Almost every pregnant woman asks this question during their pregnancy: “How will I know if I’m really in labor?” When you first think about it, you might wonder, “How do you not know?! It’s a pretty obvious and intense feeling, right?” Yes, labor can get pretty intense, but early labor (and sometimes active labor) can get confused with Braxton Hicks by some women. We’ve all heard stories about how some women didn’t make it to the hospital before their baby was born. (They thought active labor was just strong Braxton Hicks.) Or the opposite, they kept getting sent back home because they thought their Braxton Hicks was becoming the real thing.
It can be frustrating when you’re not sure what’s going on. What’s important to understand is the difference between Braxton Hicks and real labor contractions. Since I’ve been asked, “How will I know if I’m really in labor,” multiple times, I thought I would share some tips on what to look for and how to know the difference!
What Are Braxton Hicks Contractions?
Braxton Hicks contractions are when your uterine muscles tighten for approximately 30 to 60 seconds, and then it releases and relaxes. Sometimes, they can last as long as two minutes, but this isn’t as common.3
Some women begin to feel Braxton Hicks contractions as early as their second trimester (around 16–20 weeks), but they are most commonly felt in the third trimester.3 There are plenty of women, though, that never feel their Braxton Hicks during their pregnancy. This is normal too.4
What Do Braxton Hicks Contractions Feel Like?
Many women describe it as a tightening sensation in their abdomen. It doesn’t hurt, but their bump becomes tight and firm. Other women say Braxton Hicks feels like mild menstrual cramps.3
The further you are in your pregnancy and the larger your bump gets, the more likely you will feel your Braxton Hicks contractions.5 They will become stronger because your uterus has gotten larger. It’s common to feel them once or twice an hour or a few times a day during your third trimester. As you approach the end of your pregnancy, you might even see the muscles of your abdomen (uterus) tightening when they are happening.3
How Are Braxton Hicks and Labor Contractions Different?
There are several differences between Braxton Hicks contractions and labor contractions. Here are some things you will want to pay attention to as you get closer to your baby’s due date.
Braxton Hicks Contractions
Here are the main things to know about Braxton Hicks contractions:2,3,4,5
- They don’t last long: They usually are less than a minute. Sometimes they can last longer, but that’s not as common.
- They are infrequent: They mostly happen only a few times a day and no more than a couple of times an hour. This can increase the closer you get to your due date.
- They don’t increase in intensity: Whether they feel like mild cramps or are painful, the level of intensity will not change over time. Real labor contractions will become harder and stronger.
- They are usually irregular: There shouldn’t be a pattern with Braxton Hicks contractions. However, if you recognize a pattern, it will only last for a few hours and then disappear.
- They change with activity: If you have been active the whole day, they may start once you sit and relax. If you have been sitting most of the day, they can start when you become more active. The same thing happens the other way around; if you begin to experience Braxton Hicks contractions, they should disappear once you change your activity. Again, these contractions will not last. They will go away with time.
It should be noted that dehydration can cause Braxton Hicks or “false” contractions. This can lead to preterm labor, so stay hydrated during pregnancy!1,2
Here are the characteristics of labor contractions:2,3,4
- They are longer: They build up over time and can last up to 60 seconds or longer.
- They are stronger: They become more painful as time progresses. If you do not notice a change in intensity over time, it may not be actual labor.
- They are closer together: You will notice they are becoming closer and closer together. The breaks in-between are becoming shorter, causing you to focus more on breathing and relaxation techniques through each contraction.
- They become more regular: You will notice a pattern that is slowly becoming faster and more intense.
What if My Braxton Hicks Contractions Become Painful?
Braxton Hicks contractions may become more intense and even painful as your pregnancy progresses. When this happens, they may feel like the real thing. But however strong they feel at the time, if they ease off, they (unfortunately) are Braxton Hicks and not actual labor.5 I’m sorry. I know it’s such a letdown, which causes a lot of women to feel confused.
Many of my clients have noticed that Braxton Hicks contractions become more frequent when doing some activity, such as walking around IKEA or the zoo or carrying bags or their toddlers/other children. Sometimes, these activities can help early labor progress, but sometimes (if your body is not ready), it can cause you to have more painful Braxton Hicks. If you’re unsure whether they are real labor contractions or Braxton Hicks, change your activity to see if it helps. A warm bath can be helpful, too.3
If your contractions become longer, stronger, and closer together, you’re probably going into labor. But if you have any doubts, I recommend calling your doula before calling the hospital. They will tell you what’s happening and can save you a hospital trip. Doulas have experience recognizing actual labor and will know if it’s the real deal. They can then let you know when to go to the hospital when your contractions start picking up.