A brand new chapter to this Edition of the Course Manual. Preterm birth considers the emergency care required in an unplanned preterm birth. The global burden of preterm birth is significant, therefore recognition, investigation and management of preterm birth to optimise condition of the fetus before born is key. Key learning points: Preterm birth rates are increasing globally. Preterm birth is associated with neonatal morbidity and mortality that can be reduced by effective optimisation strategies. Good care requires the accurate diagnosis of preterm labour. Care should be personalised to reduced over-treatment and to improve outcomes. Good communication and planning with the neonatal team, including place and mode of birth, is vital. Good communication and information to support decision making with parents is important.