That it in the belly and pulls here there is quite normal during pregnancy. But what if a pregnant woman has far ahead of the expected date of labor, which can lead to premature birth?

At what point are Braxton Hicks contractions?

Ms. premature labor

Photo: © istockphoto.com/ skynesher

In Germany, more than 50,000 children each year come too soon for the world as the Professional Association of Gynecologists reported, representing a share of around nine per cent of all babies. Only a minor part of these babies brought intentionally earlier because it is the mother or the child is not good. The greater part of prematurity is not planned and is characterized by premature labor, premature rupture of membranes and a premature opening of the cervix.

but not every woe is threatening: Every pregnant woman has exercise labor, which "trained" the uterus for birth. These harmless pains are also known as pregnancy or Braxton Hicks contractions. They sometimes occur as early as the 20th week of pregnancy around. But sometimes women get early already such contractions that may cause a premature birth induced. This often comes only from before the 24th week of pregnancy, but it is also possible earlier.

Premature labor and exercise can feel very similar: for example, as a slight pull that one might know from menstrual pain and may also extend in the back. Or as a kind of heaviness or a feeling of pressure in the abdomen, sometimes accompanied by a downward pressure. In later pregnancy, women often observe that their abdominal wall is tight and hard for a short time.

Gut feeling does not help in the assessment

The dilemma is this: On the way the contraction feels like, can women themselves do not realize what kind the labor is. The following criteria provide us a first indication (but no more): Are there more than 24 hours spread no more than ten to 15 contractions, take it less than 30 seconds and they come very irregular, the abdomen is hard but the pregnant woman does not feel dragging and no pain, it is often to exercise labor. Other experts indicate the warning criteria for premature labor: two contractions per hour (around 25 weeks) per hour (around 37 weeks), to five contractions them regularly and painful.

Is a woman insecure, they should always consult their gynecologist. Despite the mentioned features premature labor are to be distinguished often neither in nature nor the frequency clearly harmless labor, such as the Swiss gynecologist Professor Bernhard Schüssler of the New Women's Clinic at the Kantonsspital Luzern emphasized.

The decisive factor is the effect

Even should not wait a pregnant woman to the doctor if she has contractions that take longer than half a minute, occur several times per hour, or if they have bloody discharge. The gynecologist can see on ultrasound whether the labor is having an effect. Because practice contractions are of no consequence, real labor but act on the cervix: The cervix is ​​shortened, the cervix becomes softer, the child may slip even deeper into the pool.

Video - obstetricians explains: What is the meaning premature labor?

Test helps predict premature birth

In the diagnosis ie the measurement of the length of the cervix by ultrasound is important. Often labor Schreiber (CTG) is connected, records the strength and number of contractions. Increasing importance gets the so-called. Fibronectin test. The fibronectin is a protein that occurs in the fetal membranes. It is used to bond the amniotic sac with the top layer uterus. As soon as the body of a pregnant woman prepared for the birth, come increasingly fibronectin into the vagina. "Increased levels of fibronectin between the 22nd and the 35th week of pregnancy is an indication of a greatly increased risk of premature delivery, especially at the same time existing labor or a shortening of the cervix," said superintendent Dr. med. Hans-Christian Kolberg from the Department of Obstetrics and Gynecology at St. Mary's Hospital Bottrop.

A negative test, however predicts that an expectant mother with up to 99-percent probability will not release in the next 14 days, as studies have shown. The test can therefore help shorten a hospital stay in a woman in premature labor. The fibronectin smear is so far mainly used in teaching hospitals and perinatal centers. It can be repeated if needed during pregnancy.

What causes preterm labor?

But how it ever comes to a premature labor? Risk factors include previous premature birth or miscarriage, multiple births or frequent pregnancies, placenta previa (placenta before the cervix), a detachment of the placenta, or a lack of care of the child, too much amniotic fluid, infections of the vagina or uterus, particularly young apply or already elderly mother (younger than 18, older than 35 years), artificial insemination, and smoking and alcohol or drug use. Also fibroids or uterine malformations, febrile urinary tract infections, pregnancy-induced hypertension (preeclampsia) or diabetes can have an unfavorable effect, as well as an excessive physical strain.

Restlessness in the soul - unrest in the stomach

Also big fears, frequent anger or constant stress can promote premature labor. "Stress hormones in the body causing, for example, a higher susceptibility to infections. They reduce the blood flow and affect the autonomic nervous system. So infections are more easily possible, which can then provoke a premature birth, "said Dr. Martina Rauchfuß, specialist in gynecology, psychosomatic medicine. "Preterm labor is often an indication that the pregnant women are under too much pressure. So you should look at just how much real problem behind labor, "said the senior physician at the Medical Clinic of the Charité in Berlin and President of the German Society of Psychosomatic Obstetrics and Gynecology (DGPFG).

Sex does not trigger premature labor from

Contrary to the fears of some women sex can incidentally not trigger premature labor. Only with existing preterm labor is discouraged from sexual intercourse because certain messenger substances that are contained in semen, could reinforce this labor.

How is the "labor pains" appeased?

If the gynecologist found in a woman premature birth aspirations, he often recommends a hospital stay or at least bed rest. Usually he does not recommend also from sexual intercourse until the completed 37th week. Is a vaginal infection before, it will be - depending on the cause - removes antibiotic or an antifungal agents as possible. Other underlying diseases (eg. As preeclampsia) are treated. also are often labor inhibitors (Tocolytics), if magnesium in a relatively high dose or progesterone (progesterone) to relax the uterine muscle.

Because the soul often has an impact on preterm labor, argues Dr. Martina Rauchfuß that the "verbal tocolysis" (tocolysis) itself should prevail even more to doctors, "that is, solutions should be found through dialogue."

Depending on how far the premature birth trends have progressed, the doctor sometimes promotes lung maturity in the unborn child. He relies certain medications (for. Example cortisone) so that the child can breathe even in case of premature birth.

Helps a cerclage?

In earlier decades often tried to prevent the effects of premature labor on the cervix with a so-called. Cerclage, a ribbon, which is placed around the 14th to 16th week of pregnancy to the cervix. It should strengthen this until the child was mature birth to the 37th week. But many experts now believe are: The cerclage does not help against premature labor. It is at best displayed when the cervix is ​​too weak to bear the burden of pregnancy. "This is a rare event, such as women whose cervix was changed by biopsies or scrapings. In some women, the cervix is ​​weak "and innate explains gynecologist Dr. Manfred Stumpfe from Geretsried, vice chairman of the Professional Association of Gynecologists in Bavaria.

What can women themselves?

Many midwives recommend on premature restlessness of the uterus, the so-called. Toko-oil lavender, Linaloeholz, marjoram, almond, evening primrose and wheat germ oil contains. It should reassure the womb, when applied to the abdomen. The oil is about midwives and some pharmacies (including online) available.

But that's more peace of mind comes in the abdomen, is also regular, deep relaxation - despite the concern about the premature labor - important. Here methods such as meditation, yoga, autogenous training or progressive muscle relaxation according to Jacobson (PMR) are suitable. "Deep breathing and relaxation reduce the vegetative excitability and avail the same time the baby by improving due to increased blood flow its supply," emphasizes to Dr. Sylvia Börgens, psychologist and Geburtsvorbereiterin.

In addition, smoldering conflicts, physical or mental stress must be alleviated. "The pregnant woman needs about the courage to demand protection and to change print-making situations or to bypass," said Dr. Rauchfuß.