Preventing preterm labor
A couple of weeks ago, I wrote “The Bed Rest Myth” and promised that a post about preventing preterm labor was in the works. Here is that promised post. To re-cap, I got thinking about preterm labor a little over a month ago. A family member was put on bed rest (at 7 months pregnant) for some worrisome cramping and contracting she was experiencing. Her situation catapulted preterm labor onto my radar screen with big flashing red lights. Since then I’ve spent considerable time digging through the available research, hoping to find some clues that might be helpful to women facing preterm labor (and those hoping to prevent it).
The Role of Inflammation
There is much I could say about preterm labor and the rise of preterm births over the last two decades, but that’s not really what this post is about. What I would like to discuss in detail is a common denominator linking many of the causes of preterm labor—inflammation in the body. It is fairly well known that prostaglandins ripen the cervix and can induce labor. Increased inflammation in the body means an increase of prostaglandins in the body.
The more I dug into the scientific literature about preterm labor, the more and more convinced I became that a large portion of women experiencing preterm labor have heightened levels of inflammation in their bodies from a variety of sources. It became a sort of game. I would discover something that had been shown to increase a woman’s risk of preterm birth and then I would do a search to see whether that particular risk factor also increased inflammation in the body. Over and over I found that it did.
Here are some examples:
1) Stress, anxiety and depression increase risk for preterm labor. (See here, here, and here) And there are links between depression and stress and increased inflammation in the body. As one source explained it simply, “[T]he more depression there is, the more inflammation there is” (Dr. Robert J. Hedaya, “Depression, Inflammation, Immunity and Infection“). (See also here and here)
2) Infections (uterine, placental, urinary tract, and others throughout the body) increase risk for preterm labor. (See here, here, here, and here) I like this basic explanation from Parenting.com: “During a vaginal bacterial infection, for example, the body releases infection-fighting chemicals known as cytokines, which cause inflammation. This inflammation, in turn, launches the release of prostaglandins, which begin the chemical process that initiates contractions and the dilation of the cervix” (Source). A similar inflammatory process takes place in response to all types of infection throughout the body.
3) Magnesium deficiency and vitamin d deficiency increase risk for preterm labor. (See here, here, and here) Research also demonstrates that magnesium and vitamin d both reduce inflammation in the body, while naturally their deficiency increases inflammation. (See here, here, and here)
Doctors have long been aware of the role of inflammation in preterm labor. In fact, one of the treatments commonly suggested to women experiencing preterm contractions is anti-inflammatory drugs like ibuprofen. My family member who was put on bed rest had been told to take large quantities of ibuprofen to keep her contractions at bay. She felt really uncomfortable with the amount she was taking (I was shocked too, especially now knowing the risks associated with ibuprofen consumption during pregnancy… see below). Eventually she asked if she could take less, and then, to her relief, the doctor gave her the go ahead to stop taking them altogether. (And, by way of update, she is no longer on bed rest and her contractions have not produced any cervical dilation. Yay!)
Doctors know that inflammation can produce preterm contractions. So my question is why are they recommending large quantities of drugs like ibuprofen which evidence suggests can lead to miscarriage and birth defects (see here and here) when there are so many other, much safer ways to reduce inflammation in the body?
Reducing Inflammation
So what can pregnant women (or those hoping to become pregnant) do to safely reduce inflammation levels in their bodies and by extension likely reduce their risk of preterm labor? There isn’t a cure-all. But there are simple ways to reduce your risk. And most of them are healthy steps (for anyone) and harmless. I can’t guarantee that doing any of these things will prevent or reduce preterm labor symptoms. I can only assume that they would be helpful through the application of logic according to the facts I have uncovered. I also don’t recommend implementing any of them without first consulting with your midwife or doctor. Some women will continue to have preterm labor even when all preventative measures have been taken. But these things just might help…
1) Reduce stress, anxiety and depression.
If stress, anxiety, and depression can provoke preterm labor, it would make sense to do everything within our power to reduce stress and anxiety levels in our lives and to seek out natural, psycho-therapeutic, or pharmacological anti-depressive aids. You may want to check out “Natural Treatments for Antepartum Depression.”
2) Strengthen the immune system.
A strong immune system will attack infections and eliminate them far more quickly, reducing the amount of time the body has increased levels of inflammation. Check out “Reduce Stress and Strengthen Your Immune System: 10 Natural Ways to Rejuvenate” for some helpful tips for building-up your body’s defenses.
3) Increase low magnesium and vitamin d levels.
What are the best dietary sources for magnesium? Pumpkin seeds, spinach, and swiss chard are some of the best. For more, see here. And I’m partial to sunlight as the ideal source of vitamin d, but supplements are helpful for those who experience real winters or spend a lot of their time indoors. See also my prior blogposts about magnesium (“Magnesium for pregnancy and beyond“) and vitamin d (here and here).
4) Increase your pre-pregnancy fitness level and stay active.
While pregnancy isn’t the ideal time to work on losing excess weight or to start a rigorous exercise program, research does indicate that “high body fat is related to high inflammation and high fitness to low inflammation” (Science Daily, “Fitness Reduces Inflammation“). The ideal would be for women to get into shape prior to becoming pregnant and continue to stay active during pregnancy (with their care providers’ approval). Research has found that moderate prenatal exercise may “be of value in preventing preterm labor.” (See here, here, here, and here) In addition, prenatal exercise has many other benefits discussed in my post “The positive impact of prenatal exercise.”
5) Increase your consumption of anti-inflammatory foods.
