Abstract
Preterm Labour leading to premature births has remained one of the longest unresolved conundrums in medicine. This "conundrum" of issues surrounding preterm labour and birth appears to be complex. While we continue to accept that preterm birth is difficult to predict, we are being faced with an increasing trend in preterm births owing to the preponderance of the known risk factors in the present day Obstetric population. Health care providers should know that the challenges in handling preterm births and the role of Obstetricians in improving the overall health scenario in this context has to extend beyond mere individual patient care. Adequate sensitisation of both the perinatal care team, smooth referral pathways and providing realistic choices to the family are all important in reaching a rational outcome. Optimising perinatal care for preterm babies will go a long way in achieving the sustainable development goal of ending preventable neonatal deaths.