Signs you're going into premature labour

Premature labour (or preterm labour) is labour that starts before 37 weeks.

In general, the more premature a baby is, the greater the chance they will have health problems.

There are treatments that can delay the birth, and treatments to reduce the risk of health problems for babies who are born preterm.

One in 16 women will have a preterm birth. Over 4,500 babies are born prematurely in Ireland every year.

Immediate action required: Go to your nearest maternity unit immediately if you have:

  • a gush of fluid from your vagina or fluid leaking from your vagina
  • a sudden increase in the amount of discharge from your vagina, or sudden change in the type of vaginal discharge
  • cramps that feel like period pain
  • backache - especially if it feels different to the usual backaches you've had during the pregnancy
  • contractions that get stronger and are becoming more frequent
  • a pain in your tummy
  • a sudden feeling of increased pressure in your pelvis or the feeling that your baby is pushing down
  • bleeding from your vagina
  • a 'show' - when you lose your mucous plug and sticky mucus discharges from your vagina (it can be clear or pink)
  • a feeling that something 'is not right'

Contractions and other signs that labour has started

Warning signs during pregnancy

Go to the maternity unit

If you think you may be in premature labour, go to your nearest maternity unit or hospital. Do this even if you had been planning a home birth.

Your baby may need specialised treatment immediately.

How preterm labour is diagnosed

When you arrive at the maternity unit, your midwife and obstetrician may examine you and do some tests. This is to make sure that you're in labour, and check the health of you and your baby.

These examinations and tests may include:

  • checking your temperature, blood pressure and pulse
  • examining your tummy to check your baby’s position, any tenderness in your tummy and to feel any contractions
  • a CTG (cardiotocograph), to measure your baby's heartbeat
  • testing your pee for infection and for protein, which could be a sign of pre-eclampsia
  • examining your vagina to see if your cervix is dilating - this is when the neck of your womb has started to open
  • having a small device called a speculum inserted into your vagina to hold it open so your midwife or obstetrician can see if your waters have broken
  • testing to see if any fluid coming from your vagina is amniotic fluid (the water that surrounds your baby in the womb)
  • a swab from your vagina to test for infection
  • an ultrasound scan to check your baby’s size, position in the womb, and other health indicators

The tests done on you will depend on your particular circumstances and symptoms.

Preterm prelabour rupture of the membrane (P-PROM)

A gush of fluid from your vagina could be a sign of your waters breaking or your membranes rupturing. If your waters break before 37 weeks, this is called preterm prelabour rupture of the membranes (P-PROM). It's not always obvious if this has happened.

Your midwife or obstetrician may need to examine your vagina to check if your waters have broken. They may insert a small device called a speculum into your vagina. This holds it open so it's easier to see inside. They will ask for your consent to do this.

Fluid that has leaked from your vagina may be tested.

If your waters break before labour starts, there may be a risk of infection to you and to your baby. You may be offered antibiotics to reduce this risk. Sometimes you may need to stay in hospital for this.

You might be offered a steroid injection into your muscle. The steroid in the injection helps the baby's lungs and reduces the risk of your baby having breathing difficulties if they're born too early.

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This project has received funding from the Government of Ireland’s Sláintecare Integration Fund 2019 under Grant Agreement Number 123.

Page last reviewed: 4 December 2021
Next review due: 4 December 2024