Risks of Early Labor Health Article

Some preterm labor can't be stopped. In other cases, your doctors may recommend an early birth even though you are not contracting. In this case, you and your care providers will weigh the risks of being born early against the risks to you-and your baby-of staying pregnant in a less-than-perfect situation.

Risks to the Mother

Some medical conditions pose serious risks to the mother (and baby) and require urgent delivery. Severe bleeding (hemorrhage) and infection in the womb (chorioamnionitis) are life-threatening medical complications that can make continuing the pregnancy a greater risk than delivering early. If there is an infection in your uterus, it's dangerous for both you and your baby to stay pregnant. Babies who are born infected have a much more difficult time than those born without an infection. That's why mothers with infections in the uterus are delivered right away.

Other medical conditions are less clear cut. If you have preeclampsia (high blood pressure during pregnancy) or poor blood supply to the placenta, your doctor needs to assess how severe the problem is and weigh the risks of delivering early against the benefits of delivering early. Early in a pregnancy, a placenta with a poor blood supply may be a better option for your baby than being in the neonatal intensive care unit (NICU). As your pregnancy progresses, that balance will change, and, ultimately, your baby will be better to be on the outside. For more information about hypertension in pregnancy, go to the Hypertension in Pregnancy HealthMap.

If none of these medical conditions are present and your membranes (bag of waters) have not broken, then your doctor is likely to recommend delaying delivery until at least the 35th week of pregnancy.

Risks to the Baby

Despite remarkable medical advances in the care of preterm babies, the environment of a mother's womb cannot be matched. Each week that a fetus remains in the womb makes a big difference in the chances of survival. For example:

• A baby born before 23 weeks cannot survive outside the womb.
• A baby's ability to survive outside the womb increases dramatically between 24 and 28 weeks, from about 40% at the beginning of the 24th week to more than 80% four weeks later.
• After the 28th week of pregnancy, more than 90% of babies can survive on their own.

There's also a relationship between the baby's gestational age at birth and the likelihood that he or she will have problems after birth. For example:

• Before the 28th week of pregnancy, almost all babies will have short-term complications, like difficulty breathing. About 20% of these babies will also have some long-term problems.
• For babies born between 28 and 32 weeks of pregnancy, the likelihood of both short and long-term complications begins to decrease. After 32 weeks, the risk of long-term problems is less than 10%.

Steroid medications can help your baby prepare for a possible early delivery. For more information, go to Corticosteroids.

If the fetus is very young, your doctor will probably treat your preterm labor as aggressively as possible to give your baby the best chance of survival. To find out more about how your doctor tries to prolong your pregnancy, go to Treatment of Preterm Labor: Bed Rest and Treatment of Preterm Labor: Tocolytics (medicines used to slow the progression of labor).

If you and your doctor decide that your baby should be delivered, your baby may need to go to the NICU immediately after birth. For more information, go to the Premature Baby HealthMap.

For information about preterm delivery when your pregnancy cannot be prolonged, go to Preterm Delivery.