What should you know about established preterm labour?

This is different from occasional tightening that settles with rest. A maternity team may assess contractions, cervical change, bleeding, fluid loss, infection, and the baby’s wellbeing. The timing of labour and your health help determine whether birth should be delayed, whether transfer to a unit with newborn expertise is needed, and which medicines may be appropriate. Established labour can progress quickly, so assessment should not wait for symptoms to become severe.

Contact your maternity unit immediately if you have regular tightening, pelvic pressure, period-like pain, backache, bleeding, or fluid leaking before full term. Do not drive yourself if you feel unwell or labour is advancing. In hospital, clinicians may monitor you and your baby, give fluids or antibiotics when indicated, and discuss medicine to support the baby’s lungs, such as an antenatal steroid injection. A cervical cerclage is relevant only in selected situations and is not suitable once labour or infection is established.

Seek urgent maternity care for suspected preterm labour, vaginal bleeding, a gush or continuous leak of fluid, reduced fetal movement, fever, severe abdominal pain, or an urge to push. Call emergency services if you cannot reach your maternity team or feel faint, breathless, or seriously unwell.

Has my cervix changed, and what monitoring do I need? Could delaying birth help, and what are the reasons to deliver now? Would an antenatal steroid injection or newborn-unit transfer be advised?