A: Pre-term labor is a very worrisome event occurring in nearly 12% of all births. By definition, pre-term birth occurs when the baby is delivered before 37 completed weeks of pregnancy. Physicians still don't know the exact cause of pre-term labor so it is very hard to make recommendations on ways to avoid it. There are no preventative therapies available, and no truly effective treatments once pre-term labor has begun.

We do know that certain women are at high risk of pre-term labor. Typically, these women fall into the following categories:

• Have a history of pre-term delivery
• Have given birth to twins, triplets, or more
• Have experienced vaginal bleeding during pregnancy
• Smoke cigarettes during pregnancy
• Have had prior surgery on the cervix
• Have an active vaginal bacterial infection
• Have an unusually shaped uterus
• Use iIlicit drugs during pregnancy
• Have a kidney infection during pregnancy
• Signs of pre-term labor include:
  Regular, painful uterine contractions—These contractions usually last longer than 30 seconds and come at a regular interval (less than 10 minutes apart).
  
  Increasing vaginal discharge or passage of mucus mixed with blood—Vaginal discharge is common, but a noticeable increase should prompt a call to your doctor. Heavier discharge is the result of contractions pushing secretions out of the uterus.
  
  Leaking watery fluid—Warm fluid leaking out of the vagina on a constant basis, fluid running down your leg, or a large gush of fluid are signs that the bag of water has broken. With this event, labor ensues within 24 hours in most women.
  
  Increasing pelvic pain and pressure—Inordinate pressure, more than before, may be a warning sign of labor. Admittedly, this is a tough symptom to figure out. I have found that many women notice a marked increase in the pelvic pressure in advance of pre-term labor. There are many things you can choose to worry about during pregnancy. And I know many books on pregnancy do a good job of heightening your awareness of all the complications that may occur. Thankfully, very few of them do happen. I hope you will become educated on the risk factors and signs of pre-term labor; this is your best prevention. But I also hope you won't worry yourself unnecessarily. If you are unsure whether or not you are having signs or symptoms of pre-term labor, pick up the phone and call your practitioner.