Moderate to late premature birth: symptoms & treatment (weeks 32-37)

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What is a moderate to late premature birth? 

Your baby’s development 

Signs and symptoms of labour 

What are the risks of my baby being born at 32 to 37 weeks?

Frequently asked questions

What is a moderate to late premature birth?

Babies born from 32 weeks to before 37 completed weeks are described as being moderate to late preterm. If your baby is born now, the medical conditions linked to prematurity become less serious than if they were born earlier. But they may still need specialist care in the neonatal baby unit.  

You can read about premature birth statistics here.

There are some things that can increase your risk of having a premature birth. This page has more information on what you can do to try and reduce the risk of giving birth early.

Tell your midwife or doctor if you have any symptoms that you are worried about. Do not worry if you've talked about it before and don't be concerned about wasting anyone's time. This is your pregnancy and it's important to trust your own instincts if you feel something isn't right.

If you have any urgent concerns, you should contact your medical team straight away.

For non-urgent support you can call the Tommy’s midwives on 0800 014 7800 (Monday to Friday, 9am to 5pm), or email us at [email protected].

If you are Black or Mixed-Black it is even more important to tell your midwife or doctor if there is anything that you're worried about.  

Do not worry if you've talked about it before and don't be concerned about whether you're wasting anyone's time. This is your pregnancy and it's important to trust your own instincts if you feel something isn't right.

If you feel that you are not being heard get a second opinion. Five X More is a Black maternal health organisation. They have put together 6 steps to help you speak up for yourself in pregnancy.

We run a Black and Black Mixed-Heritage helpline. If you have any concerns book a call and we will support you.

Your baby’s development

Week 32 of pregnancy

Your baby’s lungs have formed and are developing. They may also be dreaming while they’re asleep.

Week 33 of pregnancy

Your baby’s lungs are now fully developed, and they can do things like sucking and grabbing. They can also feel you touching them when you rub your tummy.

Week 34 of pregnancy

Babies are usually growing very quickly now. Their sucking reflex will become stronger during this stage and they will be sucking on their thumbs or fingers.  

Week 35 of pregnancy

Your baby is getting chubbier, which will help them to stay at the right temperature when they're born.  It’s still very important to keep an eye on your baby’s movements. It is not true that babies move less towards the end of pregnancy. You should continue to feel your baby move right up to the time you go into labour and during labour.

Do not wait until the next day to seek advice if you are worried about your baby’s movements. Contact your midwife or maternity unit immediately if you think your baby is moving less, or has stopped moving.

Week 36 of pregnancy

Your baby's lungs are probably mature enough to breathe outside the womb without any help. Your baby will also be able to suck and digest breast milk if they are born now.

Week 37 of pregnancy

Your baby is now ‘full term’, which means that they're probably developed enough, to survive in the outside world without medical intervention.  

Your baby will be trying out different facial expressions, such as frowning and smiling. This is random and not linked to sadness or happiness.

Signs and symptoms of labour

Symptoms of early labour  

Call your midwife or hospital maternity unit straight away if you think you are in early labour. It’s always best to tell your healthcare professional.  

Here are some symptoms of premature labour:

• regular contractions - these often feel like a painful tightening or cramping of muscles in your pelvic area period-type pains
• a gush or trickle of fluid from your vagina – this could be your waters breaking
• backache that's not usual for you.

Find out more about the symptoms of early labour.  

Your mental health  

Being told you are at increased risk of giving birth early can be scary and feel very stressful. It's important to try and take care of yourself emotionally as well as physically.

Bliss is a charity to support parents and families of premature or sick babies. Find out what emotional and practical support is available to you here.

What are the risks of my baby being born at 32 to 37 weeks?

The information below may be difficult to read. If you have any questions about your pregnancy or risk of premature birth, please talk to your doctor or midwife.

You can also call the Tommy’s midwives on 0800 014 7800 (Monday to Friday, 9am to 5pm), or email us at [email protected].

If your baby was born now, they would be classed as moderate to late premature rather than very preterm.   

Your baby’s long-term health will depend on several things, not just the week they were born.  

How much your baby weighs, their gender, and how well you and your baby are when you give birth will all have an impact. Your doctors will talk to you about what your options are and help you make decisions about what’s best for you and your baby.    

