What week do contractions start

Braxton-Hicks Contractions vs. Real Contractions

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Medically reviewed by Debra Sullivan, Ph. D., MSN, R.N., CNE, COI — By Stephanie Watson on January 11, 2018

Braxton-Hicks contractions are contractions that do not lead to delivery but can give you the false sensation that you are in labor. They may come and go without getting stronger or closer together.

When you’re in the final stages of pregnancy, contractions are like your body’s alarm clock, alerting you that you’re in labor. Sometimes, though, contractions can sound a false alarm.

These are called Braxton-Hicks contractions, named after the doctor who first described them. You can think of them as practice contractions that get your body ready for your baby’s arrival, but they are not the real thing.

Not sure whether you’re having Braxton-Hicks contractions or real ones? Here’s a guide to help you tell the difference.

What are Braxton-Hicks contractions?

Braxton-Hicks contractions are sometimes called “false labor” because they give you the false sensation that you are having real contractions.

Although they can thin the cervix (the opening of the uterus) as real contractions do, Braxton-Hicks contractions won’t ultimately lead to delivery.

Braxton-Hicks contractions typically start in your third trimester of pregnancy. They’ll arrive from time to time, often in the afternoon or evening and especially after you’ve had an active day. You won’t notice any real pattern, but Braxton-Hicks contractions may come more often the closer you get to your due date.

When a Braxton-Hicks contraction hits, you’ll feel a tightening in your abdomen. It’s not usually painful, but it can be.

Signs you’re having Braxton-Hicks contractions include:

contractions that come and go
contractions that don’t get stronger or closer together
contractions that go away when you change position or empty your bladder

What are real labor contractions?

Real contractions happen when your body releases a hormone called oxytocin, which stimulates your uterus to contract. They’re a signal that your body is in labor:

For many women, real contractions start at around the 40th week of pregnancy.
Real contractions that begin before the 37th week can be classified as premature labor.

Real contractions tighten the top part of your uterus to push your baby downward into the birth canal in preparation for delivery. They also thin your cervix to help your baby get through.

The feeling of a true contraction has been described as a wave. The pain starts low, rises until it peaks, and finally ebbs away. If you touch your abdomen, it feels hard during a contraction.

You can tell that you’re in true labor when the contractions are evenly spaced (for example, five minutes apart), and the time between them gets shorter and shorter (three minutes apart, then two minutes, then one). Real contractions also get more intense and painful over time.

There are other clues that you’re in labor, including these:

You may see a clump of pinkish or bloody mucus when you use the bathroom. This is called a “bloody show.”
You may feel like the baby has “dropped” lower in your belly.
You may experience fluid leaking from your vagina. This is a sign that your “water” (a bag of fluid called the amniotic sac) has broken.

How can you tell the difference?

This chart can help you tell whether you’re in real labor or just “practicing”:

What to do if you’re having contractions

Contractions that only show up from time to time are most likely Braxton-Hicks. But if they start coming regularly, time them for about an hour. If they get stronger or closer together, you are likely experiencing true labor.

When they’re about five or six minutes apart, it’s probably time to grab your bag and head to the hospital.

If you’re not sure whether you’re really in labor, call your doctor or go to your delivery hospital. You’re better off seeking medical help, even if it turns out to be a false alarm.

It’s especially important to get to the hospital if you’re less than 37 weeks into your pregnancy, the contractions are especially painful, or your water has broken.

Last medically reviewed on January 11, 2018

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Pregnancy
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How we reviewed this article:

Healthline has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical associations. We avoid using tertiary references. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.

Braxton Hicks contractions: Causes and treatment. (2017).
americanpregnancy.org/labor-and-birth/braxton-hicks/
Contractions. (2013).
marchofdimes.org/pregnancy/contractions.aspx
Labor contractions. (n.d.).
babies.sutterhealth.org/laboranddelivery/labor/ld_contractns.html
Signs that labour has begun. (2016).
nhs.uk/conditions/pregnancy-and-baby/pages/labour-signs-what-happens.aspx#close
True vs. false labor. (2017).
my.clevelandclinic.org/health/articles/9686-true-vs-false-labor

Our experts continually monitor the health and wellness space, and we update our articles when new information becomes available.

