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Before "true" labor begins, you may have "false" labor pains, also known as Braxton Hicks contractions. These irregular uterine contractions are perfectly normal as long as they are not regular and they happen at term after 37 weeks of the pregnancy. Braxton Hicks contractions  may start to occur as early as the second trimester, although more commonly in the third trimester of pregnancy. They are your body's way of getting ready for the "real thing."

WARNING: Regular contractions before 37 weeks (more than 3 weeks before your due date) are premature and not normal. Anytime you feel contractions before 37 weeks you should let your doctor know right away.

What are Braxton-Hicks contractions?

Braxton Hicks contractions are the female body’s way of preparing for birth. The uterus is often not used to contracting enough to push a seven pound infant out of the body and may need a bit of practice. For a new mom, or even the seasoned mother-to-be, Braxton Hicks contractions can occasionally be difficult to sort out from real contractions, contractions that vare practice versus those that mean it’s time to give birth.

The name "Braxton Hicks" comes from a British doctor, John Braxton Hicks,who was the first to describe the contractions that occur before real labor begins. Can you imagine constantly thinking,"This must be it," and then it wasn't. Doctors and pregnant women have Dr. Hicks to thank for clearing up all the confusion. The following information will help you determine when you are having “the real thing” or Braxton Hicks contractions.

Labor contractions are the body’s way of saying, “Let’s get ready to have a baby!” When contractions start, many new moms jump up and run off to the hospital only to be told to go back home for the night. Painful, stressful and time consuming, labor contractions are what everyone has been waiting for. 

Causes of True Labor Contractions

When the body is ready to push the baby out of the uterus and into the world, a series of changes occur in the brain and body. The brain releases signals that cause oxytocin and prostaglandins to enter the blood stream. These hormones cause labor contractions to begin. At first, many women relate the contractions to Braxton Hicks, gas, or common pregnancy pains, but soon the body starts rolling on a more regular pattern of pain and the scenario changes a bit.

It is important to note that labor contractions come in three forms:

  1. false labor contractions
  2. practice (Braxton Hicks) contractions
  3. active labor contractions

False labor contractions can include a series of contractions that feel very much like active labor contractions but have no effect on cervical dilation and effacement. Practice labor contractions are otherwise referred to as Braxton Hicks contractions and are common from week 32 until birth. Active labor contractions occur during the birthing process and start with regular contractions that thin and open the cervix.

Important Facts about True Labor Contractions

There are six signs that active labor has started and mom needs to monitor the progress of the contractions:

  1. Movement makes the pains stronger or more frequent.
  2. Labor pains increase in strength and frequency over time.
  3. Pains are accompanied by feelings of nausea of intestinal discomfort.
  4. Pain spreads to the lower back, upper abdominals and upper thighs.
  5. The mucus plug (which blocks the opening of the cervix and serves to protect the baby from bacteria during pregnancy) passes or bloody spots appear.
  6. The water breaks.

If any of these signs accompany the labor contractions, the baby is on the way and the attending obstetrician or caregiver needs to be notified.

Treatments for Labor Contractions

Some mothers feel the need to go through labor without pain medications and that choice is completely up to you as long as the baby is being born vaginally. In the case of natural childbirth, you may find relief by walking, shifting position, and breathing through the pain. Otherwise, pain medications can be discussed at the hospital to keep you feeling comfortable throughout active labor.

Causes of Braxton Hicks Contractions

Simply put, pregnancy hormones are to blame for those early onset contractions. The body understands the need to practice a bit for the big day so slowly, but surely, these hormones start the process of teaching the uterus how to contract. 

early labor signs symptoms 

What Do Braxton Hicks Contractions Feel Like?

Braxton Hicks contractions can be described as tightening in the abdomen that comes and goes. These contractions do not get closer together, do not increase with walking, do not increase in how long they last and do not feel stronger over time as they do when you are in true labor. Braxton Hicks contractions do not happen more frequently than 1 or 2  per hour. If you are under 37 weeks pregnant and you have more than 3-4 contractions per hour, please call your doctor right away because they may be premature labor.  

What Do True Labor Contractions Feel Like?

The way a contraction feels is different for each woman and may feel different from one pregnancy to the next. Labor contractions cause discomfort or a dull ache in your back and lower abdomen, along with pressure in the pelvis. Some women may also feel pain in their sides and thighs. Some women describe contractions as strong menstrual cramps, while others describe them as strong waves that feel like diarrhea cramps.

False labor can feel much like active labor, especially for a new mother. Braxton Hicks contractions can begin in the second trimester. These contractions are used to prepare the uterus for actual birth when the time comes. Most often, false labor consists of strong Braxton Hicks contractions. Think of these as exercises for the uterus. 

