Am I Really in Labor?
The threat of premature labor shouldn't cause panic. The majority of preterm babies are delivered between 34 and 36 weeks, and most of them are healthy and need little or no special care after birth. If a baby is born before 32 weeks, however, the prognosis is less optimistic.
After about 30 weeks of pregnancy, many women notice occasional uterine contractions. Called Braxton Hicks contractions, they're normal and usually painless. They tend to occur when you're tired or have just had physical activity, and they usually stop when you rest. True labor contractions come at regular intervals or progressively become more frequent or more painful; Braxton Hicks contractions don't.
You are considered to be in preterm labor when you have uterine contractions every ten minutes (or more often) as well as cervical changes (dilation, thinning, softening) prior to 37 weeks gestation.
In some cases it can be difficult for even a doctor to determine if a woman truly is in labor. Your doctor will probably tell you to go to the hospital (if you're not already there), where you can be monitored carefully. Some women at high risk for preterm labor are given a belt with electronic sensors. This is strapped around the abdomen to detect early contractions. Once or twice a day, the monitor is hooked up to a telephone so it can relay graphs of uterine activity to a nurse. The goal of home monitoring is to detect preterm labor early, when it's most treatable.
Two tests, one that measures hormones in the saliva and another that measures vaginal secretions, can also aid in diagnosing preterm labor. A vaginal ultrasound, which can accurately assess cervical dilation and other cervical changes, may help too.
If your doctor determines that you are truly in labor, she will probably attempt to halt it, unless for some medical reason it's not advisable. (For instance, if you have very high blood pressure or uterine bleeding due to a problem with the placenta, or if there's fetal distress, such as a slowed heart rate that could indicate a lack of oxygen.)