When you near the end of your pregnancy after loss, your first instinct might be to rush to your birthing facility at any sign of labor. Before you activate your birth team, though, it’s best to evaluate the surges you’re feeling and try to determine if they’re Braxton Hicks or true contractions. This is especially true if being at the hospital — where there is the potential for lots of waiting and uncertainty — is triggering for you.

Pregnant belly - Braxton Hicks or Contractions: What You Need to Know

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If you go to your birthing facility and it turns out you’re not in labor, being sent home and returning at a later time or on another day can cause anxiety. When you’re familiar with the signs of true labor, you can be in the environment that’s most comfortable for you.

In addition, knowing when your contractions are real is helpful if you’re at risk for premature labor. Because a baby born before 37 weeks can have health problems, it’s important to learn the key differences between false and true labor and keep track of them. If you do go into true labor early, you’ll want to get the medical help you need as quickly as possible[1]“Contractions and Signs of Labor,” March of Dimes, December 2018, https://www.marchofdimes.org/pregnancy/contractions-and-signs-of-labor.aspx.

So, how do you know if contractions are true or false? Read on for an explanation of the differences between Braxton Hicks and real labor.

What are Braxton Hicks Contractions?

Often called false or prodromal labor, Braxton Hicks contractions happen before real labor starts. They can begin in the first trimester, but you usually won’t notice them until the second or third trimester. These irregular, unpredictable contractions prepare the body for labor, though they do not cause the cervix to expand, and are pretty common late in pregnancy[2]Braxton Hicks Contractions, Raines DA, Cooper DB, Updated 2021 Jan 29. https://www.ncbi.nlm.nih.gov/books/NBK470546/.

Braxton Hicks contractions can be confusing because they can be umcomfortable as the uterus tightens, making you think you’re in labor when you’re not[3]“How to Tell When Labor Begins,” The American College of Obstetricians and Gynecologists, May 2020, https://www.acog.org/womens-health/faqs/how-to-tell-when-labor-begins. You might feel these practice contractions more in the evening or after physical activity, but they do not increase in intensity or grow closer together.

What Happens During Real Labor?

When labor begins, the uterus contracts and relaxes consistently. These surges follow a pattern, and their purpose is to dilate the cervix, allowing it open and making room for the baby to move down and through the birth canal.

Gestational parents often liken the sensations of early labor to menstrual cramps. As labor moves into the active and transition phases, contractions intensify, getting longer and stronger. It’s common to feel contractions in the back and abdomen. Other signs of true labor are bloody discharge and your water breaking.

How Can I Tell the Difference Between False Labor and True Labor?

There are several distinct differences. As a loss parent, you’ll want to understand the characteristics of each. Here is a summary of the key differences between true labor and false labor[4]“False Labor,” American Pregnancy Association, https://americanpregnancy.org/healthy-pregnancy/labor-and-birth/false-labor/.

Frequency and Timing of Contractions

When you are in real labor, contractions occur regularly, coming at intervals that have a pattern. As labor progresses, contractions get closer together, meaning the amount of time between them decreases. Each surge lasts about 60-90 seconds. On the other hand, there is no pattern to Braxton Hicks contractions, and they do not get closer together.

Strength of Contractions

True contractions increase in intensity, gradually becoming stronger as labor continues. With false labor, however, you will not feel the pain escalate. These practice contractions may start strong, but they weaken and then fade completely.

Position Changes

When the cervix is doing the real work of dilating, discomfort won’t stop if you move around or rest. It’s true that certain positions might help you manage labor pain better than others, but true contractions continue no matter how your body moves or how much water you drink. Meanwhile, false contractions often stop when you change positions, walk, or rest.

Location of Discomfort

True labor contractions typically start in the mid back and wrap around the belly to the center. Braxton Hicks contractions are well known for their generalized abdominal tightening only.

Takeaways about Braxton Hicks and True Contractions

Occasionally, even after considering all these scenarios, it’s still difficult to know whether you’re truly in labor. If you’re anxious or have questions, contact your healthcare provider. Sometimes the only way to tell the difference is by having a pelvic exam to find changes in your cervix that signal the start of labor.

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