Preterm labor is a condition in which your uterus starts contractions( tightening of the womb)and this in turn causes the cervix( the opening of the womb) to thin out and open earlier than normal.
This can lead to your babies being delivered way before they are fully developed. An early delivery can cause your babies to have difficulties with breathing, eating and stabilizing their body temperatures.
Ideally, if you can continue your twin pregnancy to 37 weeks, the chances of your babies having any difficulties or problems with eating, breathing or body temperature regulation are almost entirely eliminated. Premature babies have some additional worries and complications.
Causes of preterm labor
There is no definitive cause of preterm labor. It can occur in active or sedentary women, it can happen in your first pregnancy or your last. Knowing the signs, treatments and precautions that are known at this time can help you in preventing or stopping premature delivery of your twins.
Symptoms of preterm labor
The following list describes signs that have been linked with the beginning of labor.
Uterine contractions Uterine contractions are the tightening and relaxing or the uterine muscle. If you tighten and relax your bicep ( arm ) muscle and feel it with your other hand – you can feel the muscle tighten and then soften. This is how your belly will feel during contractions.
Contractions are normal during pregnancy and become more frequent as time goes on. You may have some a few times a day, usually when you are shifting position. Some are harmless braxton hicks contractions which is your body’s way of practicing. What you are watching for are regular contractions that are coming and going. They may be painless, so don’t assume just because you are not in pain, that they are not contractions. Grab a pen and paper and write down the time each one comes. If the times are rhythmic ie – every 10 minutes, and then every 9 minutes etc. this could be the start of preterm labor. You are looking for a pattern here.
Dull, low backache The backache may come and go or you may feel it constantly.
Cramps that feel like you’re having your period. These cramps occur in the lower belly, just above the pubic bone. They may come and go or be constant.
A feeling of pressure in the lower belly,back or thighs You may feel a ‘heaviness’ in the pelvis, usually in a rhythmic pattern.
Intermittent pains in the belly, back or thighs.
An increase or change in your vaginal discharge. It may become thicker, more watery or start to become blood streaked.
Leaking of fluid from the vagina – watery leaking, you may think it’s urine.
Intestinal cramps , indigestion or diarrhea.
Just a ‘feeling’ that things aren’t quite right.
Detecting preterm labor early on.
The beginning of preterm labor is often very subtle. I was at work having contractions that came and went all day without really noticing it until after dinner. By the time we went in at 28 weeks I was already 5 cm dilated. You may experience some of, or all of these signs. If you have any of the warning signs , even if you are not noticing the contractions, you may still be having silent contractions. YOU know your body – pay attention to it. It’s crucial to the health of your babies.
Monitoring your uterine contractions
It is really important to know how to feel your belly for contractions. First of all, lay down on a bed or a sofa. Place your hands with your fingertips touching your belly. Contractions usually start at the top of your uterus and will feel like a slow tension or tightening. You may even see your belly rise up slightly and then go down as your uterus relaxes. If this is indeed happening, start writing down each time it happens and timing how long each one lasts and how soon the next one comes.
Sometime silent contractions can happen without any warning signs. You should be aware of what a contraction feels like so that you are familiar with them, and then monitor yourself at least a couple of times a day for about half an hour at a time .
If you find that you are experiencing regular contractions – 10 minutes apart or less, for an hour , even while resting – notify your doctor or midwife immediately. If you are bleeding, leaking fluid from your vagina , having a change in your vaginal discharge or heavy contractions you should be calling as well.
Don’t panic. If you experience three contractions or more within a half hour:
1) Lay Down
2) Tilt yourself towards your side , use a pillow behind you for support.
3) Continue to monitor for contractions.
4) Drink a big glass of water ( dehydration can bring on contractions.)
5) Don’t wait any longer than one hour – if they haven’t slowed down or subsided within that time, you may need to be admitted.
If you are worried about, or being monitored for possible preterm labor ( and most twin pregnancies are), here are some precautions that you can take.- increase your resting times– each day , at least twice a day force yourself to rest off of your feet. Resting on your side is helpful and recommended to keep your uterus in a relaxed state. You can also elevate your hips slightly so that there is less pressure on your cervix.
– decrease or quit any strenuous activities– No jogging, running, going up and down stairs.
– No heavy lifting – small children included , laundry baskets, groceries etc.
– No heavy cleaning – even though that ‘nesting’ urge may be kicking in – don’t be scrubbing floors, moving furniture etc.
– Employment – you may need to decrease your hours or stop working early depending on the job you have .
– Sexual activity – it may be advisable to limit or stop depending on your medical condition and how high your chances are for a preterm birth. Just remember, it’s only temporary and you are trying to keep these babies in as long as possible.
– Breast preparation ( breast massage, stimulation, nipple rolling) should be avoided completely until 3 weeks before your due date as this in known to bring on contractions.
–Childbirth classes – if you are attended these , it is wise to not do any of the exercises except the breathing techniques.
Weekly monitoring for preterm labor
If it is determined that you are at high risk for preterm labor you will be seen weekly by your care provider. This can be reassuring. They will measure your uterus for the babies growth, listen to the heartbeats and check your cervix if necessary. They will be able to update you with any differences from the week before.
Follow their advice and be your own best advocate. Remember that many twins come early and if you are not aware of the signs and symptoms of preterm labor you may find yourself in a scary and unexpected situation. Be informed, know the risks and signs.
Bedrest in Pregnancy | Bleeding during Pregnancy | Complications in Twin Pregnancy |