Prolonged periods without food, decreased macronutrient intake, and certain types of physical activity have all been associated with preterm birth; however no studies to date have linked meal frequency and macronutrient intake with preterm labor. Furthermore, it is not known how frequent these behaviors occur in African American women, who are more likely than other women to experience preterm labor. The aims of the current study were to describe and compare the differences in meal frequency, macronutrient intake, and physical activity between African American women who were diagnosed with preterm labor and African American women who did not have evidence of or report preterm labor. A prospective, longitudinal, descriptive design was used. A sample of 80 pregnant African American women completed the Block 2005 food frequency questionnaire at 24 to 34 weeks gestation. Three 24-hour diet recalls, the International Physical Activity Questionnaire, Perceived Stress Scale, and average step-counts for one week were collected at baseline and six to eight weeks later. Although no significant differences were found in energy intake between the groups, more women in the preterm labor group (72.5%) skipped meals, defined as a period of > 13 hours without food, compared to the term labor group (42.5%) (p = 0.006). The odds of skipping meals were two times higher at time two for women who skipped meals than at time one (OR= 2.01, p = 0.03). Walking was significantly less in the preterm labor group than the term labor group at baseline (p = 0.02). The current study indicates that women who experience preterm labor had prolonged periods without food compared to women without preterm labor, and meal frequency patterns do not change throughout pregnancy. In addition, women in the term labor group had higher levels of walking. The results from this study are particularly important for counseling women during the prenatal period regarding the importance of frequent meal and snack consumption throughout the day. Further research is necessary to establish the mechanisms involved between these factors and preterm labor.