Premature Birth: Signs of Preterm Labor, Causes, Risks & What to Expect

What Is Premature Birth?

A “full-term” pregnancy is around 40 weeks, but premature birth means the baby arrives at least three weeks early. Doctors often group preterm births into categories:

• Late preterm: 34–36 weeks
• Moderately preterm: 32–34 weeks
• Very preterm: under 32 weeks
• Extremely preterm: under 28 weeks

The earlier the baby is born, the more help they’re likely to need after birth. A late preterm baby might just need a few extra days of observation, while an extremely preterm baby could spend weeks or months in the neonatal intensive care unit (NICU).

Understanding Preterm Labor

Preterm labor is when your body starts preparing for birth too early. That means contractions, cervical changes, or both, before 37 weeks. Sometimes, doctors can slow or stop it; other times, it progresses quickly. And the tricky part is that the signs can be easy to mistake for normal pregnancy discomforts. This is why it is important to keep your doctor informed about all the symptoms you are experiencing and not just brush them off as normal pregnancy signs. 

Signs of Preterm Labor You Shouldn’t Ignore

Although each pregnancy is unique, there are some warning signs that should always be taken seriously.  Visit the hospital or give your doctor a call if you observe:

• Contractions occurring more than four times per hour even if they are not painful 
• A dull backache that doesn't get better when you sleep
• Pressure in your lower abdomen or pelvis
• Cramps that resemble menstruation
• Abrupt changes in vaginal discharge, such as increased fluidity, wateriness, mucus-like consistency, or blood tinges
•  A trickle or gush of fluid coming from the vagina (perhaps water breaking)
•  An instinct that something is wrong

It's important to follow your gut.  Many parents claim that before the tests proved it, they "just knew" something wasn't right.

Common Causes of Premature Birth

Although the exact cause of an early labor isn't always known, the following factors are more prevalent than others:

• Infections in the mother, particularly infections of the amniotic or urinary tract
• Having multiple births (i.e. twins, triplets, etc.)
• Health issues, such as diabetes or high blood pressure
• Issues pertaining to the cervix or uterus
• Placenta previa and abruption as placental complications
• Early water breaking
• Extremely high levels of mental or physical stress

Moreover, in certain situations, such as in cases of severe preeclampsia, doctors decide to deliver the baby early for the mother's or baby's safety.

Risk Factors for Preterm Labor and Premature Birth

Preterm birth is more likely in some circumstances.  These consist of the following:

• A prior early birth
• Multiple pregnancies
• Pregnancy intervals of less than 18 months
• Insufficient or nonexistent prenatal care
• Using drugs, alcohol, or smoking
• Inadequate nourishment
• Age of the mother under 17 or over 35
• Trauma or ongoing stress
• Some conditions pertaining to reproductive health

These risk factors place a person in a higher-risk category, but they are not guarantees.  In those situations, additional monitoring can have a significant impact.

Health Risks for Babies Born Premature

Because their organs may still be developing, premature babies are more likely to experience health issues.  Among the potential issues are the following:

• Breathing issues brought on by immature lungs
• Having trouble staying warm
• Feeding difficulties brought on by immature swallowing and sucking reflexes
• Increased susceptibility to infections
• Liver immaturity-related jaundice
• Hearing or vision issues
• Failure to meet developmental milestones on time

It's crucial to keep in mind that many premature babies do well in adulthood, particularly if they receive early intervention services.

What to Expect If Your Baby Is Born Premature?

If your baby arrives early, the NICU will likely become your second home for a while. It’s a high-tech, carefully controlled environment, with warm incubators, gentle lighting, and constant monitoring. At first, the sight of your baby hooked up to wires and machines can feel overwhelming. However, you would need to rest assured that this is the best possible option for your baby at this time. The length of the NICU stay depends on your baby’s needs, but the goal is always the same: to get them strong and healthy enough to go home.

Care for Premature Newborns

Learning new routines and paying close attention to cues are common aspects of caring for a preemie.  Among the necessities are:

• Skin-to-skin kangaroo care to aid in temperature regulation and bonding
• Support for feeding—either expressed breast milk or tube feeding until they are able to nurse or bottle-feed
• Regular examinations to track development and growth
• Maintaining strict hygiene at home reduces the risk of infection
• Being patient with milestones because preemies frequently adhere to a timeline that is of “adjusted age”

Before you are discharged, your care team will go over everything with you, including safe sleep practices and feeding schedules.

Can Premature Birth Be Prevented?

While preventing every case is impossible, there are steps that can reduce the risk:

• Maintaining antenatal care
• Consuming a diet high in nutrients
• Taking care of medical issues like diabetes or high blood pressure
• Staying away from drugs, alcohol, and smoking
• Resting and lowering stress levels
• Pregnancies spaced a while apart

Doctors may suggest progesterone therapy or other preventive measures for women who have a history of preterm birth.

Conclusion

One of the most surprising outcomes of a pregnancy can be an early birth.  For both parents and infants, it's a roller coaster of medical difficulties, emotional highs and lows, and a crash course in resilience.  You can feel less surprised if preterm labor occurs if you are aware of the symptoms, the potential causes, and what to do next.

Additionally, keep in mind that they are fighters if your baby does arrive early.  They have a good chance of surviving and even thriving with the help of contemporary neonatal care, your love, and your presence.

Bibliography:

• Defilipo, É. C., Chagas, P. S. D. C., Drumond, C. D. M., & Ribeiro, L. C. (2022). Factors associated with premature birth: a case-control study. Revista Paulista De Pediatria, 40, e2020486.
• Horowitz, S., & Davis, J. M. (2024). Lung injury when development is interrupted by premature birth. In Lung growth and development (pp. 577-610). CRC Press.
• Machado, J. S., Ferreira, T. S., Lima, R. C. G., Vieira, V. C., & Medeiros, D. S. D. (2021). Premature birth: topics in physiology and pharmacological characteristics. Revista da Associação Médica Brasileira, 67(1), 150-155.
• Maluni, J., Oluoch, D., Molyneux, S., Boga, M., Jones, C., Murila, F., ... & Hinton, L. (2025). After neonatal care, what next? A qualitative study of mothers’ post-discharge experiences after premature birth in Kenya. International Journal for Equity in Health, 24(1), 17.
• Morniroli, D., Tiraferri, V., Maiocco, G., De Rose, D. U., Cresi, F., Coscia, A., ... & Giannì, M. L. (2023). Beyond survival: the lasting effects of premature birth. Frontiers in Pediatrics, 11, 1213243.