Signs and symptoms of premature labour
Early labour means going into labour before 37 weeks. After this point, your pregnancy is classed as full term.
If you think you may be going into early labour, call the hospital or your midwife straight away for advice. They will usually tell you to go straight to hospital, and they may send an ambulance for you.
It’s very difficult, but try not to panic. In 7 out of 10 cases, the symptoms go away and women give birth at term. More than 9 out of 10 women do not give birth within 14 days of having these symptoms.
What are the signs of premature labour?
If you have any of the following symptoms, call the hospital or midwife straight away, because you could be in labour:
- regular contractions or tightenings
- period-type pains or pressure in your vaginal area
- a "show" – when the plug of mucus that has sealed the cervix during pregnancy comes away and out of the vagina
- a gush or trickle of fluid from your vagina – this could be your waters breaking
Tell your midwife or hospital staff immediately if:
- you are bleeding
- your baby is moving less than usual
- your waters have broken and they are smelly or coloured.
You may have some signs labour has started, but not others. For example, your waters may have broken but with no contractions, or you may have contractions but your waters haven’t broken.
Many women experience Braxton Hicks, sometimes known as practice contractions. These can become quite strong during the third trimester, and it's easy to mistake them for the real thing. They are usually not painful, so it is important to get checked in hospital if you are having painful contractions.
Find out what contractions really feel like.
What happens at the hospital?
The doctor or midwife at the hospital will examine you and offer you tests to find out if:
- your waters have broken
- you’re in labour
- you have an infection.
These tests may include:
- a vaginal examination to check if your cervix is opening
- blood tests to check for infection
- urine tests to check for infection (or protein for pre-eclampsia)
- a check of your pulse, blood pressure and temperature
- feeling your bump to check the baby’s position
- swabs for infections such as bacterial vaginosis and group B strep
- monitoring and recording any contractions
- a check of your baby’s heartbeat
- a vaginal swab (such as a fetal fibronectin test) to see if your body is preparing to give birth.
Your baby’s movements
Your healthcare team should also ask you about your baby’s movements in the last 24 hours. If they don’t, tell them about your baby’s movements. You should continue to feel your baby move in a normal pattern right up to the time you go into labour and during labour. Tell your healthcare professional immediately if you think your baby’s movements have slowed down, stopped or changed.
If your waters have broken early (preterm premature rupture of the membranes – PPROM)
Normally your waters break shortly before or during labour. If your waters break before labour at less than 37 weeks of pregnancy, this is known as preterm prelabour rupture of membranes or PPROM. If this happens, it can (but does not always) trigger early labour.
Find out more about PPROM.
How will I know if my waters have broken?
This may feel like a mild popping sensation and/or a trickle or gush of fluid that you can’t stop, unlike when you wee. You may not have any sensation of the actual ‘breaking’, and then the only sign that your waters have broken is the trickle of fluid.
Find out more about what to expect when your waters break.
What happens if I am in preterm labour?
The midwife or doctor will talk to you about whether it’s best to birth your baby now (either by vaginal delivery or caesarean section) or try to slow down labour using medication. They will consider:
- how many weeks pregnant you are
- you and your baby’s health
- what neonatal facilities are available and whether you need to be moved to another hospital
- what you want to do.
You may need to be moved to a hospital that has facilities for premature deliveries. Find out more about in utero transfer.
Removing a stitch (cerclage) if you have one
If you are going to give birth and have had a transvaginal cervical stitch, you will need to have it removed before your baby is born. This is because there is a risk of it tearing if it is still in place while you are having contractions.
If you had a transabdominal stitch, the healthcare team will prepare for a caesarean section. This is because this type of stitch will prevent the cervix from opening so you will not be able to have a vaginal birth.
Sadly, babies that are born prematurely are more likely to have some health problems. To help reduce the risks you may be offered medication either to delay the birth, or to improve the baby’s health before they are born. Find out more about preparing your baby for a premature birth and giving birth to a premature baby.
What happens if I’m not in labour?
If labour hasn't started, your healthcare professional will investigate what may be causing your symptoms and if you and your baby would benefit from further treatment.
They may sometimes recommend that you stay in hospital so they can monitor you and your baby.
Download the My Prem Baby app
Information and support for parents at risk of preterm birth
NHS. Premature labour and birth. https://www.nhs.uk/conditions/pregnancy-and-baby/premature-early-labour/ (Page last reviewed 9 December 2020 Next review due 9 December 2023)
NHS. Signs that labour has begun. https://www.nhs.uk/conditions/pregnancy-and-baby/labour-signs-what-happens/ (Page last reviewed 30 November 2020 Next update due: 30 November 2023)
NICE (2015). Preterm labour and birth. National Institute for health and care excellence https://www.nice.org.uk/guidance/ng25
Royal College of Obstetricians & Gynaecologists (2019) When your waters break prematurely. https://www.rcog.org.uk/en/patients/patient-leaflets/when-your-waters-break-prematurely/
Royal College of Obstetricians & Gynaecologists (2018) Cervical stitch. https://www.rcog.org.uk/en/patients/patient-leaflets/cervical-stitch/