When you’re pregnant, every twinge, cramp, and contraction can set off a series of questions: Is this normal? Is it time to go to the hospital?
As a labor and delivery nurse, I’ve helped countless moms-to-be navigate this confusing stage, so let’s break it down together. Knowing the difference between Braxton Hicks contractions and real labor contractions can help you feel more confident as your due date approaches.
So let’s chat about all things contractions so you can feel confident about what is ahead!
What is a contraction?
First off, your baby lives inside a big muscle called your uterus. A contraction happens when this uterine muscles flexes and tightens, which during labor will push baby against your cervix causing it to dilate.
If you tighten any muscle, such as on your arm, it feels hard like a rock right? That is the same thing your uterus does. If you feel your belly during a contraction it is hard and then softens as the contraction releases.
Now that you understand what a contraction itself is, let’s talk about what the difference is between a true labor contraction and Braxton Hicks contraction.
What are Braxton Hicks contractions?
Braxton Hicks contractions are often referred to as “practice contractions.” They help prepare your uterus for the big day but aren’t strong enough to start labor. These contractions can start as early as the second trimester, but most women notice them in the third trimester.
Braxton Hicks contractions tend to:
- Be irregular and infrequent.
- Vary in intensity but usually stay mild.
- Stop when you change positions, rest, or hydrate.
- Can be more frequent with a full bladder
Most moms will say that they are uncomfortable, but not painful. And usually you will feel most of the tightening at the top of your uterus, called the fundus.
What are real labor contractions?
Real labor contractions are contractions that come in a regular pattern, are becoming more intense, and are changing your cervix. That last point is the key!
Labor contractions = cervical change
Real labor contractions tend to:
- Start mild and build in intensity.
- Follow a regular pattern (e.g., every 5 minutes for an hour).
- Last longer over time.
All of these points result in your cervix dilating and effacing more so that you progress closer and closer to having your baby!
Understanding Contraction Intensity: Mild, Moderate, and Strong
Mild Contractions
- Feels like menstrual cramps or tightening in your abdomen.
- Usually lasts about 30 seconds.
- Easy to talk through.
If you’re feeling mild contractions, it could be Braxton Hicks or early labor. Really the only way to know which they are is to wait and see if they become stronger or try some of the techniques to lessen contractions that we just talked about such as hydration, rest, and a warm bath.
Moderate Contractions
- Feels like a stronger cramping sensation or tightening that may take your breath away, possibly even some pain in your back
- Lasts around 45-60 seconds.
- May start to feel like there is a pattern or rhythm to their timing
At this stage, pay attention to timing. If your contractions are consistent and about 5-7 minutes apart, it may be time to call your doctor or midwife.
Strong Contractions
- Feels like a deep, intense pressure or tightening that radiates through your back and pelvis.
- Lasts 60-90 seconds.
- Requires focused breathing to manage.
- I like to say that if you are telling your partner to shut up and let you get through this contraction they are pretty intense!
Strong contractions are a hallmark of active labor. If you’ve reached this point, grab your hospital bag and call your provider if you haven’t already.
When should you go to the hospital?
It can be really hard to know when the best time to call your doctor or head to the hospital. I know many new moms have a fear of getting sent home (which is super normal and a lot more common than people realize) so if you have any questions, it is best to check with your provider.
You should go get check out if:
- You are contracting regularly, less than 5 minutes apart for 2 hours
- These contractions are getting more intense and you feel like you have to breath through them
- You feel a gush of fluid like your water broke may have broken
- These contractions are accompanied by bleeding
- You are too uncomfortable to sit during a contraction
- You are feeling decreased movement of your baby
Maybe wait a little longer if:
- Your contractions are irregular and more than 10 minutes apart
- You can tell you are contracting, but they aren’t uncomfortable
- You lost your mucus plug but you are not contracting
These are just guidelines. It is always a great option to call your doctor, advice nurse line, or even your labor and delivery unit to see if you should come in. Often times they will not give you a concrete yes or no (that is your choice to make) but they can walk you through the signs and symptoms you are experiencing.
And if you are heading to the hospital soon, don’t forget to have your hospital bag ready to go! Get your free hospital bag checklist and make sure you have everything you need to have a wonderful experience!
Trust Your Instincts!
Remember, every pregnancy is unique. If something doesn’t feel right, call your healthcare provider—even if it turns out to be a false alarm. As a labor and delivery nurse, I can promise you that we’d rather reassure you than have you stay home when it’s time to deliver your baby.
Understanding the difference between Braxton Hicks and real labor contractions can help you feel more in control as you approach the finish line. Keep monitoring your body, trust your instincts, and don’t hesitate to reach out for support. You’ve got this, mama!