What treatments are used to prevent preterm labor and birth?

Currently, treatment options for preventing preterm labor or birth are somewhat limited, in part because the cause of preterm labor or birth is often unknown. But there are a few options, described in the following sections.

Hormone treatment. Progesterone, a hormone produced by the body during pregnancy, was thought to prevent preterm birth in certain groups at high risk of preterm birth, such as those with a prior preterm birth. NICHD’s Maternal-Fetal Medicine Units Network found that progesterone given to women at risk of preterm birth due to a prior preterm birth reduces chances of a subsequent preterm birth by one-third, when started at 16 weeks of gestation and continued to 37 weeks of gestation.^1,2 Because subsequent research did not show the same effect, use of progesterone to prevent preterm birth is now under review by the U.S. Food and Drug Administration.

Cerclage. A surgical procedure called cervical cerclage is sometimes used to try to prevent early labor in women who have an incompetent (weak) cervix and have experienced early pregnancy loss accompanied by a painless opening (dilation) of the cervix (the bottom part of the uterus). In the cerclage procedure, a doctor stitches the cervix closed. The stitch is then removed closer to the woman's due date.

Bed rest. Contrary to expectations, confining the mother to bed rest does not help to prevent preterm birth. In fact, bed rest can make preterm birth even more likely among some women.^3,4

Women should discuss all of their treatment options—including the risks and benefits—with their health care providers. If possible, these discussions should occur during regular prenatal care  visits, before there is any urgency, to allow for a complete discussion of all the issues.