Braxton Hicks Contractions Versus The Real Deal

Think you’re in labor? Here’s how to tell the difference between Braxton Hicks and real contractions.

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Pregnancy is hard. Another person is literally growing inside of you, pregnancy hormones have your body and emotions all over the place, and you know your feet are still attached to your legs even though you haven’t seen them in weeks. As if that’s not enough, Mother Nature decided to throw in a curve ball with Braxton Hicks contractions. Braxton Hicks, put shortly, are your body’s way of warming up for labor. But how do you know if you’re experiencing real contractions or the practice variety? We spoke to OB-GYNs Janelle Cooper, MD, at Baltimore’s Mercy Medical Center and Chase White, MD, at the Department of Obstetrics and Gynecology at Einstein Medical Center in Philadelphia, to find out everything you need to know about Braxton Hicks contractions.

What are Braxton Hicks contractions?

“Braxton Hicks contractions are contractions that happen before the onset of labor. They can also be defined as contractions that occur in the third trimester that usually do not result in cervical dilation,” says Cooper. “The uterus is made of muscle tissue, and naturally muscles will contract from time to time, so Braxton Hicks can be felt earlier in pregnancy, sometimes even early in the second trimester.”

In addition, Braxton Hicks may actually help prep the uterus for labor.

“Braxton Hicks contractions may be a part of the process of remodeling the uterus in preparation for labor,” White explains. “Later in the third trimester, the irregular contractions that many women experience are not only the classic disorganized ‘Braxton Hicks’ contractions, but are actually normal, effective contractions. They occur infrequently at first, becoming more frequent as the pregnancy progresses. They start the process of cervical shortening, softening, and opening that ultimately results in active labor and then birth.”

What do Braxton Hicks feel like?

Some women describe Braxton Hicks contractions as feeling sort of like your abdomen suddenly tightens all over: not exactly painful, but not all that comfortable either. Others describe it more as a cramping sensation. And according to Cooper, some of her patients have said Braxton Hicks contractions feel like “[the] baby is balling up tightly and then releasing the position.”

How will I know the difference between Braxton Hicks and real contractions?

Oh, you’ll know, my sweet little starfish. But just in case you don’t, there are some key differences between Braxton Hicks and real contractions. Typically, Braxton Hicks contractions:

  • Are irregular and pretty infrequent. You may have several Braxton Hicks contractions in a row and then nothing for several days. Or you may have Braxton Hicks contractions once or twice a day but nothing that can be timed regularly.
  • Do not increase in intensity. As mentioned before, Braxton Hicks are usually uncomfortable—not painful—and they don’t increase in intensity as they occur.
  • Frequently disappear with no warning. Braxton Hicks are just as likely to stop with no warning as they are to start.

On the other hand, real contractions are pretty much the opposite of Braxton Hicks. Real contractions can be regularly timed, increase with intensity, and are most definitely painful as they progress. Every woman is different, of course, but most women (myself included!) report real contractions to feel like the worst period cramps of your life rather than an abdominal tightening sensation.

Causes of Braxton Hicks Contractions

“Certain factors, like not drinking enough water throughout the day, or abdominal trauma as in a car accident, can trigger Braxton Hicks,” says Cooper. In addition, Braxton Hicks can be triggered by overexertion and even orgasm! Before you throw your bag in the car and rush to the hospital, though, there are a couple of tricks you can try to test whether you’re experiencing Braxton Hicks contractions or the real deal.

  • Dehydration is a big trigger for Braxton Hicks. If you’re experiencing these practice contractions, first try drinking a big glass of water to see if they subside.
  • Sometimes you can experience Braxton Hicks if you’ve overdone it, say in a prenatal fitness class or just working around the house. If you feel that familiar tightening, take a break. Put your feet up, relax, and put on an episode of The Office.
  • Braxton Hicks can also be caused by a full bladder. If it’s been a while since you had a bathroom break, and you’re experiencing irregular contractions, take a pee break.
  • Sex can also trigger false contractions, since orgasm stimulates the uterus. Now, I don’t recommend you stop having sex (or orgasms!), but taking a short bath (30 minutes or less) after sex may help alleviate Braxton Hicks contractions.

Braxton Hicks Contractions and False Labor

Let’s recap: Typically, Braxton Hicks contractions are fairly painless, irregular, and can often be alleviated by drinking a glass of water or resting. But sometimes—especially as you near your due date—Braxton Hicks can mimic real contractions pretty darn well, which is known as false labor.

“The onset of preterm labor can be subtle, and it is sometimes impossible to distinguish between normal uterine irritability, like Braxton Hicks, and true preterm labor without a physical exam or other tests.” —Chase White, MD

During false labor, your contractions may come more quickly, are more painful, and may even increase in intensity. White says the difference is that false labor can actually contribute to cervical ripening and dilation, which could lead to preterm labor. “If you are still preterm (before 37 weeks) but the contractions are coming frequently (I use 4 or more contractions per hour as my threshold), it is essential that you speak to your OB-GYN and come in to be evaluated,” White cautions. “The onset of preterm labor can be subtle, and it is sometimes impossible to distinguish between normal uterine irritability, like Braxton Hicks, and true preterm labor without a physical exam or other tests.” To determine whether you’re really in labor, your doctor will probably recommend that you bypass the office and head straight to the hospital. Once you’re there, you’ll get hooked up to a fetal monitor to check on baby, and you’ll probably have a cervical check to see if you’re dilated. White prefers to think of these kinds of contractions as “early labor” when it occurs at term. He continues, “These regular contractions are not the disorganized uterine contractions that classically we call ‘Braxton Hicks.’ Rather, they are part of the preparation for active labor.  While they will sometimes abate on their own, sometimes they will become progressively more frequent and then transition into active labor.”

Braxton Hicks Q+A With Janelle Cooper, MD

I get Braxton Hicks every time I exercise. Should I stop working out?

“Exercise is great in pregnancy, but if you’re in pain, or having Braxton Hicks, you may want to stop at that time and consider a decrease in the intensity or length of your workouts going forward.”

Are you sure Braxton Hicks contractions don’t lead to labor?

“They don’t lead to labor. Think of Braxton Hicks as a dress rehearsal for labor.” The dress rehearsal comes before the show, but really, it’s just practice.

I know Braxton Hicks are supposed to be painless, but can they cause pelvic pain and cramping?

Generally, they are painless. But they can be painful and may cause any discomforts of pregnancy (back pain, hip pain, vaginal pain or pressure) to amplify, resulting in additional pelvic pain and possibly cramping.”

Can you please tell my partner that frequent back rubs are proven to alleviate Braxton Hicks?

“Back rubs (or foot rubs) from a partner help to calm and soothe overall and may distract from the contractions, so I’d recommend trying it!”

Katie Martin
Katie Raye Martin is a freelance writer, navy wife, new mom, and chocoholic. In addition to HealthyWay, she has contributed to NextGenMilSpouse, a blog for the millennial military spouse, and Pregnant Chicken, a pregnancy blog. Since welcoming her first son a few months ago, Katie has become a pregnancy expert and cloth diapering connoisseur. When she’s not writing (or changing diapers) Katie is training for her first half-marathon.

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