Whilst it is true that we still don’t completely understand what triggers labour to start; there are some things that can increase your chance of giving birth prematurely (before 37 weeks gestation).
Here is a list of reasons why you may experience early labour:
1. Anything that stretches the uterus. The uterus is a muscle, and when it is overstretched it can contract more. Sometimes, these contractions can lead to premature labour. Situations where the uterus may be more distended include:
- Carrying more than one baby
- Having an excessive amount of amniotic fluid
- Large fibroids in the wall of the uterus
- Being pregnant with a very large baby (which sometimes happens when women have poorly controlled gestational diabetes, for example).
2. Having a short cervix. The cervix is what helps hold the uterus closed, and a short cervix (generally defined as less than 2.5 cm long) can increase your risk of giving birth early.
3. Structurally abnormal uterus. A uterus that is only partially developed or that has a septum running down the middle can increase the risk of delivering early. Luckily, most abnormalities can be identified on ultrasound or through other imaging studies.
4. Very closely spaced pregnancies. Women who get pregnant again within 18 months of giving birth are at increased risk of premature delivery. It is not well understood why this happens, but it may be that the woman’s body has not completely recovered (physically and nutritionally) from having recently been pregnant.
5. A previous premature delivery. Having given birth prematurely before (not because of induced labour, but spontaneously going into labour before 37 weeks) is one of the biggest risk factors for delivering early again. If you fall into this category, maintain regular contact with your doctor or midwife, as they will take the necessary steps to help reduce your risk of delivering too soon. Your healthcare provider will probably recommend early screening to check your cervical length, as well as possible progesterone injections (17-hydroxyprogesterone caproate) to reduce the chances of you going into labour early again.
6. Bleeding. Bleeding during pregnancy is often scary, but the reality is there are multiple triggers, so all you can do is schedule an appointment with your healthcare provider to try and establish the cause. Blood in the uterus can irritate it, and when a muscle like the uterus gets irritated, it can contract, possibly leading to premature labour.
7. Smoking and drug use during pregnancy. Smoking and recreational drugs should be avoided by all pregnant women, due to the numerous health risks they pose for both mother and unborn baby. One of these risks is premature labour. This is a modifiable risk factor as the mother can implement lifestyle changes to lower the risk.
8. Untreated infections. Untreated urinary tract infections and sexually transmitted infections can increase the risk of premature labour. It is important to mention any abnormal symptoms to your doctor or midwife.
9. A pre-pregnancy low body mass index (BMI). Women whose BMI is below 19.8 when they conceive are at increased risk of premature labour. If you are underweight and attempting to become pregnant, you should consult a doctor to discuss healthy ways to increase your BMI prior to conceiving. Ensuring that you are a healthy weight at the start of your pregnancy, increases the chances of a trouble-free labour and delivery.
10. Using fertility treatments to conceive. Babies conceived via fertility treatments such as in vitro fertilization (IVF) are more likely to be born prematurely.
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