Multiple pregnancies are considered high risk by nature and you will likely be monitored more closely than someone carrying only one baby. However, you should be familiar with the signs and symptoms of preterm labor so that you can respond quickly and seek appropriate care.
According to the March of Dimes, preterm labor is defined as any labor that occurs between 20 weeks and 37 weeks of pregnancy.
You should familiarize yourself with the the symptoms:
- Contractions (your abdomen tightens like a fist) every 10 minutes or more often
- Change in vaginal discharge (leaking fluid or bleeding from your vagina)
- Pelvic pressure—the feeling that your baby is pushing down
- Low, dull backache
- Cramps that feel like your period
- Abdominal cramps with or without diarrhea
Don’t let anyone tell you that these symptoms are “normal discomforts of pregnancy”! If any of them (you don’t need to have all of them) happen before your 37th week of pregnancy, you need to do something about it.
If you start to have any of these symptoms between 20 weeks and 37 weeks of pregnancy, call your health care provider or go to the hospital right away if you think you are having preterm labor. Your provider may tell you to:
- Come to the office or go to the hospital for evaluation.
- Stop what you are doing and rest on your left side for one hour.
- Drink 2–3 glasses of water or juice (not coffee or soda).
If the symptoms get worse, or don’t go away after one hour, call your health care provider again or go to the hospital. If the symptoms go away, take it easy for the rest of the day. If the symptoms stop but come back, call your health care provider again or go to the hospital.
When you call your provider, be sure to tell the person on the phone that you are pregnant with twins (triplets/quads) and are concerned about the possibility of preterm labor. The only way your provider can know if preterm labor is starting is by doing an internal examination of your cervix (the bottom of your uterus). If your cervix is opening up (dilating), preterm labor could be beginning. Your provider may also perform monitoring to determine if you are having contractions and the frequency.
You and your health care provider are a team, working together to have a healthy pregnancy and healthy babies. Your team works best when both of you participate fully, so your knowledge about preterm labor can be essential in helping to prevent a preterm birth. Talk to your health care provider about all of this, and be sure to keep all of your prenatal care appointments. Preterm birth is one of the complications of pregnancy that health care providers are working hard to eliminate. Your participation in this effort is just as important as theirs!
If you are put on bed rest due to preterm labor, read Surviving Bed Rest.
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