If you are in late pregnancy, it's hard to know when it is "go" time. You may feel many different sensations as your body prepares to deliver your baby. It can be difficult to tell true labor from false labor. Your doctor or midwife may have explained the 5-1-1 rule, but you may wonder how helpful that will be when you are really in labor.
In true labor, you'll have regular, strong contractions. Your cervix will begin to open to let your baby be born. This can be a slow, gradual process, although occasionally it happens quickly. Remember that just as you differ from others, your pregnancy and your labor and delivery may be different, too. Contact your doctor or care team if you have questions about true labor vs. false labor.
What are Braxton Hicks or false labor contractions?
Long before you are ready to deliver, you may feel your uterus tighten. These contractions usually begin in the third trimester of your pregnancy. Most of the time, these early contractions are painless. Occasionally, they may cause a sharp pang. They may make you wonder, "Am I going into labor?"
Pregnant women have had to distinguish between true labor and false labor for as long as women have been having babies. In the late 1800s, an English doctor named John Braxton Hicks described the early contractions of false labor and suggested a purpose for them. He believed they improved the circulation of blood and fluid inside the uterus.
Today, many doctors call these contractions " Braxton Hicks contractions" or simply "Braxton Hicks." They may describe them as your body practicing for labor. False labor contractions may improve the muscle tone of the uterus and increase blood flow.
How to tell if it is false labor
Besides being less painful than true labor, Braxton Hicks contractions also:
- Happen fewer than 4 times an hour
- Are irregular
- Don't increase in strength or intensity
- May start or stop when you change positions
You may also have false labor if you have been unusually active, if you have just had sex, or if your bladder is very full. Reducing your activity level, changing your position, and emptying your bladder may help the contractions stop.
The location of the contraction is another clue whether you are having false labor. Often womens feel Braxton Hicks contractions in one small area, or only in the front of the belly. True labor often begins in the back or wraps around the whole abdomen.
Signs that you are in true labor
You may be in true labor if your contractions:
- Get closer together
- Get stronger
- Start in the back and move to the front
- Don't go away when you change positions or alter your level of activity
Other signs of true labor include:
- Bloody show. The passing of mucus with or without a pinkish or red discharge can mean that labor is about to begin.
- Water breaking. If you lose amniotic fluid, either as a gush or a trickle, labor has usually already begun or is about to begin.
- Sick stomach. Some women experience nausea and vomiting during labor.
The 5-1-1 rule
The main sign of true labor occurs at the neck of the uterus, called the cervix. When you are in true labor, the cervix thins out and opens up. You won't be able to detect when this process has started. You'll have to rely on other ways to tell when it is time to go to the hospital.
Your doctor may have told you to follow the 5-1-1 rule. This means that you should call your doctor and head to the hospital when:
- Your contractions are coming every five minutes, or more frequently
- Each contraction lasts one minute or longer
- This pattern has been consistent for at least one hour
Once you arrive at the hospital, a member of your care team will check your cervix, and you'll know more about how far along you are in the birthing process.
Going to the hospital
Your goal may be not to go to the hospital until you are in true labor, but trust your instincts. If your body is telling you to call your doctor, go ahead. And definitely call your doctor or go to the hospital if:
- Your baby stops moving
- You have vaginal bleeding that is more than spotting
- You have a headache, vision changes, sudden swelling, or trouble breathing
If you go to the hospital with false labor, you won't be the first or last to do so. Your doctor may tell you to go home and wait a little longer. But your mind will be more at ease.
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Raines, D.; D. B. Cooper. StatPearls, "Braxton Hicks Contractions," StatPearls Publishing, 2021.
UT Southwestern Medical Center: "False alarm: Braxton Hicks contractions vs. true labor."
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Braxton Hicks Contractions (False Labor)Braxton Hicks contractions are also known as false labor pains. Though these irregular uterine contractions may occur in the second trimester, they're more likely to occur during the third trimester of pregnancy. Unlike true labor pains, false labor pains are often irregular, may stop when you walk, rest, or change positions, and the contractions do not get closer together or stronger.
Braxton Hicks vs. True Labor: How to Tell the DifferenceSome pregnant women may mistake Braxton Hicks contractions (false labor) for real labor contractions, especially in the first pregnancy. Real labor contractions occur at regular intervals that become progressively shorter; more painful as labor progresses; are described as a tightening, pounding, or stabbing pain. Braxton Hicks contractions do not occur in regular intervals; do not become longer over time; and may disappear for a period of time and then return. Braxton Hicks contractions occur in third trimester of pregnancy, however, sometimes can occur in the second trimester. True labor contractions begin around your due date (unless your baby is preterm, in which you will be in preterm labor). So how can you tell the difference? Here are a few similarities and differences between Braxton Hicks contractions and True or real labor contractions.
Braxton Hicks contractions
Braxton Hicks contractions tend to become more frequent toward the end of pregnancy, and are not as painful as real labor contractions; do not occur in regular intervals; do not become longer over time; and may disappear for a period of time and then return.
Frequently one of the early symptoms and signs of true labor is when the contractions begin to occur less than 10 minutes apart.
Real labor contractions occur at regular intervals that become progressively shorter; more painful as labor progresses; are described as a tightening, pounding, or stabbing pain; may feel similar to menstrual cramps; and sometimes Braxton Hicks contractions can be triggered by dehydration, sexual intercourse, increased activity of the mother or baby, touching of the pregnant woman's abdomen, or a distended bladder.
Natural and home remedies to soothe and provide comfort for Braxton Hicks contractions include relaxation exercises like deep breathing or mental relaxation; change positions or take a walk if you have been active and rest; drink a glass of herbal tea or water; eat; or soak in a warm bath for 30 minutes (or less).
Preterm labor signs and symptomsWhen you have reached 37 weeks, and the contractions are more painful and are increasing in frequency you will have abdominal pain or menstrual-like cramping, an increase in pelvic pressure or back pain, and the contractions are more than four contractions an hour.
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