India has the highest number of preterm births globally, with around 8 out of every 100 babies born prematurely. A preterm birth occurs when a baby is delivered before 37 completed weeks of pregnancy, and preventing it is a key focus during antenatal care.
For many expectant mothers, the idea of going into labour too soon can be worrying. That’s why gynaecologists closely monitor each pregnancy through regular check-ups, scans and screenings to identify any early warning signs and intervene promptly.
Several factors can lead to preterm labour, but they generally fall into three broad categories:
• Spontaneous preterm labour – when contractions start on their own before 37 weeks.
• PPROM – preterm pre-labour rupture of the membranes, where the water bag breaks early.
• Planned preterm labour – when labour is medically induced because it is safer for the baby to be born sooner rather than later. Examples include high blood pressure in the mother (preeclampsia), restricted fetal growth or other maternal complications.
These are some of the recognised preterm labor causes that gynaecologists look for when assessing at-risk pregnancies. In some cases, there may not be a single identifiable reason, but rather a combination of factors like infection, stress, smoking, or previous preterm birth that increase the risk.
If you are less than 37 weeks pregnant and notice certain changes in your body, it’s essential to contact your doctor or maternity hospital right away. Some of the key preterm labour symptoms to watch out for include:
• Regular contractions or uterine tightenings
• Period-like cramps or pelvic pressure
• A gush or continuous trickle of fluid from the vagina – this could be your waters breaking
• Persistent or unusual backache
Even if these signs seem mild, they should never be ignored. Early medical attention can make a significant difference in managing preterm labor symptoms and protecting both mother and baby.
Once you reach the hospital, your care team will perform a series of checks and tests to confirm whether labour has started and to rule out possible complications such as infection or ruptured membranes. This typically includes:
• Checking your pulse, blood pressure, and temperature
• Abdominal examination to assess contractions
• Vaginal examination and cervical assessment
• Urine and blood tests
• Vaginal swabs to rule out infection
• Cardiotocography (CTG) to monitor contractions and the baby’s heartbeat
• Vaginal sonography to measure cervical length
Together, these assessments form part of the preterm labor diagnosis process. They help doctors decide on the right course of action — whether to manage the condition conservatively, admit you for observation or begin treatment to delay delivery.
When there are signs of preterm labour, your doctor may recommend specific treatments to help delay delivery and improve your baby’s chances of a healthy outcome.
• The doctor may offer medicines (tocolytics) to try to slow down or stop labour.
• Steroid injections can improve the baby’s lung maturity and help the baby become ready to breathe.
• Medicine (magnesium sulphate) to protect the baby’s brain, nervous system and prevent cerebral palsy.
These are standard components of preterm birth prevention in maternity practice and are carefully timed depending on the mother’s condition and gestational age.
Your doctor may suggest preventive treatment if you have certain risk factors, such as:
You may be offered treatment to prevent early labour if
• You have given birth at less than 34 weeks pregnant before
• You had a miscarriage at 16 weeks of pregnancy before
• Water has broken before 37 weeks in a previous pregnancy
• If the present pregnancy is twins or triplets
• Cervix has been injured in the past, for example, through surgery
Tests to prevent preterm birth include a vaginal ultrasound between 16 and 24 weeks of pregnancy to measure the length of the cervix. A cervix shorter than 25 mm has been linked to a higher risk of preterm labour and preterm birth. Detecting this allows doctors to intervene before contractions begin.
Doctors may suggest one or more of the following strategies as part of evidence-based preterm labour treatment guidelines:
1. A small tablet of hormone medicine that you put into your vagina
2. An operation to put a stitch in the cervix to help support it
3. Cessation of smoking and substance abuse
4. Prevention of multiple pregnancy
Each of these is part of the current preterm birth prevention and preterm labour treatment guidelines followed by obstetric specialists.
Preterm birth refers to babies born alive before 37 completed weeks of pregnancy. The earlier a baby is born, the higher the risk of complications. Recognising preterm labour causes early helps doctors plan timely intervention and reduce risks.
While 38 weeks is technically term, preventive measures start much earlier for women at risk. Regular antenatal visits, cervical-length scans, prescribed progesterone tablets and avoiding smoking or stress are key steps in preterm birth prevention.
The most common cause of preterm labour is spontaneous onset without a clear trigger, though infections, multiple pregnancy, high blood pressure and cervical shortening are known causes of preterm birth.
Generally, babies born after 34 weeks have a much better outcome. However, each baby is unique. Continuous neonatal care and regular follow-ups ensure the best possible recovery and development for premature infants.
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