Braxton Hicks or Real Contractions - How to Tell the Difference

Your belly tightens. Is this it? Are these real contractions, or just Braxton Hicks?

Almost every pregnant woman asks this question - especially those expecting their first baby. Your body sends signals, but they're not always easy to interpret. Fortunately, there are some clear differences you can look for.

What Are Braxton Hicks Contractions?

Braxton Hicks, also called practice contractions or false labor, are involuntary contractions of the uterus that don't lead to delivery. They're your body's way of preparing the uterus for what's to come.

Practice contractions can start as early as week 20, but most women notice them first in the third trimester. They have some typical characteristics:

• Irregular - they don't come at regular intervals
• Mild - uncomfortable, but rarely painful
• Short - usually last 30 seconds or less
• Go away - if you change position or rest, they stop
• Localized - felt mostly in the front of the belly

Braxton Hicks contractions are completely harmless. They're your body's way of preparing the uterus for labor.

What Are Real Contractions?

Real labor contractions are contractions that open the cervix and lead to delivery. They differ from Braxton Hicks in several important ways:

• Regular - they come at even intervals that gradually become shorter
• Stronger over time - each contraction is more intense than the previous one
• Longer - they last 45-90 seconds and get longer
• Persistent - they don't stop when you rest or change position
• Whole belly - the pain radiates from the back and around to the front

Checklist: Braxton Hicks or Real Contractions?

Use this checklist when you're unsure:

It's probably Braxton Hicks if:

1. The contractions are irregular
2. They go away when you walk, rest, or drink water
3. They're only felt in the front of the belly
4. They don't get stronger over time
5. They last under 30 seconds

It's probably real contractions if:

1. They come at regular intervals
2. They get stronger and more frequent over time
3. They don't stop no matter what you do
4. The pain starts in the back and spreads forward
5. They last 45 seconds or more

Prodromal Labor - When It's In Between

Some women experience prodromal labor, which is something in between. These contractions are stronger than regular Braxton Hicks and can be quite painful, but they don't cause the cervix to dilate.

Prodromal labor is characterized by:

• They can be regular for a few hours, then stop
• They can come and go over several days
• They're stronger than Braxton Hicks, but don't lead to progress
• They're most common in the evening and at night

This can be frustrating, but prodromal labor serves a purpose. It ripens the cervix and prepares the body. Many who have experienced prodromal labor find that the actual delivery goes faster when it finally starts.

What Triggers Braxton Hicks?

Practice contractions can be triggered by:

• Physical activity - after exercise, housework, or a long walk
• Dehydration - too little fluid can cause contractions
• Full bladder - pressure on the uterus
• Sexual activity - hormones can trigger contractions
• Baby moving - kicks and movements can set off Braxton Hicks

Drink a glass of water, change position, and rest a bit. If they go away, they were Braxton Hicks.

When Should You Contact the Hospital?

Contact your labor and delivery unit if:

• Contractions follow a regular pattern for over an hour
• They follow the 5-1-1 pattern (5 min apart, 1 min long, for 1 hour)
• You have water breaking or blood-tinged mucus (bloody show)
• You're before week 37 and feel regular contractions
• You're unsure and worried

How to Use a Contraction Timer

The most reliable way to distinguish Braxton Hicks from real contractions is to measure the pattern:

1. Start timing when a contraction begins
2. Stop when it releases
3. Repeat for 4-5 contractions
4. Look at the pattern - are the intervals even and getting shorter?

After a few recordings, you'll see whether there's a regular pattern. Irregular intervals point to Braxton Hicks. Even, decreasing intervals point to real contractions.

Common Questions

What is the difference between Braxton Hicks and real contractions?

Braxton Hicks are irregular, mild, and go away when you change position or rest. Real contractions are regular, get stronger over time, last longer, and don't stop no matter what you do. Real contractions are often felt in the entire belly and lower back.

When do practice contractions start in pregnancy?

Practice contractions can start as early as week 20, but most women notice them first in the third trimester. They're often triggered by physical activity, dehydration, a full bladder, or the baby moving.

Should I call the hospital if I'm unsure whether it's Braxton Hicks or real contractions?

Yes, it's always fine to call your labor and delivery unit if you're in doubt. Contact the hospital especially if contractions follow a regular pattern for over an hour, you have water breaking, or you're before week 37.

Summary

It's completely normal to be unsure. Most pregnant women ask themselves whether it's Braxton Hicks or real contractions multiple times before actual labor starts. Use the checklist and a contraction timer to get clarity. And remember - it's always okay to call your hospital if you're in doubt.

Read More

• 5-1-1 Rule: When to Go to the Hospital
• Early Labor Contractions

Sources

1. ACOG - How to Tell When Labor Begins
2. Mayo Clinic - Braxton Hicks Contractions