When To Call a Doctor

Preterm labor can be difficult to recognize. Get the earliest possible medical care for preterm labor by calling your doctor or your nurse-midwife about signs of possible preterm labor.

Any time during your pregnancy

Call your doctor or your nurse-midwife if you have:

• An increase or gush of fluid from your vagina. It is possible to mistake a leak of amniotic fluid for a problem with bladder control or excess cervical mucus.
• Bleeding or spotting from your vagina.
• Painful or frequent urination or urine that is cloudy, foul-smelling, or bloody.

Between 20 and 37 weeks of your pregnancy

Call your doctor, your nurse-midwife, or the labor and delivery unit of your local hospital if:

• You have had regular contractions for an hour. This means about 4 or more in 20 minutes, or about 8 or more within 1 hour, even after you have had a glass of water and are resting.
• You have unexplained low back pain or pelvic pressure.
• You have uterine tenderness, unexplained fever, or weakness (possible symptoms of infection).
• You have intestinal cramping with or without diarrhea.
• The baby has stopped moving or is moving much less than normal. See fetal movement counting for information on how to check your baby's activity.

Watchful Waiting

If you are having painless or mild contractions that are irregular or more than 15 minutes apart:

• Stop what you are doing.
• Empty your bladder.
• Drink 2 to 3 glasses of water or juice (too little body fluid can cause contractions).
• Lie down on your left side for at least an hour, and keep track of how often you have contractions.

Call your doctor if you have had regular contractions for an hour. This means about 4 or more in 20 minutes, or about 8 or more within 1 hour, even after you have had a glass of water and are resting.

If your contractions stop, they were probably Braxton Hicks contractions, which are harmless and normal. Braxton Hicks contractions are often irregularly timed and uncomfortable rather than painful.

Who To See

If you are in premature labor, you may be seen by:

• An obstetrician.
• A perinatologist, also known as a maternal-fetal medicine specialist.
• A family medicine doctor.

You may continue to see your certified nurse-midwife or certified professional midwife, who will consult with one of the doctors listed above.

If it appears that your labor cannot be stopped, you may also see a neonatologist, a doctor who specializes in the intensive care of infants.

To prepare for your appointment, see the topic Making the Most of Your Appointment.