What You Need to Know about Preterm Labor and Premature Birth

Preterm labor and premature birth can happen to anyone, sometimes without warning. There are some common risk factors that increase the chances of preterm labor and premature birth. Knowing these risk factors and the warning signs of preterm labor are important for your health and your baby's health.

About 1 in 10 births in the U.S. are premature. Most premature births are spontaneous. They happen when a pregnant person goes into labor early or their water breaks early. Sometimes, premature births are intentional (or planned). These happen if there are complications that could otherwise cause more harm to the pregnant person or baby.

Although having risk factors increases the chance of preterm labor and premature birth can happen even when no risk factors are present.

What is Preterm Labor?

  • Labor that begins before 37 weeks of pregnancy

Know the Signs of Preterm Labor

  • Mild cramps that may feel like period cramps*
  • Pressure in the belly or pelvis*
  • Low, dull backache*
  • Contractions where the muscles in the belly tighten every 10 minutes or sooner. These may or may not be painful*
  • Vaginal spotting or bleeding
  • Changes in vaginal discharge, such as discharge that is bloody, watery, more than usual, or smells different*
  • Water breaks – this may feel like a gush as if you've wet your pants, or a constant leak, or slow drip from the vagina

*These signs may be normal, but should be evaluated by a health care provider, especially when risk factors are present.

What is a Premature Birth?

  • A birth that happens before 37 weeks of pregnancy

Who is at Risk of Having a Premature Birth?

Pregnant people have a higher risk of premature birth if they:

  • Are younger than 17 years or older than 35 years
  • Are underweight
  • Are carrying more than one baby (twins, triplets, etc.)
  • Had in vitro fertilization or similar assistance in getting pregnant
  • Have extra amniotic fluid (a health care provider would diagnose this)
  • Smoke or use illicit drugs during pregnancy
  • Have had a vaginal infection during the pregnancy
  • Have had vaginal bleeding during the pregnancy
  • Were diagnosed with an infection in pregnancy (urinary tract infection, flu, COVID-19, etc.)

Past pregnancies can also increase risk if the pregnant person had:

  • A premature birth before, or
  • Early cervical shortening or dilation, or
  • An injury to the cervix

If you think you are having preterm labor, call your health care provider. If you don't have a provider, go to the hospital as soon as possible.

Getting prenatal care early (in the first trimester) and throughout the pregnancy is important. It can help find any problems that might lead to preterm labor or premature birth. Prenatal care is even more important for people who have had preterm labor, premature birth, or other complications in earlier pregnancies.

Preterm labor does not always result in a premature birth. If someone goes into labor early, there may be treatments that can delay or stop labor. If labor is too far along to be stopped, premature birth may happen.

Premature births may also happen if there is a complication that puts the pregnant person's life or the baby's life in danger. There are several pregnancy complications that even with medical care may result in early childbirth to protect the pregnant person and their baby.

What Happens if My Baby is Born Early?

The closer a pregnancy is to term (40 weeks of pregnancy), the more likely that baby is to be healthy. Not all babies born early will have the same health issues. Babies born early may be at risk for many possible complications. These can be mild to severe.

  • These may include problems with breathing, feeding, hearing, or vision, delays in meeting developmental milestones like holding their head up or rolling over.
  • There may be permanent developmental problems that may be severe.
  • In some cases, the complications from a premature birth can be fatal to the baby. It is the 2nd most common cause of infant death.

If you have any questions about your pregnancy or your baby's health, please talk with your healthcare provider.

Know Your Rights:

Statement of Medical Assistance Program (Medicaid)

New York State's Medical Assistance Program provides coverage for all income-eligible pregnant persons that live in the state, regardless of immigration status. For more information, visit https://nystateofhealth.ny.gov or talk to the hospital's Patient Billing Services Department.

Statement of Right to Discharge Review

In New York State, all hospitalized patients have certain rights. This includes the right to a discharge review before being discharged from a hospital. If you feel like you are being discharged too soon, you can appeal this decision. The hospital will give you a discharge notice that includes instructions and contact information on how to appeal a discharge.

For more information, visit https://www.health.ny.gov/publications/1449/.

Hospital Requirements for Emergency Medical Conditions

Under the federal Emergency Medical Treatment and Labor Act of 1986 (EMTALA), U.S. hospitals are required to provide care to any patient with an emergency medical condition, regardless of their ability to pay. This includes active labor. Hospitals are required to screen and stabilize the patient. If the patient needs a higher level of care than the hospital can provide, the hospital must transfer the patient to an appropriate hospital.

For more information, visit https://www.health.ny.gov/community/adults/women/

Hospitals and health care providers: Distribution of this fact sheet meets the requirements of PHL 2803-w for preterm labor and premature birth education.