How to Tell the Difference between Real Labour and Braxton Hicks

Getting ready to give birth is an exciting time, but when you’re a first time mum (sometimes known online as a FTM), there might be a few things you’re a little bit unsure about, such as how do you know when it’s “real” labour and not just stomach ache or cramps? It can feel even more confusing when you hear about Braxton Hicks contractions.

If you’re in your second trimester or moving into the third trimester of the pregnancy, you may suddenly notice your bump tightening. The front of your belly goes firm, it feels uncomfortable, maybe like mild menstrual cramps or pressure in the lower abdomen, and then it just passes.

These are known as Braxton Hicks contractions.

For many pregnant women, these “practice contractions” can be a surprise, especially during a first pregnancy. Are these labour pains? Is this the real thing? Should I be calling the maternity unit?

Here’s some more information on what Braxton Hicks are, why they happen, and the most important question you might be asking, how to tell the difference between real labour and Braxton Hicks contractions.

What are Braxton Hicks contractions?

Braxton Hicks contractions are intermittent uterine contractions that happen during pregnancy. They are often described as false labour or false contractions because they do not lead to dilatation of the cervix or directly to the birth of your baby.

You’ll be reassured to know that they are a normal part of pregnancy and can begin as early as the 20th week, although many women do not notice them until later. They tend to become more noticeable during the third trimester of the pregnancy, particularly around the 30th weeks of your pregnancy and beyond.

Physically, what’s happening is that the uterine muscles and muscle fibres tighten for a short period and then relax again. It’s your body’s way of preparing for the big day, helping improve blood flow to the placenta and practising the relaxation of the uterine muscle. They are sometimes called practice contractions for this reason.

What do Braxton Hicks feel like?

Braxton Hicks contractions usually feel like:

• A tightening across the front of your abdomen
• Pressure in a specific area of the abdomen
• A firm sensation at the front of your belly
• Mild menstrual cramping
• A brief tightening in the lower abdomen

They are often described as uncomfortable rather than painful. Some women experience them as sporadic contractions that come and go randomly.

You might notice them more:

• After a long day on your feet
• After short walks or exercise
• When your bladder is full
• When your baby moves
• In the evening

They can feel more intense in the ninth month, which is why they are commonly mistaken for real labour contractions.

How to tell the difference between real labour and Braxton Hicks

This is the question most parents really want answered! Here’s a clear comparison to help you feel more confident about whether you’re experiencing the beginning of labour or not:

Braxton Hicks contractions

• Irregular contractions
• Do not happen at regular intervals
• Do not get closer together
• Usually stay mild
• Often ease if you change position
• May stop after a warm bath, rest or hydration
• No vaginal bleeding or bloody show
• No leaking amniotic fluid
• No progressive abdominal pain
• No dilatation of the cervix

True labour contractions

• Happen at regular intervals
• Gradually get closer together
• Increase in intensity
• Become more painful over time
• Continue regardless of whether you rest or change position
• Often start in the lower back and move to the front
• May be accompanied by bloody show
• May involve leaking amniotic fluid
• Lead to dilatation of the cervix
• Feel like real contractions that build, peak and release

True labour contractions, sometimes referred to as contractions of true labor, follow a pattern. They don’t disappear with a warm bath or a lie down. They become stronger, longer and more frequent.

If you’re timing them and they’re happening at regular intervals, lasting around 30 to 60 seconds, and increasing in intensity, it may be a sign of labour.

A simple self-check you can try

If you’re unsure whether you’re experiencing false labor or real labor contractions, try this:

• Change position
• Drink water
• Have a warm bath
• Practise breathing exercises
• Rest on your side

If the contractions slow down or stop, they are likely Braxton Hicks. If they continue and become more painful or regular, it could be true labour.

When should you call your healthcare provider?

Even though Braxton Hicks are a normal part of pregnancy, there are times when you should contact your healthcare provider or maternity unit.

Call your healthcare professional if you experience:

• Regular contractions before 37 weeks gestation
• Suspected preterm labour or preterm labor
• Vaginal bleeding
• A sudden gush or trickle of amniotic fluid
• Severe abdominal pain
• A painful contraction that does not ease
• Reduced baby’s movements
• Symptoms of a medical condition such as placental abruption

Preterm labour can sometimes be mistaken for false contractions, so if you are under 37 weeks and experiencing regular contractions or contractions that are painful or accompanied by the other symptoms above, it’s always a good idea to seek medical advice.

Your healthcare provider may assess fetal heart rate variations, perform examinations to check for dilatation of the cervix, or run test results if needed. Follow-up care may be arranged depending on what they find.

Why do Braxton Hicks happen?

Researchers and clinicians suggest that Braxton Hicks contractions may help your body prepare for birth in the following ways:

• Tone the uterine muscles
• Increase blood flow to the placenta
• Prepare the uterus for labour contractions
• Help your body practise coordinated uterine contractions

They are not a sign that something is wrong. They are simply part of your body’s preparation for the big event!

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You may notice them more in a first pregnancy because everything feels new and unfamiliar. Although in further pregnancies, some women report feeling them earlier and more frequently.

Can Braxton Hicks be painful?

For most pregnant women, Braxton Hicks are mild. However, some women do describe them as uncomfortable or even moderately painful, particularly late in pregnancy.

If they feel like strong menstrual cramping or tighten across the lower back and abdomen, it can be difficult to tell whether they are true contractions.

The key differences remain:

• Pattern
• Progression
• Increasing intensity

True labor contractions build and intensify over time. Braxton Hicks do not.

How to ease Braxton Hicks contractions

If you are experiencing uncomfortable practice contractions, you might find relief from:

• Drinking water
• Resting
• Changing position
• Gentle short walks
• A warm bath
• Relaxation techniques
• Breathing exercises

These methods help the uterine muscle relax and often reduce sporadic contractions.

There is no specific medical treatment for Braxton Hicks because they are not harmful. However, always speak to your healthcare provider if you are unsure – you’re not bothering anyone by seeking medical advice!

Braxton Hicks vs other pregnancy pains

It’s also worth remembering that not all abdominal discomfort in pregnancy is contractions,

Round ligament pain can cause sharp pain in a specific area of the abdomen when you move suddenly. Digestive issues can cause abdominal pain. Lower back discomfort is common as your body changes shape.

If the sensation is brief, position-related and not rhythmic, it may not be uterine contractions at all.

The bottom line

Braxton Hicks contractions are a completely normal part of pregnancy. They are false contractions, not signs of labour, and they do not cause dilatation of the cervix.

The easiest way to tell the difference between real labour and Braxton Hicks is to look for:

• Regular contractions
• Increasing intensity
• Shortening intervals
• Persistence despite rest
• Associated signs of labor such as bloody show or leaking amniotic fluid

If you ever feel unsure, trust your instincts and contact your maternity unit. No healthcare professional will ever mind you checking!

As your due date approaches, especially in the ninth month, it is natural to analyse every tightening and wonder whether this is the real thing. Remember that your body is simply preparing for birth.

And when it is true labour, you will notice the difference.