true labor or braxton hicks

What are Braxton Hicks contractions?

Braxton Hicks contractions are the body’s way of preparing for birth. The uterus usually does not contract 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.

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. 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. Although labor contractions are what everyone has been waiting for, false contractions can be painful, stressful, and time-consuming.

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.

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.

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 bloodstream and 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 in 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. Braxton Hicks contractions 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.

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 or 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 you should call your doctor or midwife.

Pain relief 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.

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. You may also feel pain in your 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. 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 able to measure their own cervix so can't tell the difference between false labor contractions and active contractions, but here are some signs:

Progression: Active labor contractions are progressive. They will start off light and progress to stronger, harder pains. The time between contractions also progresses. At 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.

Walk it Off: 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.

Location: 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 are characterized by pain in the front and pelvic area. 

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

How do I know when contractions indicate 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
Braxton Hicks Contractions True Labor

Irregular in intensity
No cervical changes 

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

Can Braxton Hicks contractions affect the baby?

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

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

Braxton Hicks contractions may occasionally cause more annoyance than pain. And if they are 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.

Call your doctor if you experience any of these:

  • 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

Read More:
Early Labor Symptoms and Signs
Separating Mom From Baby After Birth Causes Stress
What Happens in the Third Trimester of Pregnancy
Third Trimester Checklist