Assessing Prematurity Risks for Intended Parents

As the birth of your child nears, doctors will begin to pay close attention to your surrogate’s body. While your child is the only one who knows 100% when he or she will be born, there are certain tests that can be done to help doctors get a better sense of if your child will be born prematurely. In addition to watching things like cervical thinning and dilation, doctors can also perform a fetal fibronectin test. Here’s a look at how this test works and what it can reveal.

A fetal fibronectin test is conducted in office by your surrogate’s OBGYN. The test is simple and considered routine. In the test, the care provider will swab the opening of the cervix with a cotton swab. Later, the lab will evaluate the swab to see if there is fibronectin present. Fibronectin is a protein produced by the fetal membranes. This protein serves as a glue to hold the fetal sac to the uterine wall. The protein will begin to appear in the vaginal secretions as the sack separates from the uterine wall in preparation for labor or early in the laboring process.

If the test comes back negative, it is highly unlikely that your surrogate will give birth within the next two weeks.

If the test comes back positive, things can begin to get interesting. While a negative result is highly accurate, a positive fibronectin result is not a reliable predictor of immediate impending labor and birth. However, in the event of a positive read, doctors may take extra precautions such as administering steroids to accelerate lung development in the baby or place your surrogate on bed rest in an event to postpone the onset of labor.

While some doctors will perform these tests routinely, others will only administer them if there is a reason to suspect that birth may be nearing. We routinely see this test performed in women carrying multiples as the pressure on the cervix begins to cause it to dilate. While this cervical dilation may represent early labor, it is often just par for the course with a multiple gestation. For this reason, many doctors will test for fibronectin in conjunction with a change in cervical dilation.

Additionally, doctors may order this test if a woman has irregular contractions that are not clearly definable by early labor or Braxton Hicks (practice) contractions. Having one of these tests done doesn’t have to be a cause for alarm. While some of these tests can be quite accurate, others are only a predictive analytic tool that may not offer a concrete timeline for birth.


Kim Bergman, PhD, a licensed psychologist of 26 years, has specialized in the area of gay and lesbian parenting, parenting by choice and third party assisted reproduction for over two decades. Dr. Bergman has created a comprehensive psychological screening, support and monitoring process for intended parents, surrogates and donors. She is the co-owner of Growing Generations and is a member of the American Society for Reproductive Medicine, the American Psychological Association, the Los Angeles County Psychological Association, the Lesbian and Gay Psychotherapy Association, and the Gay and Lesbian Medical Association. She is on the national Emeritus board of the Family Equality Council. Dr. Bergman writes, teaches and speaks extensively on parenting by choice. Along with co-authors, she published “Gay Men Who Become Fathers via Surrogacy: The Transition to Parenthood” (Journal of GLBT Family Studies, April 2010). Dr. Bergman’s is the author of the book, Your Future Family: The Essential Guide to Assisted Reproduction (Conari Press 2019) as well as the children's book You Began as a Wish (Independent Press 2019). Dr. Bergman created her own family using third party assisted reproduction and she lives with her wife of 35 years. She has two adult daughters.