Important: Not every premature birth can be prevented, and having risk factors does not mean you will deliver early. This guide supports—not replaces—personalized prenatal care.
Preterm labor means labor that begins before 37 completed weeks of pregnancy. Early prenatal care can help your clinician identify risk factors and decide whether monitoring or treatment is appropriate for you.
Start With Individual Risk Assessment #
Tell your obstetric clinician early if you have any of the following:
- a previous spontaneous preterm birth;
- a previous second-trimester pregnancy loss;
- a known short cervix or cervical surgery;
- twins or another multiple pregnancy;
- uterine abnormalities;
- vaginal bleeding during pregnancy;
- high blood pressure, diabetes, or another ongoing health condition;
- a current infection; or
- a short interval since your last pregnancy.
Keep prenatal appointments and follow the schedule recommended for your pregnancy. There is no single visit frequency that is right for everyone.
Everyday Steps That Support a Healthy Pregnancy #
- Do not smoke or vape, and avoid secondhand smoke.
- Avoid alcohol and non-prescribed drugs.
- Take medications and supplements only as directed by your prenatal clinician.
- Eat regularly, stay hydrated, and take a prenatal vitamin as recommended.
- Ask what type and amount of physical activity is appropriate for you.
- Seek help for significant stress, anxiety, depression, unsafe housing, food insecurity, or intimate-partner violence.
- Contact your healthcare team when you have symptoms of a urinary, vaginal, dental, or other infection. Do not self-treat with leftover antibiotics.
Bed rest is not a routine way to prevent preterm birth and can have harms. Restrict activity only when your healthcare professional gives you a specific reason and plan.
Treatments Are Based on Your History and Cervical Length #
A clinician may recommend transvaginal ultrasound to measure cervical length when your history or pregnancy indicates it.
Depending on the findings, options may include vaginal progesterone for certain patients with a shortened cervix or cervical cerclage for selected high-risk pregnancies. These are prescription or procedural decisions—not general preventive measures—and should be made with an obstetric or maternal-fetal medicine specialist.
17-alpha hydroxyprogesterone caproate (17-OHPC, formerly sold as Makena) is not recommended for preventing recurrent preterm birth. The U.S. FDA withdrew approval of Makena and its generic versions in 2023 after confirmatory evidence did not show clinical benefit. If you have questions about progesterone treatment, discuss the specific formulation and your individual circumstances with your clinician.
For assisted reproduction, discuss single-embryo transfer when appropriate, because multiple pregnancy increases the likelihood of preterm birth.
Know the Possible Signs of Preterm Labor #
Contact your maternity unit or obstetric clinician immediately—do not wait for the next appointment—if you are under 37 weeks and notice:
- regular or frequent contractions or abdominal tightening;
- new pelvic pressure;
- a constant, dull lower backache;
- menstrual-like cramps;
- a change or increase in vaginal discharge;
- leaking fluid;
- vaginal bleeding; or
- a strong sense that something is wrong.
Emergency evaluation may include checking the cervix, monitoring contractions and the baby’s wellbeing, and testing for ruptured membranes or infection. Medicines such as antenatal corticosteroids or short-term tocolysis are treatments clinicians may use after preterm labor is suspected; they are not treatments to start on your own.
General educational information only; it does not replace advice from your obstetric healthcare team. Medical information reviewed September 2026.
