Tommy's PregnancyHub

What happens if I'm told I am at risk of premature birth?

You may be told by your healthcare professional that you are at higher risk of a premature birth. Here’s more about what you can expect if this happens.

What happens if I’m told I am at risk of premature birth?

The care you’ll receive to reduce your risk of giving birth early will depend on why you are at risk.

Prolonging pregnancy (monitoring)

Your healthcare professional will aim to prolong your pregnancy for as long as safely possible. This will give your baby more time to develop in the womb. If so, your condition may be monitored more closely for the rest of your pregnancy. You may also be offered treatment. You may be offered treatment to prevent early birth if:

  • you've given birth at less than 34 weeks pregnant before
  • you've had a miscarriage from 14 weeks pregnant before
  • your waters have broken before 37 weeks, in this pregnancy or before
  • your cervix has been injured in the past, for example through surgery
  • your cervix is shorter than expected (this is usually measured with a scan in your vagina). 

You will need to look out for any signs of early labour. If you go into labour suddenly, it may be possible to delay it. Again, it all depends on why you are at risk. 

Lifestyle changes to prevent premature birth

You may also be given advice about lifestyle changes that you could make to prevent premature birth. For example, smoking increases your risk of premature birth. If you smoke, you will be encouraged to quit. This can be very hard, but there is lots of support available if you need help. 

Find out more about lifestyle factors and premature birth.

Planned premature birth

If your healthcare professional is concerned about the health of you or your baby, they may advise you that giving birth early is the best thing to do. This may mean that labour needs to be started artificially (known as induced labour) or you may be advised to have a caesarean section. Your midwife and doctor will discuss with you the benefits and risks of continuing with the pregnancy versus your baby being born premature.

You can still make a birth plan and discuss your wishes with your midwife or doctor. 

Cervical length scanning

You will likely be referred for a scan of your cervix (neck of the womb). This scan measures the length of your cervix and helps your healthcare professional predict the chances of you giving birth early. 

If your cervix is a normal length (depending on the number of weeks pregnant you are) then your chances of a preterm delivery are low. If your cervix is shorter than normal you may be at higher risk of giving birth early. If this is the case, your doctor will talk to you about what your options are. This may include treatment, such as a cervical stitch or hormones (progesterone). Find out more about prolonging pregnancy (treatment). 

The cervical scan is an internal examination. It involves inserting a probe into your vagina so that it lies next to your cervix. This is the best way to get an accurate measurement of your cervix. The scan is not painful and will not harm your baby. 

The fetal fibronectin test and the QUIPP app

If you are at risk of premature birth, your doctor or midwife may do a vaginal swab test, such as a fetal fibronectin test, a test reviewed by Tommy’s researchers. This can predict if you are at higher risk of giving birth prematurely. Fetal fibronectin is a protein made by babies’ cells in the womb, and acts as a 'glue' that keeps the amniotic sac attached to the lining of the womb. If you destined to give birth early,  the protein may be released into the vagina, where it can be measured using a swab.

Your healthcare professional can use the results of this test (alongside other risk factors you have) to estimate the likelihood that you will give birth early.

What does it all mean for my pregnancy?

If you have been told that you are at high risk of giving birth early, it’s important to take care of your emotional health. Pregnancy can be an emotional experience at the best of times, so it’s important to try to reduce stress as much as possible. 

Find out more about coping with the idea of a premature birth.

NHS. Premature labour and birth. https://www.nhs.uk/conditions/pregnancy-and-baby/premature-early-labour/ (Page last updated 9 December 2020 Next review due: 9 December 2023)

Clinical Knowledge Summaries. Pre-conception advice and management. https://cks.nice.org.uk/antenatal-care-uncomplicated-pregnancy (Last updated February 2019 Next review planned 2021)

The Mid Yorkshire Hospitals NHS Trust. Preventing preterm birth. https://www.midyorks.nhs.uk/download/doc/docm93jijm4n5837.pdf?amp;ver=7152 (Last reviewed: October 2018. Next review due: 2021)