Braxton-Hicks vs. True Labor: How to Spot the Difference

As you start to approach your due date, you’ll probably be hyper-aware of any tightening sensations in your abdomen. However, not every twinge and cramp is a sign that labor is beginning. Braxton-Hicks contractions (named after the doctor who first described them) are often mistaken for true labor contractions. Unlike true labor, Braxton-Hicks are irregular, less severe, and typically subside if you change positions. They are your body's way of preparing for labor, but it doesn't mean labor is coming. Let’s take a closer look at what Braxton-Hicks contractions are and how to tell whether or not you may be in labor.

What Are Braxton-Hicks Contractions?

Braxton Hicks contractions are essentially a practice run for childbirth. Your uterus is tightening and releasing in order to prepare for all the hard work of pushing a baby out of your body. While Braxton-Hicks can be painful and hard to differentiate from true labor, they’re not effective enough to actually move the baby out. Your uterine muscles are flexing in preparation for the big job they'll have to do in the near future. Keep in mind that while they can be hard to distinguish from the real thing, they're not efficient enough to push your baby out the way actual labor contractions are.

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What do Braxton-Hicks Contractions Feel Like?

Braxton Hicks contractions begin with an uncomfortable squeezing sensation that starts at the top of your uterus and extends downwards. They cause your belly to become quite firm and weirdly distorted (almost pointy). As you approach your estimated due date, the contractions become stronger and more regular. They often occur when you change positions and stop when you rest. You can still talk, walk, and go about your normal activities during Braxton-Hicks contractions. First-time moms may be less aware of them than those who’ve experienced childbirth previously.

Where Do You Feel Braxton-Hicks Contractions the Most?

Braxton-Hicks contractions are comparable to the cramps you may have during your menstrual period. You’ll typically feel them in the front of your abdomen, but not in your back or the lower part of your uterus. While they’re not exactly comfortable, they’re usually not too painful.

When Do Braxton-Hicks Contractions Begin?

Braxton-Hicks contractions can start any time from about halfway through your pregnancy (20 weeks) and beyond. These contractions become more noticeable, frequent, and intense beginning around 32 weeks and will continue through the end of pregnancy.

How Long Does a Braxton-Hicks Contraction Last?

A Braxton-Hicks contraction typically lasts between 15 and 30 seconds, but it can last for as long as two minutes.

What Causes Braxton-Hicks Contractions?

Braxton-Hicks are basically triggered by hormones signaling the body to slowly begin preparing for labor and delivery. Some experts have hypothesized that the process may also help soften and efface the cervix in preparation for childbirth. 

Why Am I Having So Many Braxton-Hicks Contractions?

Doctors aren’t really sure why some people experience this phenomenon and others don’t. There are a few things that may factor into whether or not you have Braxton-Hicks contractions, including:

• not drinking enough water
• having sex
• lifting something heavy
• needing to urinate
• being very active

How Can You Tell the Difference Between Braxton-Hicks vs Contractions (i.e., True vs False Labor)?

Braxton-Hicks are erratic, unpredictable, and rarely very painful. They tend to start and stop at irregular intervals or when you move around, shift positions, or drink a glass of water. True labor contractions, however, are more regular and predictable and tend to last about a full minute each. They’ll also become more frequent and intense. Changing positions does not make true labor pains go away. In fact, walking or even talking may become difficult or make the pain worse.

It can be hard to differentiate between true labor and Braxton Hicks contractions, even for seasoned moms. The distinction is usually connected to the frequency, intensity, and location of the contractions. To help you tell the difference, take a look at this table from the Cleveland Clinic. 

Try to time your contractions, and jot down how much time it takes from the start of one contraction to the start of the next. Evaluate how much pain you’re feeling. Do this for about an hour.

Is Not Having Braxton-Hicks Contractions Normal?

It’s also normal to never experience Braxton-Hicks contractions and won’t affect your ability to safely deliver your baby. Many people with first-time pregnancies simply don’t notice them, and others don’t recognize what they are when they do experience them. At any rate, don’t stress over not having them. It’s possible they’re just very mild or that they’ll show up later in your pregnancy. Check-in with your healthcare provider to ask specific questions or to get a little reassurance that everything is okay.

What Can I Do to Help Ease Braxton-Hicks Contractions?

If your Braxton-Hicks contractions are particularly uncomfortable, there are a few things you can try to help your body relax.

• Drink a glass of water and stay hydrated. Even slight dehydration can trigger discomfort.
• Have a snack.
• Change positions or walk around if you’ve been lying down.
• Sit down or lie down if you’ve been active.
• Practice the visualization and breathing techniques you learned during childbirth class, and encourage your partner to practice with you.
• Try to urinate.
• Unwind by taking a warm (not hot) bath, getting a prenatal massage, or reading a book.

When to Call Your Doctor

Reach out to your OB-GYN or midwife if you’re feeling worried or uneasy about any of your symptoms or if you’re unsure whether your contractions are true labor or Braxton-Hicks. Labor signs can be tricky, so it’s always safest to defer to your healthcare provider. They may ask you to come in or to head to the hospital for further evaluation. Sure, it might end up being a false alarm – but you certainly wouldn’t be the first person to go in thinking they might be in labor. Labor symptoms can be different for every person and for every pregnancy. Getting checked out by your healthcare team is the only way to know if your labor pain is the real thing.