Types of preterm labour

Spontaneous preterm labour starts without a planned decision to deliver and involves regular contractions with changes to the cervix. Preterm prelabour rupture of membranes means the waters break before labour begins and before term; contractions may follow later or may already be present. Medically indicated preterm birth is planned because a problem such as severe maternal illness, placental bleeding or concern about the baby's wellbeing makes early delivery safer.

Some episodes involve contractions that settle and do not lead to birth, while others progress. A clinical assessment may include questions about pain and fluid loss, examination, monitoring of contractions and the baby's heartbeat, and tests chosen by the maternity team.

Call your maternity unit promptly for regular tightening, pelvic pressure, persistent backache, period-like cramps, bleeding, a gush or trickle of fluid, or a change in fetal movement. Note when symptoms began and whether fluid has a colour or smell. Do not place anything in the vagina or delay assessment to see whether symptoms pass.

Depending on gestational age and findings, clinicians may discuss observation, treatment to slow contractions, antibiotics when membranes have ruptured, or an [Antenatal Steroid Injection](/treatments/pregnancy-and-birth-care/antenatal-corticosteroid-injection/) to support fetal lung development. A [Cervical Cerclage](/treatments/pregnancy-and-birth-care/cervical-cerclage/) is used in selected situations involving the cervix, usually before labour starts.

Seek immediate maternity assessment for suspected waters breaking, vaginal bleeding, painful regular contractions, fever, severe abdominal pain, faintness or reduced fetal movement. Infection, placental problems and labour can require rapid treatment. If you cannot reach your maternity unit, use local emergency services.

Ask which pattern is suspected, whether the cervix or membranes have changed, how the baby is being monitored, and what treatments may help in your situation. Discuss where care should take place, what warning signs to watch for at home, and how a possible early birth could affect you and your baby.