Previous preterm birth, the strongest single predictor
Short cervical length (under 25mm) detected on ultrasound
Carrying multiples (twins, triplets)
Uterine or cervical abnormalities
Infection or inflammation during pregnancy
Chronic stress, housing instability, or racism-related stress
Smoking, substance use, or inadequate prenatal care
Underweight before pregnancy or poor nutrition during
Black women are 49% more likely to deliver preterm than white women, even when controlling for income and education. This is structural, not individual. Advocate loudly for monitoring if anything on this list applies to you.
If any of these apply to you
Ask your provider directly: "What monitoring is in place for my risk factors?" and "What's the plan if I go into labor early?" Review the signs of preterm labor so you know exactly what to watch for.