What are the symptoms of preterm labor you notice first?

Cramping/Contrations. Cramping and contractions are common. Tightening of the abdomen can also be noted. Rhythmic back pain, pevlic pressure, change in vaginal discharge, spotting or bleeding, or large gush of fluid can also be a sign. In any case where there is concern, the pregnant woman should seek immediate care with her OB provider or at an OB facility.