So, what can cause you to go into labor early? Here`s a question that most mothers are eager to find answers for.
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What Can Cause You to Go into Labor Early?
Premature birth can be caused by medical conditions which involve the fetus, mother or both. Most of the time it`s determined by a combination of several factors. In around 30% of cases, it isn`t discovered a specific cause.
Causes of premature labor include:
- Multiple pregnancies cause around 30% of the cases of premature labor.
- Women with twin pregnancy have an increased risk of complications, both maternal and fetal; they generally give birth before term.
- Infections may lead to preterm birth or premature rupture of membranes.
- Placenta abruption, premature separation of the uterine placenta.
- Drug consumption, such as cocaine or methamphetamine.
- Uterine or cervical problems, such as short cervix, uterine fibroids or a uterus with abnormal shape.
Some pregnancy complications may put the life of the mother or fetus in danger, so it`s necessary to trigger the birth before its term. These are indications for the induction of premature birth and represent 15% to 20% of total preterm births. Whenever possible, medications will be used to trigger natural birth. Still, there are situations when natural birth isn`t recommended, so it will be used Caesarean birth instead.
When Is Preterm Birth Necessary?
- Preeclampsia, which can affect the liver, kidneys, brain and placenta; this medical conditions is caused by pregnancy and consists of an increase of blood pressure and edema occurrence, sometimes leading to a decrease of blood flow to the fetus and the occurrence of seizures in the mother.
- Poor fetal development.
- Placenta praevia, which occurs when the placenta partially covers the cervical canal; in this case, birth isn`t recommended due to a massive bleeding that may occur, putting the life of the mother or fetus in danger; in this case, C-section may be recommended, being performed before the occurrence of contractions; around half of cases of placenta praevia causes births before term.
The immediate recognition of the first signs of premature labor may help in preventing a premature birth. For this reason, 1 – 2 months before the birth term, any woman needs to seek for medical assistance immediately in case of:
- If your water broke.
- Multiple contractions (if there are more than 8 contractions per hour) – these are similar to menstrual cramps and are accompanied by pain and pressure in the abdominal area.
- Constant and diffuse back pain.
- Pelvic pressure and pain.
- Vaginal bleeding.
- Watery vaginal discharges – it may involve amniotic liquid from the uterus due to “water break.”
When to Contact the Doctor?
If there`s any sign of premature labor, it`s recommended to contact the doctor or visit the hospital immediately. A beneficial measure may be to have to obstetrician`s number near you at all times. In case that the future mother may show a risk of premature labor, the specialist may recommend an increased number of prenatal visits.
Sometimes, the causes for premature labor or birth aren`t clear! There are a lot of factors that may be involved:
- Previous experiences of premature labor.
- Pregnancy of twins, triplets or more babies.
- Less than 6 months between pregnancies.
- IVF conception.
- Various uterine, cervical problems or fetal development issues.
- Smoking, alcohol or drug consumption.
- Improper nutrition for fetal development.
- Underweight or overweight before or during pregnancy.
- Stressful life events, such as loss of a close friend or family violence.
- Loss of pregnancy or multiple abortions.
- Physical injury, trauma.
For unknown reasons, black women are more prone to premature births (more info). However, these may trigger for any woman.
Premature labor can have various complications:
- For mothers, except the fact that it starts too early, premature labor is similar to abnormal labor. Unfortunately, the treatments used for delaying labor have a low success rate and may imply pretty serious risks. Therefore, drugs that stop uterine contractions may determine liquid accumulation in the lungs, which may obstruct the breathing process. Other side effects depend on the type of drugs used for stopping labor. For example, some drugs may cause fatigue or muscle weakness. Other may cause palpitations, changes in the levels of blood sugar, headache, nausea or dizziness. In the best case scenario, the drugs recommended by the doctor will take effect in less than 48 hours, the contractions will decrease and the baby`s chances of surviving will increase. Still, the obstetrician will evaluate the possible risks from the use of drugs for both the mother and baby. (Read more about Braxton Hicks contractions here)
- For babies – The complications of premature birth vary depending on how fast the baby is born. Although the survival for babies born between 23 and 26 weeks may be possible, the baby`s chances of survival are lower if the baby is younger.
Complications involving premature birth may include:
- Breathing difficulties.
- Brain bleeding (intracranial hemorrhage).
- Fluid accumulation in the brain (hydrocephalus).
- Cerebral palsy and other neurological problems.
- Vision disorders.
- Gastrointestinal disorders.
- Development delays.
- Learning disabilities.
- Hearing issues.
Less severe complications may involve:
- Yellow skin and sclera – jaundice.
- Decrease in the number of red blood cells (anemia).
- Low blood pressure.
