When to worry about severe abdominal pain in pregnancy with preterm labour

Preterm labour refers to labour beginning before the expected time of birth. Abdominal pain may occur with waves of tightening, lower backache, pelvic pressure, or menstrual-like cramps. A watery trickle or gush may mean the waters have broken, and bleeding can also be present.

Occasional mild tightening can have harmless explanations, but severe pain, a regular pattern, or symptoms that are becoming stronger should not be assessed at home. The maternity team may examine the cervix, check for fluid loss, monitor contractions, and assess the baby.

Contact your maternity unit immediately and describe the pain, its pattern, any tightening, fluid, bleeding, fever, or backache. Use a pad for fluid or bleeding so the team can understand what is happening; do not insert anything into the vagina. Rest while arranging assessment, and take your pregnancy information with you if it is readily available.

Call emergency services for heavy bleeding, severe continuous pain, fainting, breathing difficulty, collapse, or reduced or absent fetal movement. Seek immediate maternity assessment for painful regular tightenings, suspected broken waters, or pain that persists despite rest. Do not wait for contractions to become closer together before calling if you are worried.

Ask how to identify your labour pattern, what to do if fluid leaks again, how fetal movements should be counted, which hospital entrance to use, and whom to call overnight or at weekends.