The charity Bliss has more information about the tests and care your baby might receive.

Your healthcare team will monitor your premature baby closely to make sure they get the best possible care. It’s important to talk to your health care provider about postnatal care such as feeding, contact with your baby and tests or investigations as soon as possible. This will give you time to understand the information and ask any questions.

Premature birth at weeks 32 to 33

It’s unlikely that your baby will have any severe problems linked to being born prematurely. But they will still need specialist care in the neonatal baby unit.

They will still need help with their breathing but they are much less likely to need intubation (where a breathing tube is placed into the baby’s mouth or nose and into their lungs) than if they were born earlier. 

Instead, they will have small prongs gently put into their nostrils or have a mask put over their nose. This is connected to a machine (called ‘CPAP’ or ‘high flow’) that provides air, with or without extra oxygen, with pressure to make breathing easier for them.

Babies born now often find it hard to keep warm , so they will be placed in an incubator or on a heated mattress in a cot.

Some babies may start to show signs of wanting to feed/suck, but they will not be able to get all the milk they need without some extra help. They will need a thin tube passed through their nose or mouth into their tummy that milk can be given through. They may also need fluids (a ‘drip’) through a thin tube into a vein (intravenous or IV line).  

Your baby will also be tested and may be treated for infection.

Your healthcare team will monitor your premature baby closely to make sure they receive the best possible care.

Premature birth at weeks 34 to 36

If your baby is born now, they are the least likely to have any severe problems associated with being born prematurely. They may still need to go to the neonatal unit for specialist care, if this cannot be provided on the maternity ward with you. They will need to be watched more carefully than full-term babies.  

The risk of any breathing problems is lower, but some babies may need some support. They may need small prongs put into their nostrils or have a mask put over their nose connected to a machine (called ‘CPAP’ or ‘high flow’) that provides air, with or without extra oxygen, with pressure to make breathing easier for them.

Babies born now may find it hard to keep themselves at the right temperature, so they might be placed in an incubator or on a heated mattress in a cot.

Most babies will need support while they are learning to feed. They will need a thin tube passed through their nose or mouth into their tummy that milk can be given through. They may also need fluids (a ‘drip’) through a thin tube into a vein (intravenous or IV line). Some babies may also need support if they develop jaundice.  

Your baby will also be tested and may be treated for infection.

Your healthcare team will monitor your premature baby closely to make sure they receive the best possible care.

Premature birth at week 36 to 37

At this point the risk of any breathing problems is very low, but some babies may still need some support. Some babies may also need support if they are having difficulties feeding or develop jaundice. This care is usually given on the maternity ward.  

Babies born now may not be able keep themselves at the right temperature, so they might be placed in an incubator or on a heated mattress in a cot.

Your healthcare team will make sure your baby gets the best possible care.  

Frequently asked questions

How can I be involved in my baby’s care?

It can be hard to know how you can be a part of your baby’s care in a neonatal unit but being involved can really help you and your baby. Bliss is a charity for babies born premature or sick and they have information and support for how look after your baby on the neonatal unit.

What is ‘intubation?’  

Intubation is when the medical team put a breathing tube through your baby’s mouth or nose and into their lungs. This is connected to a machine called a ventilator. This machine does most or all of the breathing for the baby. Your baby will also be given some medicine into their lungs (surfactant) to help with their breathing.

Am I more likely to have a premature birth if I am having twins / a multiple birth?

Yes. Twins and triplets are more likely to be born prematurely and have a low birthweight. Your risk is also higher if you've given birth prematurely before, or if a cervical length scan found that you have a short cervix. Around 6 in 10 twins are born before 37 weeks. Almost 8 in 10 triplets are born before 35 weeks.

If you are expecting twins or triplets, you will be offered a planned birth at:

• 37 weeks for twins with a placenta each
• 36 weeks for identical twins sharing a placenta
• 35 weeks for an uncomplicated triplet pregnancy
• 32-33 weeks for MCMA twins (monochorionic monoamniotic (MCMA) twins  share both a placenta and a sac – this is a much rarer type of pregnancy).

Your healthcare team will work closely with you throughout your pregnancy and after your babies are born to help make sure you and your babies are safe and healthy.