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Labour & Delivery / Pregnancy / Smartmum

Labour Pains Before 37 Weeks: What Should I Do?

Labour Pains Before 37 Weeks: What Should I Do?

Labour Pains Before 37 Weeks: What Should I Do?

Preterm birth may be more common than you thought: about 1 in every 10 babies are born preterm — before the pregnancy reaches 37 weeks. Premature babies suffer a significantly higher risk of infections, respiratory and gut complications, and often require close monitoring in an intensive care unit for an extended period of time.

As such, if you notice the following signs before you’ve reached 37 weeks, it’s best to seek medical attention right away:

  • Moderate pain and contractions similar to period cramps
  • Straw-coloured liquid leaks from vagina
  • Plug of mucus leaks from vagina (called a “show”)
  • Low, dull backache below waistline
  • Pelvic pressure (like the baby is pushing down)

Contractions without Breaking Water

The first thing your doctor will do is to determine whether you’re actually in labour. In addition to monitoring your contractions and your baby’s heartbeat, your doctor may also:

  • Perform an abdominal ultrasound to check the amount of amniotic fluid present and confirm the baby’s growth, gestational age and position
  • Perform a vaginal exam to check the state of your cervix
  • Collect a urine sample from you and take cervical and vaginal cultures to test for infection
  • Test you for foetal fibronectin — a negative result means you probably won’t deliver within 2 weeks

Contractions that aren’t accompanied by pain are Braxton Hicks contractions and will not induce labour. If your doctor concludes that you’re not actually in labour and mother and child appear healthy, you will be sent home.

Even if your labour contractions have started, it doesn’t always mean you have to deliver right away — if your pregnancy is shy of 34 weeks and the baby is shown to be healthy, you’ll be given medication to stop the contractions and prolong the pregnancy, while your baby will be given steroids to speed up the development of its lungs. You’ll be placed under close observation and transferred to a hospital with special neonatal care facilities where possible.

Ruptured Membrane without Contractions

Premature rupture of the membranes (PROM) carries an increased risk of infection. The course of action — whether to induce, delay or wait for the onset of labour — depends on many factors. Your medical team will weigh the risks and give you sound medical advice based on your unique situation.

Weeks 34–37: Late-preterm Labour

If you go into preterm labour between Week 34 and Week 37 and there are no other complications in your pregnancy, the prognosis for your baby is actually quite good. Except for a longer stay in the neonatal unit and perhaps some health issues without long-term effect, your baby will likely grow up just as healthy as full-term babies.

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A/Prof Tan Thiam Chye
MBBS (S'pore), M.Med(O&G) (S'pore) Head & Senior Consultant Department of Obstetrics and Gynaecology KK Women's and Children's Hospital Director (Clinical), Office of Patient Experience Deputy Director (Education), KKH Campus Associate Professor Duke - NUS Graduate Medical School Singapore

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