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Signs of Premature Labour

There are a number of signs of what might be the onset of premature labour. If you experience any of these signs between weeks 20 to 37 of your pregnancy, consult your health care provider right away or proceed to your nearest labour and delivery department.

  • any cramping or contractions
  • low, dull backache
  • sharp or prolonged pain in the stomach
  • a sudden gush or just a trickle of clear, watery fluid from the vagina
  • intense pelvic pressure
  • bright red blood from the vagina

Additionally, some women may experience the signs of labour 25 weeks into their pregnancy and be convinced that they are having false labour because it seems too early. Moreover, the onset of premature labour may have no symptoms at all.

Signs of labour

Many women worry about false labour and showing up at the hospital too early, only to be sent back home. Others are concerned that they will wait too long, and end up having an unplanned delivery in the car or at home. How do you know what signs and symptoms to look out for? What are the differences between false labour and real labour? When is the right time to call your health care provider or proceed to the hospital? These are questions that almost every pregnant woman is concerned about.

The days leading up to full term labour

In the days before the contractions of labour begin, the uterus is “awakened” and prepared for labour. The cervix starts to soften and ripen. The body goes through a number of changes, such as the following:

  • lightening and engagement, when the baby begins to descend down into the pelvis
  • pressure on the pelvis and rectum, cramps and groin pain, and sometimes a persistent backache
  • more fatigue, or alternatively, sudden spurts of energy
  • thickening of the vaginal discharge
  • diarrhea

False labour

If you have only the following symptoms, you probably are not yet in real labour:

  • irregular contractions that do not get worse or more frequent over time; sometimes they ease with time
  • contractions that are of low intensity or short in duration
  • pain that is confined to the lower abdomen and groin, rather than the lower back

Monitor the contractions to see if they start to increase in frequency and intensity, and watch out for signs of real labour. If you are not sure whether you are in real labour, call your health care provider or the hospital if you are planning a hospital birth, and they will provide you with extra guidance.

Real labour

Real labour is characterized by forceful and painful contractions. Here are a few signs and symptoms of real labour:

  • contractions that get progressively stronger, more regular, and more frequent over time
  • pain in the abdomen and back, which may also spread to the legs
  • release of the blood-streaked mucous from the vagina, referred to as the “bloody show,” if it has not already occurred
  • rupture of the fetal membranes, causing a gush or trickle of amniotic fluid from the vagina

It should be noted that some women experiencing real but premature labour will only feel pain in the back or none at all initially.

When to consult your health care provider

If you have any of the following signs or symptoms, call your health care provider right away or proceed to your hospital:

  • regular contractions that are increasing in intensity and frequency
  • pain that is worse than you anticipated
  • rupture of the fetal membranes: If you feel a gush or trickle of clear fluid from your vagina, it means that your fetal membranes have ruptured. You should obtain medical help if this happens, whether or not you have started feeling labour pains yet. If your fetal membranes rupture before the onset of labour pains -­ a condition known as premature rupture of the fetal membranes ­- the baby could be at risk, and you may need to have labour induced.
  • significant bleeding from your vagina: This is a medical emergency. If you have bleeding (not just spotting) at any time during your pregnancy or when labour begins, you should proceed to a hospital right away.

It’s best to err on the side of caution. So if you think you might be in labour, call your health care provider.

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Last ReviewedReviewed by
July 10, 2006

Nicolette Caccia, MD, FRCSC

Andrew James, BSc, MBChB, FRACP, FRCPC

 
 
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