I began learning about anti-inflammatory foods about four years ago when I first learned that raw pineapple had anti-inflammatory properties much like over-the-counter pain relievers (such as ibuprofen). I dug deeper into anti-inflammatory foods earlier this year (see my blogpost “Pain, pain, go away“) searching for ways to reduce my daily aches and pains naturally. Rather than taking vast quantities of ibuprofen, you may want to try consuming larger quantities of anti-inflammatory foods such as: olive oil, fish oil (and other omega-3′s), turmeric, sweet potatoes, blueberries (and other berries), papaya, broccoli, cauliflower, cherries, garlic, ginger, almonds, apples, cinnamon, dark chocolate, rosemary, chili peppers, meats from grass-fed animals (if you’re a meat-eater), and more.
You’ll also want to reduce your intake of foods that increase inflammation such as: refined sugars and grains, polyunsaturated vegetable oils (such as safflower, soy, sunflower, corn and cottonseed oil), processed meats, alcohol, MSG, aspartame, and any foods you may be allergic to.
***
My hope is that more and more care providers will begin recommending more natural ways to reduce inflammation to all their clients, particularly those who experience preterm contractions. But, having said that, I also want to make it clear that preterm labor should be taken very seriously. Do not try to self-treat if you suddenly begin to experience possible preterm labor symptoms. The March of Dimes urges:
Call your health care provider or go to the hospital right away if you think you are having preterm labor. The signs of preterm labor include:
- Contractions (your abdomen tightens like a fist) every 10 minutes or more often
- Change in vaginal discharge (leaking fluid or bleeding from your vagina)
- Pelvic pressure—the feeling that your baby is pushing down
- Low, dull backache
- Cramps that feel like your period
- Abdominal cramps with or without diarrhea
(Source: Preterm Labor and Birth: A Serious Pregnancy Complication)
Do you have any other tips for preventing preterm labor naturally? Have you had any luck using any of the inflammation-reducing tips I shared above? I’d love to hear from you.
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Thanks you for this post! I am willing to try all the things you suggested. I have had preterm labor with all of my pregnancies, the last two ending in pPROM at 33 and 31 week. Fortunately they are healthy kids now but I don’t want to go what we went through again. I have had two 17P shots thus far in my current pregnancy but I had a horrible allergic reaction to the last one and won’t be taking them anymore. I am looking forward to eating lots of the foods you suggested and avoid all of the ones that you mentioned to avoid. I am hoping to make it to full term without too man complications but I am already having preterm contractions at 18 weeks.
Busca, your post on inflammation reminds me of my recent visits to my chinese medicine practitioner whose recommendation I needed to rid myself of “phlegm” and “damp” resulted in a major diet change trending toward many of the anti-inflammatory foods you recommended. I bet you’d find the chinese approach interesting.
BTW – YAY! for the advice to avoid yucky oils like canola, safflower etc.
Pregnant women (and all of us) should stick to healthy, stable oils like organic olive, coconut and (gasp!) butter.
Love your posts!
Monna
interesting, thanks
Thanks for this! I had PTL with my first son.
I definitely fell into the infection category with my first. I had a UTI that never cleared up until after he was born. I also was not eating very healthy or exercising or anything positive like that!
These are some great ideas to help moms lower their risk for PTL. Thanks!
WONDERFUL! It took me a while to finally get to read this after you first posted it, but I’m so impressed! I love how you really delve into a subject and learn everything you can about it, and this post was no exception. I’m definitely passing this one on!
This is a great post. It definitely makes sense from what I know of my mother’s experience. My mother was worried about me my whole pregnancy, because she had a really hard time with hers. Her first ended at 24 weeks and the twins didn’t make it; my twin sister and I were born a year later at 31 weeks, and she carried my brother to 37 weeks. She had a really hard time with urinary tract infections during all of her pregnancies, although never had them when she wasn’t pregnant.
Years later she was diagnosed with Lupus, which probably had something to do with her difficulty in carrying a pregnancy. For the past 15 years she has managed it with a vitamin regimen. If she had known then what she does now, she may have been able to avoid the loss of the first set of twins, but I guess that I wouldn’t be here if that was the case…
I had a very healthy pregnancy, which I largely attribute to my efforts to eat a healthy diet before and during pregnancy.
I had preterm labor in March and delivered my son at 37 1/2 weeks at the beginning of April. They have no idea what caused it. I also had a velamentous insertion of the umbilical cord. Although the doctors don’t think this had anything to do with it I still wonder. I’m hoping not to go through it again in any future pregnancies. Once you have had preterm labor you are at increased risk for it in future pregnancies. I found some information that suggests that waiting at least 1 year before conceiving again may decrease the risk.
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That’s a lot of great information to go through. I believe wholeheartedly in the mantra that you are what you eat… which becomes even more crucial when you are pregnant and have your child’s nutrition in mind as well as your own.
Although my last pregnancy was considered high risk (because of age mostly), I felt that nutrition was the one area I could really control that would make the pregnancy healthier despite my age.
Fantastic post! I love most of your tips. I would caution, though, against eating tons of pineapple to reduce inflammation. The bromelaine in raw pineapple can act as a muscle stimulant and strengthen contractions. Many cultures that traditionally eat lots of pineapple discourage its consumption during pregnancy for this reason. :) So maybe the other inflammation-reducing foods would be safer for pregnant women!
Thanks for this blog. I wish I had researched more during pregnancy. Web browsing was no no at work and at home I got too tired. Also, I wanted not to do too much research because I thought I will jinx it, how very stupid. In my case, I think my PTL was because of stress, no emotional suport. Once husband had suddenly became very domaninating about every, mostly my pregnancy. He was acting really weird based on what he is acting now. Everything became a powerstruggle for everyone involved. I still get upset when I think of it…I guess all women go through this- forever remember their pregnancy and in my case forever will feel guilty.