Premature Labor With Twins

Medically Reviewed by Traci C. Johnson, MD on June 08, 2023
3 min read

Also called preterm labor, premature labor is when you start having contractions and true labor after your 20th week of pregnancy and more than 3 weeks before you expect to deliver your babies.

A baby that is born prematurely is much more likely to have health and development problems. It's much better for your babies to have time to grow and develop in your uterus. That's why it's a good idea for every pregnant woman to learn the signs and symptoms of premature labor.

Recognizing the signs and knowing what to do about them increases the chance that you can get help quickly to stop preterm labor. This prevents your babies from being born too early, so your babies have more time to grow and develop in the uterus.

Premature labor can vary between mild to painful symptoms, but there are several warning signs and symptoms. They include:

  • Contractions in your uterus every 10 minutes or more often
  • Tightening or low, dull backache that may be constant or come and go, but changing positions and other comfort measures don't ease it
  • Menstrual-like cramps or lower abdominal cramping that may feel like gas pains, with or without diarrhea
  • Increased pressure in your pelvis or vagina
  • Increased vaginal discharge
  • Leaking of fluid from the vagina
  • Vaginal bleeding
  • Flu-like symptoms such as nausea, vomiting, or diarrhea
  • Less movement or kicking by your babies

Call your doctor right away if you have:

  • Leaking of fluid from the vagina
  • Vaginal bleeding
  • Sudden increase of vaginal discharge

Check for contractions if you have any of these signs of premature labor:

  • Menstrual-like or abdominal cramps
  • Low, dull backache
  • Pelvic or vaginal pressure

Here's how to check for contractions:

  • Lie down -- on your left side if you can.
  • Place your fingertips on your abdomen.
  • Check to see if you can feel your uterus tightening and softening.
  • Use a contraction timer or write down the time at the beginning of one contraction and again at the beginning of the next contraction.

Call your doctor if:

  • You have contractions every 10 minutes or more often that do not go away within an hour after changing your position, relaxing, or drinking 2 to 3 glasses of water.
  • You have any of the warning signs listed above and they get worse.
  • Pain is severe and persistent.

After discussing your signs of premature labor, your doctor may tell you to go to the hospital. Once you arrive, a doctor or nurse will:

  • Check your pulse, blood pressure, and temperature
  • Put a monitor on your abdomen to check your babies' heart rates and your uterine contractions
  • Check your cervix to see if it is opening
  • If your doctor recommends it, you may have a swab lab test called a fetal fibronectin test that tries to predict your risk of delivering the babies soon.

If you are in premature labor, you may need treatment, which may include:

  • Intravenous (IV) fluids (given into your vein)
  • Medicine to relax your uterus and stop labor
  • Medicine to help speed up the development of your babies' lungs
  • Bed rest
  • Being admitted to the hospital

If your labor has progressed and the doctor cannot stop it, you may need to deliver your babies right away.

If you are not in premature labor, you will be able to go home.