How to Recognize Preterm Labor Symptoms by By Angela Davids, www.KeepEmCookin.com
An estimated 1 million women per year in the United States will experience preterm labor. That’s about 1 in 4 pregnant women who will ask the question, “Could I really be in labor this early?”
With more than 20 potential and known causes of preterm labor, the answer is often yes. There are obvious contributing factors, such as the use of alcohol, cigarettes, and drugs. Other potential causes are beyond your control, such as an infection or an underlying disease. In about 50 percent of cases, no specific cause is ever found. You may not know your specific risk of preterm labor, but you can be prepared.
There are several options for treating preterm labor, but it is essential that a mom-to-be seeks medical attention in time. During an episode of preterm labor, contractions cause the cervix to soften, shorten, and dilate. Without enough cervix to support the weight of the baby, it may be impossible to stop labor.
Call your healthcare provider immediately if you are less than 37 weeks pregnant and you experience any of the following preterm labor symptoms:
Four or more contractions in one hour, either with or without pain; cramping that may feel like menstrual cramps
Vaginal or rectal pressure; a feeling like the baby could just “fall out”
Increased discharge; loss of the mucus plug
Lower backache that may persist, or come and go
Bleeding of any sort or amount
Leaking fluid; a gush of fluid
Increased bowel movements or diarrhea
A decrease in the baby's activity; fewer kicks
A sense that something just isn't right
One of the greatest challenges of recognizing preterm labor symptoms is that the warning signs can be the same or similar to the normal and expected discomforts of pregnancy. This can make it easy for you—and even your healthcare providers—to overlook the red flags of preterm labor. Here’s how to tell the difference between normal conditions of pregnancy and preterm labor symptoms:
Are These Braxton Hicks Contractions or am I in Labor?
Also called "practice contractions" or "false labor," Braxton Hicks contractions are irregular, and they may stop when you change position, lie down, or drink a few glasses of water. The amount of discomfort or pain can vary from woman to woman. "Real" contractions will come at regular intervals, become more frequent, and won't stop with a change in position or by lying down or drinking water. Contractions may feel like a tightening of your belly, lower back pain, or menstrual cramps. Or all three at once! True contractions will cause your cervix to soften and dilate, which can be checked only with a manual exam or an ultrasound of the cervix. If you are less than 37 weeks along and have had four or more contractions in an hour, call your doctor immediately to see if you should come in to have your cervix checked.
If you are waiting for a return call from your doctor, drink multiple glasses of water and lie down on your left side.
Is This Round Ligament Pain or Preterm Labor Cramping?
Pregnancy brings so many aches and pains that it can be difficult for you tell what is normal. Round ligament pain results from the stretching of the uterus, which is completely normal. But, this type of abdominal pain and sometimes spasms can feel similar to menstrual cramping, which is a sign of preterm labor. Round ligament pains may come on suddenly with movement and may be sharp, or they can stick around and feel dull and achy. The pain will be along the bikini lines, frequently on the right side, and can cause discomfort from the groin to the hips. With the cramping of preterm labor, the pain will be in the area above the pubic bone and below the belly button. You may also have pain in your lower back. You may have other symptoms of preterm labor as well.
Is Bleeding Normal or Should I call my OB?
Bleeding is common, but it is never normal. Consider it a warning and call your doctor at the first sign of bleeding. In the first trimester, bleeding can be a sign of miscarriage, ectopic pregnancy, or other complications. In the second and third trimesters, bleeding can result from placenta previa or placental abruption, or from other threats to the pregnancy. Bleeding following a manual exam or intercourse is generally acceptable, but never hesitate to call your doctor to describe your symptoms. If you are unable to reach your doctor, go to your hospital's emergency room or labor and delivery department. Be prepared to describe the amount of time you’ve been bleeding, how much, and if you are also having any cramping or a fever.
How Can I Tell the Difference Between Urine and Amniotic Fluid?
One way to tell if the wet sensation you're feeling is urine or amniotic fluid is to take note of the smell. You likely know the smell of urine. The smell of amniotic fluid isn't quite so easy to detect. It may be sweet smelling, or odorless. If you aren't sure, consider the quantity and frequency. A small trickle that doesn't stop is likely to be amniotic fluid, and so is that big gush you see in movies. Occasional wetness is likely to be urine. If you have been having contractions and the contractions suddenly become more intense when you stand up or use the bathroom, that also can be a sign that your water has broken. Your doctor can do a simple test in the office to determine if any amniotic fluid is present and can also discuss with you any signs of preterm labor.
Is This Normal Discharge or Am I Losing the Mucus Plug?
A white, thin or milky discharge called leukorrhea is normal in pregnancy, and it can be abundant. It can be odorless or have a mild, inoffensive smell. But, if it is causing itching, burning, or inflammation, it is more likely to be a yeast infection and you should contact your doctor. Also call your doctor if the discharge is any color other than white or it has a bad smell. It may be bacterial vaginosis or a sexually transmitted disease.
If you notice that the discharge has become clear and sticky like egg whites, and you are not yet 37 weeks, it may be a sign of preterm labor. The mucus plug may be deteriorating as the cervix begins to soften and dilate. The mucus plug can be expelled gradually, or in one or more gel-like globs that can appear clear, white, or yellow and may be tinged with blood.
When Should I Call My Doctor?
Never hesitate to call your doctor. If your symptoms continue, call again or go directly to the Labor and Delivery department of your hospital. And don't hesitate to say, "I think this is preterm labor." It's called women's intuition for a reason, ladies! Also, be as descriptive as possible when explaining what you are feeling. Visit www.keepemcookin.com/talk.aspx for sample scripts that will help you best describe your symptoms.
About the author:
Angela Davids is the founder of Keep ’Em Cookin’: Prevent Preterm Birth, an organization that gives women the greatest chance of carrying their babies to term by providing current information on high-risk pregnancy and offering online community support. A mother of two, Angela experienced multiple episodes of preterm labor with both pregnancies. With close monitoring, medication, and bed rest, she carried both babies to term. Visit www.KeepEmCookin.com to learn more, talk with moms on pregnancy bed rest at http://forum.KeepEmCookin.com, and follow Keep ’Em Cookin’ on Twitter at http://twitter.com/KeepEmCookin.
(This article was reviewed by the AskMyObgyn our medical staff in August 2009. Please see our Terms for our policy regarding other websites advertised on this site.)
