Premature labour and birth

Premature labour is labour that happens before the 37th week of pregnancy. About 8 out of 100 babies will be born prematurely.

Call your midwife or maternity unit if you're less than 37 weeks pregnant and you have:

  • regular contractions or tightenings
  • 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

You can also call your midwife or maternity unit if you're unsure or worried about anything.

The midwife or hospital will offer checks, tests and monitoring to find out whether:

These may include a vaginal examination, blood test, urine test and cardiotocography to record contractions and the baby's heartbeat.

They'll need to check you and your baby to find out whether you're in labour and discuss your care choices with you.

Planned premature labour

In some cases, pre-term labour is planned and induced because it's safer for the baby to be born sooner rather than later.

This could be because of a health condition in the mother (such as pre-eclampsia) or in the baby. 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 birth partner, midwife and doctor.

If your waters have broken

If your waters have broken (called preterm pre-labour rupture of membranes, P-PROM), there's an increased risk of infection for you and your baby. You'll be offered:

P-PROM does not definitely mean you're going into labour but you may be advised to stay in hospital for a few days. When you go home, you'll be advised to call your midwife or maternity unit immediately if:

If your pre-term labour is planned or unplanned or if your waters have broken prematurely, you may be offered steroid injections.

You'll be offered immediate induction or a caesarean section if:

If your waters have not broken

Your midwife or doctor should discuss with you the symptoms of pre-term labour and offer checks to see if you're in labour. These checks can include asking you about your medical and pregnancy history, and about possible labour signs, such as: 

You may be offered a vaginal examination, and your pulse, blood pressure and temperature may also be checked.

Your midwife or doctor will also check your baby. They'll probably feel your bump to find out the baby's position and how far into your pelvis the baby's head is.

They should also ask about your baby's movements in the last 24 hours. Tell them if you've noticed any changes.

If you're in premature labour

The midwife or doctor may offer:

Slowing down labour or stopping it is not appropriate in all circumstances – your midwife or doctor can discuss your situation with you. They will consider:

You may be offered a course of steroid injections to help your baby's lungs get ready for breathing if they're born prematurely.

Steroids may not be offered after 36 weeks as your baby's lungs are likely to be ready for breathing on their own.

If you're in premature labour and you're 24 to 29 weeks pregnant you should be offered magnesium sulphate (through a drip). This can help protect your baby's brain development.

You may also be offered it if you're in labour and 30 to 33 weeks pregnant. This is to protect your baby against problems linked to being born too soon, such as cerebral palsy.

If you take magnesium sulphate for more than 5 to 7 days or several times during your pregnancy, your newborn baby may be offered extra checks. This is because prolonged use of magnesium sulphate in pregnancy has in rare cases been linked to bone problems in newborn babies. It's very unlikely that you'll be given magnesium sulphate for more than 24 hours.

Treatment to prevent early labour

You may be offered treatment to prevent early labour if:

You'll usually be offered a vaginal ultrasound scan between 16 and 24 weeks of pregnancy to see if treatment may be helpful. The length of your cervix will also be measured, as having a cervix that is shorter than 25mm has been linked to a higher risk of early labour and birth.

There are 2 treatments that may be offered:

Your midwife or doctor will discuss the risks and benefits with you, depending on your circumstances. Treatment usually starts before 24 weeks of pregnancy.

If you have signs of preterm labour, emergency preventative treatment may be considered. Your doctor will discuss the risks and benefits of emergency treatment with you.

What are the risks to my baby of being born early?

Babies born before full term (before 37 weeks) are vulnerable to problems associated with being born premature. The earlier in the pregnancy a baby is born, the more vulnerable they are.

It's possible for a baby to survive if born around 24 weeks of pregnancy onwards.

Babies born this early need special care in a hospital with specialist facilities for premature babies. This is called a neonatal unit. They may have health and development problems because they have not fully developed in the womb.

If your baby is likely to be delivered early, you should be admitted to a hospital with a neonatal unit. 

Not all hospitals have facilities for the care of very premature babies, so it may be necessary to transfer you and your baby to another unit.

Find out about babies who need special intensive care

Twins and multiples

Twins and triplets are often born prematurely. Find out about giving birth to twins.

If you have any reason to think that your labour may be starting early, contact your hospital straight away.