Braxton Hicks vs. True Labor Contractions: How To Tell the Difference Between Signs and Symptoms

  • Medical Author:
    Melissa Conrad Stöppler, MD

    Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

  • Medical Editor: Charles Patrick Davis, MD, PhD
    Charles Patrick Davis, MD, PhD

    Charles Patrick Davis, MD, PhD

    Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.

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What are Braxton Hicks contractions? What are true or real labor contractions?

Braxton Hicks contractions or "false labor," are irregular contractions that occur during the third trimester of pregnancy, or possibly in the second trimester. Braxton Hicks contractions usually are milder than those of real labor, and they do not occur at regular intervals.

True labor contractions occur at regular intervals and are stronger than Braxton Hicks contractions.

What do Braxton Hicks vs. real contractions feel like?

In both Braxton Hicks and real labor contractions, the lower abdominal area and/or groin seem to tighten or squeeze, and then relaxation follows.

Braxton Hicks contractions do not occur at regular time intervals, and they can occur at any time of day. However, many pregnant women report that they can feel Braxton Hicks contractions at night when the bladder is full, and during exercise or sex. Braxton Hicks contractions may not be painful, particularly when they begin earlier in pregnancy.

True labor contractions during childbirth usually get closer together, become stronger, and happen at intervals that become closer together. Many women often describe the pain of real labor contractions as occurring in a wave-like fashion.

How can I tell the difference between Braxton Hicks and true labor (symptoms and signs)?

Some pregnant women experience Braxton Hicks (false labor) contractions during the second trimester. When this occurs, the contractions do not come in regular intervals, and most women do not notice them. False labor contractions do not worsen over time, and do not occur closer together. They may even lessen or go away when you move or change body positions. Braxton Hicks contractions may cause an uncomfortable tightening sensation, but usually are not as painful as the real thing, or true labor contractions. Sometimes women who are experiencing Braxton-Hicks contractions believe that they represent real labor and experience a “false alarm” due to these symptoms.

True labor or real labor contractions usually begin after the 37th week of pregnancy, except in the case of preterm or early labor. They are a sign that labor is starting, they occur at regular time intervals, and become stronger (more intense and painful), and closer together over time. Labor contractions and pain are most likely to occur close to your due date when true labor starts in preparation for birth of your baby. You also may have other signs of labor, such as your water breaking (leaking amniotic fluid), passing of the vaginal mucus plug and/or "bloody show," when the mucus plug is blood-tinged.

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Your Guide to Labor and Delivery of Your Baby

The experience of childbirth is unique to each woman. Normal labor begins about three weeks before your due date. Signs and symptoms that labor may be near include "lightening," wich is when your baby's head descends to the floor of your pelvis.

Another sign that labor is near is the release of the "mucus plug." The cervical glands produce mucus to prevent bacteria, fungi, or viruses from entering the uterus through your cervix. When your baby's head begins to touch the mucus plug a small amount of blood is expelled.

How long do Braxton Hicks last? How long do real labor contractions last?

Braxton Hicks contractions can vary in length, from less than 30 seconds, to up to 2 minutes or more. Labor contractions usually last from 30 to 90 seconds.

When should I call my doctor, doula, or midwife if I think I may be in labor?

Before you are 37 weeks pregnant you should contact your care provider, obstetrician, or go to the hospital if you have labor contractions that are becoming more frequent (every 10 minutes or sooner) and painful. You should also seek medical assistance if you have abdominal pain, low back pain, cramping, a feeling of pressure in the pelvis or lower abdomen, vaginal bleeding, or a change in vaginal discharge.

After the 37th week, your healthcare team will advise you when you should call them or go to the hospital. With true labor, the contractions will happen regularly and become stronger, lasting about 30 to 90 seconds and do not go away. Always contact your obstetrician or midwife if your water breaks, you have vaginal bleeding, are experiencing severe pain, or have any change in your symptoms that is concerning.

REFERENCES:

American Pregnancy Association.
<http://americanpregnancy.org>

Milton, SH, MD. "Normal Labor and Delivery." Medscape. Updated: Feb 25, 2016.

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Reviewed on 8/24/2017
References
REFERENCES:

American Pregnancy Association.
<http://americanpregnancy.org>

Milton, SH, MD. "Normal Labor and Delivery." Medscape. Updated: Feb 25, 2016.

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