False labor may present with pains in the abdomen and back as well as a contracting or tightening of the uterus. This is common and expected. False labor does not, however, cause effacement or thinning of the cervix. But pregnant women are not be able to measure their own cervix so how can she tell the difference between false labor contractions and active contractions? Active labor contractions are progressive. They will start off light and progress to stronger, harder pains. The time between contractions also progresses. In the beginning of active labor, contractions come at intervals of 20 to 30 minutes. As labor progresses, the time slowly gets shorter and shorter until contractions come at even intervals of around two minutes.

Walking is another way to tell false labor from real labor. Braxton Hicks contractions tend to ease off when mom walks around or rests. This is not true of real labor contractions. The location of the contractions is different as well. Real contractions tend to present in the lower back and spread to the front of the abdomen. False labor contractions is characterized with pain in the front and pelvic area. 

When in question, always contact the attending physician about pains and contractions. Having questions answered is often enough to keep a pregnant woman from heading to the hospital way too early.

pregnancy labor diagnosis and pain

How Do I Know When Contractions Indicate I am in True Labor?

To figure out if the contractions you are feeling are the real thing, ask yourself the following questions.

Contraction Characteristics False Labor True Labor
How often do the contractions occur? Contractions are often irregular and do not get closer together Contractions come at regular intervals and last about 30-70 seconds. As time goes on, they get closer together.
Do they change with movement? Contractions may stop when you walk or rest, or may even stop if you change positions Contractions continue despite movement or changing positions
How strong are they? Contractions are usually weak and do not get much stronger. Or they may be strong at first and then get weaker. Contractions steadily increase in strength
Where do you feel the pain? Contractions are usually only felt in the front of the abdomen or pelvic region Contractions usually start in the lower back and move to the front of the abdomen

If you have signs of true labor, contact your health care provider immediately. If you are experiencing any of the following you may be in true labor.

  • Contractions (tightening of the muscles in the uterus which cause discomfort or a dull ache in the lower abdomen) every 10 minutes or more in an hour.
  • Regular tightening or pain in your back or lower abdomen.
  • Pressure in the pelvis or vagina.
  • Menstrual-like cramps.
  • Bleeding.
  • Fluid leak.
  • Flu-like symptoms such as nausea, vomiting or diarrhea.

In contrast, if you are having Braxton Hicks contractions, you really don't need to do anything unless they are causing you discomfort. If they are making you uncomfortable try the following:

  • Take a walk. False labor contractions often stop when you change position or get up and walk.
  • Get some sleep or rest.
  • Relax.
  • Drink water, juice or herbal tea.
  • Eat a snack or small meal.
  • Get a massage.

It is essential to call your doctor at any time if you have:

  • Bright red vaginal bleeding.
  • Continuous leaking of fluid or wetness, or if your water breaks (can be felt as a "gushing" of fluid).
  • Strong contractions every 5 minutes for an hour.
  • Contractions that you are unable to "walk through."
  • A noticeable change in your baby's movement or if you feel less than 10 movements every two hours.
  • Any symptoms of contractions if you are not yet 37 weeks.

Important Facts About Braxton Hicks Contractions

Braxton Hicks contractions are different from labor contractions. From week 20 until the end of the pregnancy, the uterus will practice from time to time for the big day. At first, this practice may not even be noticeable to mom, but as time goes on and the baby grows larger, the contractions will get stronger. Typically, Braxton Hicks contractions will last between 15 seconds and two minutes. The contractions are not often evenly spaced like labor contractions and do not increase in frequency and strength as time goes on.

If contractions last longer than two minutes or they become stronger and more frequent over time, it is time to seek medical attention. Early labor can be stopped in some cases with medications that keep the baby growing inside the uterus until the time for labor is right.

Braxton Hicks Contractions True Labor

Irregular in intensity
No cervical changes 

Less than 2-3 minutes apart
Last longer than 30 seconds
Cervix  changes

Treatment for Braxton Hicks Contractions

There is no cure for Braxton Hicks contractions as they are a natural process of pregnancy. When pains occur, you can move from one position to another to keep the pain minimal. These contractions may be preparation tools for the uterus, but you can also use this time to practice breathing and labor techniques you will use on the big day.

Can Braxton Hicks contractions affect baby?

If these are true Braxton Hick contractions and they are not premature labor then they are inlikely to affect the baby. If  they don’t turn into preterm labor, they won’t increase the risk opf preterm birth! In fact, some doctor say these contractions are toning up your uterus and promoting the flow of blood to your placenta, so think of it as nourishing baby.

What’s the best way to treat Braxton Hicks contractions?

Braxton Hicks contractions may occasionally cause more annoyance than pain. And if they arte not actual labor contractions then there is no need to treat them. Mild Braxton Hicks contractions are very common and nothing to worry about, but call your doctor if you're before the 37th week of pregnancy and you feel four or more contractions in an hour—that might be a sign of preterm labor.

What can I do to prevent Braxton Hicks contractions?

You cannot prevent Braxton Hicks contractions. Other than staying well-hydrated and not overdoing it activity-wise, there’s not much to do. Just be on the lookout for signs of preterm labor and you’ll be totally fine.