Preterm labor is defined as regular uterine contractions accompanied by cervical change before 37 completed weeks of gestation, and it affects roughly 10% of pregnancies worldwide. It remains the leading cause of neonatal morbidity and mortality, so the nurse who understands tocolytic therapy plays a direct role in improving newborn outcomes. Tocolytics are medications that suppress or delay uterine contractions. Their purpose is narrow and specific: to buy a short window of time, usually 48 to 72 hours, so that antenatal corticosteroids can be given to mature the fetal lungs and so the pregnant person can be transferred to a facility with a neonatal intensive care unit. No tocolytic agent has been shown to improve neonatal outcomes when continued beyond 48 hours. For that reason, prolonged or repeated tocolysis is discouraged, and each agent carries meaningful maternal and fetal risk that must be balanced against any benefit. The decision to begin therapy always rests on a careful risk-benefit analysis. A key principle for examinations and for safe practice is that tocolytics are not used when delivery is actually safer than...