reviewed: 09/04/2018 
Next review due: 09/04/2018)

Kalinderi K, et al. Urinary tract infection during pregnancy: current concepts on a common multifaceted problem. Journal of Obstetrics and Gynaecology. 2018;38(4):448-453. doi:10.1080/01443615.2017.1370579