In the case of babies born prematurely, some disorders or difficulties may appear later during childhood or adulthood. Poor school performance can be a first sign. Some studies suggest that little ones born prematurely may have increased chances as during adulthood to develop type 2 diabetes or other cardiovascular diseases. Still, not all babies born prematurely have medical or development issues. Up to 28 – 30 weeks, the risk for severe complications is a lot smaller. When babies born between 32 and 36 weeks are involved, most medical issues which may appear are on short term.
What Will Happen at the Hospital?
When you`ll get to the hospital, you`ll probably feel overwhelmed or anxious, and things may seem out of control. However, the doctor and nurse will explain what will happen with you and the baby. Ask all the questions you need because this will help you make good decisions about your care. – Read more info!
The doctor will probably ask you what happened and if you`ve experienced something similar during previous pregnancies. You`ll receive a consultation which will consist of a vaginal examination and an ultrasound to see if the cervix has shortened and dilated and is ready for birth.
You`ll receive a fetal fibronectin test to see if the premature contractions represent a “false” labor. Unfortunately, this test can only be done in some hospitals.
If the membranes aren`t broken and there are no signs that the labor may have started, you`ll probably be able to go home. Sometimes the symptoms of a premature labor stop and the pregnancy can continue for a longer period of time, this usually happening in almost 50% from all cases during which a pregnant woman has thought she has entered into labor. Still, if labor really started, there are little things that can be done to be stopped.
What Will Happen if Labor Starts?
If you are between 24th and 34th weeks of pregnancy, your doctor will make you steroid injections which will help the baby`s lungs to mature. Tocolytics, the anti-contraction medications that will probably be used at this point, may delay the stages of labor for a few days, enough to complete the treatment with steroids. These medications will act only in certain circumstances, when are administrated during early labor and aren`t usually able to stop a premature labor completely. – Read more!
If the membranes are broken, you`ll receive a test for the GBS infection (group B streptococcus). If the test is positive, you`ll start an intravenous antibiotic treatment which will reduce the risk of transmitting any infections to the baby.
The doctor will monitor the baby`s heart beats. You can ask for a treatment to reduce your pain, although you`ll be advised against the administration of pethidine (meperidine) or other opioid painkillers because they will affect the baby`s respiration. An epidural anesthesia is now perhaps the best option for pain relief.
You can give birth vaginally. If you are over 34 weeks of pregnancy, the obstetrician will probably want to conduct a normal labor. However, a C-section may be recommended if there`ll be any complications, such as fetal distress or massive bleeding.
What Will Happen when the Baby Will Be Born Prematurely?
If the baby is born:
- Between 34th and 36th weeks of pregnancy: he won`t need any treatment. It`s possible to look very small, but he may be able to stay in the salon with you or he may be admitted in the Rehabilitation Unit for premature babies, depending on how well he feeds himself or if he has any problems with any infection, blood pressure or blood sugar.
- Between 32nd and 33rd weeks: the baby will need specialized care because he may experience an infection or he may have breathing or eating issues. The baby will be able to stay with you in the Rehabilitation Unit for premature babies or he`ll be directly admitted Neonatal Intensive Care Unit (NICU).
- Between 28th and 31st weeks: the baby will need specialized care in the NICU. Even though he`ll be stronger than the babies with early ages, he`ll have a moderate risk to suffer from infections, hypothermia or hypoglycemia.
- Under 27 weeks: the baby will need specialized care in the NICU, having a increased risk of hypoglycemia, hypothermia, hypotension and infections, and he`ll need respiratory support.
If your baby will need immediate care, you`ll probably won`t be able to see him as much as you`ll want before he`ll be taken away from you. This may be somehow scary at first and you may feel the need for support. Once the baby is stabilized, you`ll be able to see him as much as you want, even if he is in the intensive care unit. Even so, there are many things that you can do for him, like changing his diapers, petting him, talk to him and probably to keep him in your arms and feed him.
Treatments & Drugs
The treatment may address both women in premature labor and premature born babies.
When mothers are concerned, the treatment depends on how advanced is the pregnancy and how intense is labor. Taking into consideration 2 factors, the obstetrician may recommend:
- Rest – sometimes rest and consuming important amounts of liquid are enough to stop premature contractions.
- Cervical cerclage – if a pregnant woman doesn`t have contractions, but the cervix opens, there`s a procedure, known as cervical cerclage, which may help in preventing premature birth. This involves stitching the cervix strong sutures to maintain it closed. The sutures will be removed during the last month of pregnancy.
- Drugs for delaying labor – in some cases the doctor may recommend some drugs to stop the contractions. These drugs will relax the smooth muscles. These medicinal substances may be administrated by intravenously or intramuscular injection. Unfortunately, usually their effect is on short term.
- Steroid injection for maturing the baby`s lungs – If the pregnancy is of 23 – 34 weeks, the doctor may recommend the administration of an injection with steroids for fetal lung maturation acceleration. After week 34, the fetal lung development is advanced, therefore, the injection of steroids won`t be necessary.