Is it real labor contractions or Braxton Hicks?


by Baylor Scott & White Health

Nov 1, 2018

If you’re a first-time mom-to-be, you have probably thought some of these questions: When should I go to the hospital? What do real labor contractions feel like? How will I know when it’s the “real thing?”

It is completely normal to experience wonder and often anxiety about knowing when and how labor will start, and how your labor journey will unfold. It is my goal as a childbirth instructor and a labor and delivery nurse to educate new parents on what to expect during the labor process, and when it’s time to go to the hospital.

What to expect when you’re having contractions

To help alleviate some of your fear and anxiety about labor, it’s important for you to understand the labor process. Just like every child is unique, every labor journey is unique as well. Therefore, the progression of labor will vary from woman to woman, and from child to child.

Just like every child is unique, every labor journey is unique as well.

The first stage of labor has three phases: early labor, active labor and transition. Early labor, the beginning phase, is by far the longest part of labor, which tends to be unpredictable and can last anywhere from a few hours to a few days. During this phase, the uterus starts to contract or tighten. However, the contractions are typically mild and often irregular.

But as early labor progresses to the active phase, the contractions increase in both intensity and frequency.

When it’s time to go to the hospital

The general rule for moms who are “term,” or greater than 37 weeks’ gestation, and have uncomplicated pregnancies, is the 5-1-1 rule. When contractions are regularly five minutes apart, lasting an average of one minute and occurring for a total of one hour, it’s time to call your obstetrician and most likely head to the hospital for the active phase of labor!

Most healthcare providers do encourage moms to stay home for the early phase of labor to decrease your stay in the hospital as well as be more comfortable in your own home.

However, one of the most important teaching points for moms to know is that you should call your doctor when you think you are in labor or when your water is broken. This not only facilitates excellent communication between you and your doctor, it also allows them to notify the hospital staff that you’re on the way to the hospital.

Related: Expecting a baby? Look for these 5 services in the place where you will deliver

Real contractions vs. Braxton Hicks

There are, however, times when it’s difficult to tell if labor is starting or not. Sometimes, the uterus will contract or tighten, “practicing” for labor. This is known as Braxton Hicks contractions, or practice contractions.
When trying to distinguish between labor contractions or Braxton Hicks contractions, there are a few things you should keep in mind.

1. Location

With true labor contractions, you’ll feel the pain starting at the top of your uterus.

True labor contractions are set in motion by hormones that trigger the uterus to contract in a rhythmic pattern. Labor contractions come with intentionality, and the contractions start at the top of the uterus and squeeze the baby’s head down, propelling it into the pelvis and thus putting pressure on your cervix. Pressure from the baby’s head is what causes the cervix to open and thin out.

But Braxton Hicks contractions are often described more as “cramping” or “lower uterine” tightening versus labor contractions that most often start at the top of the uterus.

2. Intensity

Labor contractions will always increase in intensity as labor progresses, but false contractions, or Braxton Hicks contractions, are not regular in intensity — these cramps might wax and wane instead of steadily increasing.

3. Frequency

Once labor starts, the contractions do not stop. Therefore, contractions that go away for a few days are not labor contractions.

Related: What to pack in your hospital bag before childbirth

How to prepare for childbirth

While every birth story has its own unique path, the average length of labor for first-time moms is eight to 24 hours in duration — the largest part of that being early labor.

It is important to remember that you can trust your healthcare team. If in doubt, always call your doctor for advice and try not to rely on the internet as a source of information. (Yes, I do realize you’re reading this on the internet, but not all the information out there comes from a verified medical expert like me!)

It is also a great idea for expecting moms and dads to enroll in a birthing class where you can learn a wealth of information pertaining to childbirth. Information is the key to being as prepared as you can be for this life-changing event. Talk to your doctor about what options might be available near you, whether in-person or online.

Preparing for pregnancy? Find out what to include in your birth plan.

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