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Preterm labor and birth—or giving birth to a preemie—isn’t well understood. Because doctors don’t fully understand why it happens, there are few reliable ways to completely predict it or prevent it. However, studies have shown that there are ways you can lower your chance of having another preemie.

1. Plan your pregnancies—and space them at least 18 months apart.

Waiting 18 months before you get pregnant again allows time for your body to heal and reduces your chance of having another preterm birth. Pregnancy planning makes sure that you, your family, and your body are prepared for a new addition.

2. Use highly effective contraception as soon as possible after you give birth.

The best way to ensure an 18-month space between pregnancies is to use the most effective methods of contraception, which include the IUD or implant. Talk to your health care provider about what type of contraception is best for you. You can safely start using some forms of contraception before you even leave the hospital.

3. If you delivered early because of preterm labor or because your water broke, talk to your health care provider about taking 17P in your next pregnancy.

Progesterone is a natural body hormone that is important for pregnancy. For women who have a history of preterm birth, a special form of progesterone called 17P can lower your chance of having another preemie.

In fact, 17P is one of the most effective treatments available for women with a history of giving birth to preemies. Studies show that treatment with 17P lowers your chance of another preterm birth by about one-third (30 percent).

Who can get progesterone shots? If you’ve given birth to one preemie (not twins or more) because of preterm labor or because your water broke early, you’re eligible for progesterone shots during your next pregnancy.

Are progesterone shots safe? Studies have shown that progesterone shots are safe for both mother and baby. Your chance of having another preemie may be reduced if you take the shots. Studies have followed babies until they turned four years old, and these studies showed no problems from the progesterone shots.

You may be a little sore in the spot where you get the shot.

How do you get progesterone shots? Your health care provider can prescribe 17P. You will receive progesterone shots each week between 16 weeks and 36 weeks of pregnancy.

There are two forms of the drug:

1. Prepared (compounded) at special pharmacies
2. A brand name drug called Makenaâ„¢

Your health care provider will talk to you about these options and help you choose which form of the drug is right for you.

4. Stay or get to a healthy weight.

Overweight and underweight women have a higher chance of giving birth to preemies. Work with your doctor to achieve a healthy weight based on what your doctor recommends. Don’t get discouraged—even small changes in your weight may lower your chance of giving birth to a preemie.

5. Don’t smoke and don’t use substances that increase your chances of having a preemie.

Smoking increases your odds of having a preemie. The more you smoke, the higher your odds are. Prescription pain medication (opioids) and recreational drugs (like marijuana, cocaine, and methamphetamine) also increase your chances of having a preemie.

If you smoke or use drugs, talk to your health care provider. Your health care provider can give you support and information to help you quit. Don’t give up! Most people try to quit several times before they are successful. There has never been a better time to quit.

• You can get information and support to quit smoking at or by calling the Utah Tobacco Quit Line: 1.800.QUIT.NOW (1-800-784-8669).
• To locate counseling or treatment for substance use, visit or call 1-800-662-HELP (1-800-662-4357).

6. Take care of chronic diseases.

If you have a chronic disease (such as heart disease, diabetes, high blood pressure, or autoimmune disease), work with your health care provider to make sure it is well controlled before your next pregnancy. Treating these diseases before you get pregnant will keep you healthy and may reduce your chance of another early delivery.

7. If you’ve had infertility treatment, talk to your health care provider about ways to lower your chance of having more than one baby (twins or triplets).

Fertility treatment may increase your chance of getting pregnant with more than one baby. Unfortunately, twin and triplet pregnancies are at much higher risk of delivering early. Talk to your health care provider about ways to reduce your chance of multiples. You are more likely to have a healthy pregnancy and baby if you only carry only one baby at a time.

8. Get a personal risk assessment from a specialist.

Before your next pregnancy, see a maternal fetal medicine (MFM) physician. MFM physicians specialize in high-risk pregnancies and preterm birth (giving birth to preemies).

A consultation (where you talk face-to-face with a specialist about your unique situation) will give you specific information on how to reduce YOUR chance of having another preemie.

9. See your health care provider early and regularly during your pregnancy.

When you do get pregnant, see your health care provider early and regularly during pregnancy. Women who receive good prenatal care have a lower chance giving birth to a preemie.

10. Take a multivitamin with folic acid (at least 400 mcg).

Make this a habit! Experts recommend that every woman of childbearing age take folic acid, even if she’s not planning to become pregnant. Long-term supplementation helps prevent certain birth defects and may lower your chance of having a preemie.