Braxton-Hicks Contractions (False Labor Pains)

What are Braxton-Hicks contractions?

Known as false labor, Braxton-Hicks contractions may be the first contractions you feel during pregnancy. They can start anywhere from the 20th week on. If you put a hand on your abdomen during a contraction, you can sometimes feel your abdominal muscles tighten and release, becoming hard, then softening again. This is different from feeling the baby move, which you may notice a little before 20 weeks.

For some women, these contractions are painless, while other women experience a short but sharp burst of pain. Think of them as warm-up exercises for your uterus. They are your body's way of getting ready for labor.

Should I be concerned if the contractions get more intense?

Many women find that Braxton-Hicks contractions increase in frequency as their pregnancy progresses. When you are physically active, you may have more Braxton-Hicks contractions than at other times.

Most women first notice these false labor contractions late in the second trimester -- around 24 weeks or so -- but they can become much more common in the last weeks of your pregnancy. The contractions themselves may also last longer and be more intense or painful. This is because the muscles in your uterus are getting stronger in preparation for labor.

How do I tell the difference between Braxton-Hicks contractions and real labor?

It's easy to be fooled into thinking Braxton-Hicks contractions are real labor. Here are the four main differences between Braxton-Hicks contractions and true labor.

  • Timing. Braxton-Hicks contractions tend to be irregular, while real labor contractions tend to follow a regular pattern. For example, you may get two Braxton-Hicks contractions within a few minutes of each other, then not get another one for 10 minutes. Real labor contractions, on the other hand, tend to come at regular intervals.
  • To determine whether it's real labor this time, keep track of your contractions for an hour, measuring from the beginning of one to the beginning of the next. If the contractions come about every five to 10 minutes, it's time to call your doctor.
  • If you get even five or six of these contractions a day, it's worth calling your doctor if you get them before your baby is due. Early labor and delivery can also begin with short, irregular, or relatively low-intensity contractions, and it's important to make sure that the cervix is not opening up prematurely.
  • Length. Braxton-Hicks contractions can be short or long, and they also vary in intensity. One might feel like your abdomen is tightening into a hard ball, while the next might be barely noticeable. Real labor contractions, on the other hand, do not decrease in intensity, tend to last at least 30 seconds at first, and then get progressively longer.
  • Control. Try changing your position or walking around to see if movement affects the contractions. Braxton-Hicks contractions often stop or decrease if you move from sitting to standing or from standing to lying down. If it's real labor, however, the contractions will continue no matter what you do. And in fact, increasing your activity level by moving around or walking may intensify rather than diminish labor contractions.
  • Location. If you feel painful contractions just around the front of your belly, then you're probably experiencing false labor. True labor pain usually starts in the back and moves towards the front.

If you can't be sure whether you are experiencing false or true labor, call your practitioner. False labor contractions don't affect the cervix. But if you experience true labor, your cervix will begin to dilate. Your doctor can check and tell right away whether it's the big day or not.

Expecting false alarms

As your body gets ready for labor, it's not always easy to tell the difference between real labor and your body's effort to prepare for it. The key thing is not to be embarrassed: Get your contractions checked out. It's much better to be safe than sorry, and it doesn't take much for your doctor to examine you and tell you what's really going on.

References

Mayo Clinic. Signs of Labor: Know what to expect. March 2009 http://www.mayoclinic.com/invoke.cfm?id=PR00083

March of Dimes. Abdominal Pain or Cramping. June 2009 http://www.marchofdimes.com/pnhec/159_15241.asp

False Labor. Penn Pregnancy Health Center. http://www.pennhealth.com/health_info/pregnancy/labordelivery/articles/braxhicks.html

University of Michigan Health System. How to Tell When Labor Begins. http://www.med.umich.edu/obgyn/smartmoms/labor/labor/beginning.htm

Shanahan, M. Kelly. Your Over-35 Week-by-Week Pregnancy Guide. Prima Publishing.

Sears, William et al. The Pregnancy Book. Little, Brown and Company.

American College of Obstetricians and Gynecologists. How to Tell When Labor Begins. http://www.acog.org/publications/patient_education/bp004.cfm

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