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Preterm Labor in Pregnancy with Twins or More

What are the Signs of Preterm Labor?


Updated July 14, 2014

A pregnant couple hugging in the kitchen
Cultura/Nick Daly/Riser/Getty Images

From the moment you found out you were having twins or more, the term "preterm labor" started buzzing in your ear. It's true that multiples are at risk of being born early. Statistics show that seventy percent of multiples are born before their due date. With triplets, quadruplets and other higher order multiples, the odds are higher, nearly 100 percent.

Before you get panicked at the inevitability of preterm labor, let's break down the statistics. If you are having "just" twins, you are likely to have full-term, healthy twins within the last few weeks of the third trimester. Of the seventy percent that were reportedly born early, many were born within a few weeks of their due date. Fewer are born severely prematurely at 24-28 weeks.

You can increase your odds by maintaining a healthy pregnancy. (See Ten Things Not to Do When You're Pregnant with Multiples.) Rather than fretting about the possibility of preterm labor, prepare for a positive outcome by educating yourself about the warning signs.

Tune in to your body's cues. Although not every woman knows in advance that she's going into labor, sometimes there are signals that can prompt you to get medical attention. Timely action can make a big difference for your babies.

Here are the common signs of preterm labor. Contact your doctor if you have any concerns about your pregnancy.

  • More than four or five contractions per hour

  • Regular contractions that increase in frequency

  • Rhythmic or persistent pelvic pressure

  • Cramps, similar to menstrual cramping

  • Backache

  • Diarrhea or upset stomach

  • A change in vaginal discharge

  • Vaginal bleeding

  • Uneasy or urgent sense that something is wrong

It's important for all expectant mothers of multiples to be aware of the risks, as well as the signs of preterm labor. Howevever, don't let fear take the joy out of your pregnancy.

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