Preterm Labor and Preterm Birth Prevention

Preventing preterm labor and birth is important for the health of your child. Babies born prematurely (before 37 weeks) can be critically ill at birth and experience lifelong health complications, including cerebral palsy, an eye disease called retinopathy of prematurity, undeveloped lungs, and developmental delays. Many of these issues can be avoided if you seek treatment to prevent preterm birth early in your pregnancy.

Preconception Consultation
Prevention can begin before you become pregnant. We offer preconception consultations to women who have a history of delivering a premature baby or who have risk factors or a medical condition that puts them at high risk for preterm labor. These sessions provide insights into the possible reasons a premature birth occurred and offer potential prevention measures for future pregnancies.

Preterm Birth Prevention Plan
If you are pregnant and at elevated risk for preterm delivery, you will meet with a perinatologist who specializes in managing high-risk pregnancies. He or she will evaluate your condition, carefully review your medical history, and develop a comprehensive preterm birth prevention plan. Some medical interventions must be started as early as the first trimester, so it's best to seek care as soon as your baby's heartbeat has been confirmed.

Our goal is to maintain your pregnancy to 37 weeks or beyond.

Lifestyle Counseling

You may benefit from counseling related to weight management, proper nutrition, substance abuse, and smoking cessation.

Psychosocial and Emotional Support

Learning to reduce stress through various strategies may help reduce your risk for preterm birth. 

Cervical Length Imaging

An ultrasound measures the length of your cervix to determine if you are an appropriate candidate for supplemental progesterone or a surgical procedure called cerclage.

Progesterone

This hormone supplement may help reduce your risk of preterm delivery. Depending on your needs, progesterone may be given vaginally in the form of a suppository, capsule or gel, or via weekly injections. Progesterone therapy works best when it is started between weeks 16 and 20 of your pregnancy. 

Cerclage

If an ultrasound indicates you have a weak cervix -- called “cervical insufficiency -- a stitch may be placed vaginally or abdominally to keep the cervix closed and prevent it from opening before the pregnancy reaches full term.

Prenatal Care

Your specialized care to prevent preterm birth will coincide with standard prenatal care that includes fetal monitoring, overall health evaluations for you, and prenatal testing.

Maternal-Fetal Medicine Specialists
Our perinatologists are board certified in obstetrics and gynecology and have completed additional, fellowship training in maternal-fetal medicine. This means they are experts in caring for both the mother and fetus during high-risk pregnancies.

Additional Members of Your Care Team
Your care team will include other specialists at Duke, all of whom work together to keep you and your baby healthy. You may receive care from registered dietitians, clinical social workers, psychologists, and -- once your baby is born -- neonatologists.

Delivery at Duke University Hospital
Our perinatologists can deliver your baby at Duke University Hospital, or we can coordinate your care with your local obstetrician. We do our best to help you have the birth experience you choose.

You May Be Able to Participate in Preterm Birth Prevention Research
These ongoing studies help our perinatologists better understand the causes of preterm birth in hopes of reducing rates in the future.