Pregnant woman experiencing back pain/cramps

Signs of premature labor

Pregnancy is a time filled with happiness, anticipation, and sometimes, uncertainty. As your due date inches closer, you might start thinking about the possibility of going into labor early. About 10% of babies in the U.S. are born prematurely, meaning they’re delivered before 37 weeks.

Risk Factors

In some cases, the cause of preterm labor is unknown. However, certain factors like infection, cervical problems, substance use, and some medical conditions are associated with a higher risk. Knowing the risk factors can give you an idea of how likely you are to experience premature labor.

  • Pregnant with multiples: Preterm birth is also more common with multiples. In fact, it happens more often than not. On average, twins are born at 36.5 weeks, triplets are born at 33 weeks, and quadruplets are born at 31 weeks.
  • Previous premature birth: f you’ve delivered a child prematurely before, you’re more likely to have another preterm birth, even if the initial cause was unknown.
  • Infections: Infection is one of the most common causes of very early preterm birth (between 20 and 32 weeks). This can include uterine, vaginal, and bladder infections, as well as infections in the mouth.
  • High blood pressure: Gestational hypertension (high blood pressure) and preeclampsia can cause pregnancy complications, including preterm birth.
  • Being underweight or overweight: Being underweight or overweight throughout pregnancy can increase a person’s chances of premature labor.
  • Substance use: There are many dangers of smoking/vaping, drinking alcohol, and using drugs during pregnancy, including an increase in the risk of preterm labor.
  • Shortened cervix: As your body prepares for childbirth, your cervix (the opening of your uterus) shortens. When this happens earlier in pregnancy, the chances of delivering a premature baby are higher.

What to look for

There’s no surefire way to tell when you’ll deliver your baby, but it’s good to know the signs of preterm labor.

  • Increased vaginal discharge: If you notice discharge that’s thick and mucousy, watery, or bloody, it could be a warning sign of premature labor.
  • Backache: You may also notice a low, dull backache. The sensation might come and go or be more constant.
  • Pelvic pressure: A feeling of pressure on your lower belly, like your baby is pushing down on your pelvis, can be a sign of preterm labor.
  • Cramps: If you experience severe cramping in your lower abdomen — similar to menstrual cramps but more intense — it could actually be early contractions.
  • Regular contractions: The most obvious sign of premature labor is regular contractions. If you’re contracting as often as every ten minutes, you should contact your healthcare provider right away.

Identifying preterm labor contractions

Bear in mind that premature contractions don’t always mean labor is around the corner. Also, even if you do go into preterm labor, it could be a while until you deliver your baby. Do not be afraid to contact your provider if you have concerns.

That said, it can be hard to know whether you’re contracting, especially if this is your first pregnancy. If you think you’re experiencing early contractions and could be in preterm labor, lie down and place your hand on top of your lower abdomen. If your belly becomes tight and hard and then softens again, it’s a contraction. If this happens six or more times in an hour, it’s time to call your healthcare provider.

Learn more about preterm labor


Reviewed by the Ovia Health Clinical Team
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