Current Version

Jan 11, 2018

Written By

Stephanie Watson

Edited By

Frank Crooks

Medically Reviewed By

Debra Sullivan, PhD, MSN, RN, CNE, COI

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Medically reviewed by Debra Sullivan, Ph.D., MSN, R.N., CNE, COI — By Stephanie Watson on January 11, 2018

Braxton Hicks contractions | Pregnancy Birth and Baby

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Key facts

Braxton Hicks contractions are a normal part of pregnancy.
Braxton Hicks contractions feel like the muscles across your belly are tightening.
Braxton Hicks contractions are irregular, usually lasting for about 30 seconds — while they can be uncomfortable, they aren’t usually painful.
Braxton Hicks contractions don’t mean that you’re going into labour.
If you’re not sure if you are having Braxton Hicks or labour contractions, contact your doctor or midwife.

What are Braxton Hicks contractions?

If you feel tightening or pressure in your abdomen (tummy) during your pregnancy, you may be having Braxton Hicks contractions. Braxton Hicks are sometimes called ‘false’ or ‘practice’ contractions. They’re a normal part of pregnancy that can come and go.

Braxton Hicks contractions prepare your body for giving birth by toning the muscles in your uterus.

Braxton Hicks contractions don’t cause labour and aren’t a sign that labour is beginning.

If you’re not sure whether you’re experiencing Braxton Hicks contractions or actual labour, contact your doctor or midwife.

What do Braxton Hicks contractions feel like?

Braxton Hicks contractions feel like the muscles across your belly are tightening.

Braxton Hicks contractions come irregularly and usually last for about 30 seconds. However, they can last for up to 2 minutes. While they can be uncomfortable, they usually aren’t painful.

When do you get Braxton Hicks contractions?

Braxton Hicks contractions can occur from early in your pregnancy, but you may not feel them until the second trimester. They are most often felt in the third trimester.

In late pregnancy, you may experience Braxton Hicks contractions more often.

How are Braxton Hicks contractions different from labour pain?

There are some differences between Braxton Hicks contractions and true labour contractions. Your doctor or midwife will consider these differences when deciding whether you’re in labour.

Braxton Hicks contractions:

don’t open or dilate your cervix
usually last for about 30 seconds
can be uncomfortable, but usually aren’t painful
come and go at irregular times
usually occur no more than once or twice an hour, a few times a day — until late in your pregnancy
usually stop if you change position or activity or go for a walk
usually stop if you have a warm bath or shower

Real labour contractions:

open or dilate your cervix
last 30 to 70 seconds
are painful or require all of your attention
become very regular, and get closer together as time passes
last longer as time passes
get stronger or come more often when you walk
get stronger over time

Should I call my doctor or midwife?

Call your doctor or midwife or go to the hospital if:

your waters break
you have contractions that are getting stronger, closer together and more regular

If you’re less than 37 weeks pregnant, contractions can be a sign of premature labour. Contact your doctor or midwife immediately if you feel pain, pressure or discomfort in your:

pelvis
abdomen (tummy)
lower back

You should also contact your doctor or midwife immediately if you have any signs of labour.

At any stage of pregnancy, you should contact your doctor or midwife immediately if you:

have persistent pain in your abdomen (tummy)
have vaginal bleeding
are concerned about your baby’s movements
feel very unwell

If you’re in doubt, don’t hesitate to call your doctor or midwife for advice.

How can I ease the discomfort?

Braxton Hicks contractions are normal and don’t need treatment. But if you feel uncomfortable, you can try:

lying down or changing position
taking a walk
relaxing in a warm bath
having a massage
staying hydrated
urinating (weeing)

It may help to practise your breathing exercises during your Braxton Hicks contractions.

Resources and support

For more information about Braxton Hicks contractions speak to your doctor or midwife.

Speak to a maternal child health nurse

Call Pregnancy, Birth and Baby to speak to a maternal child health nurse on 1800 882 436 or video call. Available 7am to midnight (AET), 7 days a week.

Sources:

Mater Mothers' Hospital (Labour and birth information), QLD Health (Journey of labour), Tasmanian Government Dept of Health (Your health during pregnancy), RANZCOG (Labour and birth), Western Sydney Local health district (How will I know I’m in labour? Fact Sheet), Queensland Government (Preterm labour and birth)

Learn more here about the development and quality assurance of healthdirect content.

Last reviewed: December 2022

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Harbingers - childbirth is coming soon!

Wrestler Maria Vladimirovna

Obstetrician-gynecologist

MD GROUP Clinical Hospital, Mother and Child Clinic Savelovskaya

False contractions

They may appear after the 38th week of pregnancy. False contractions are similar to Braxton-Hicks contractions, which a woman could already feel starting from the second trimester of pregnancy (the uterus seems to stiffen for a few seconds - a couple of minutes, then the tension in it subsides). False contractions train the uterus before childbirth, they are irregular and painless, the intervals between them are not reduced. Real labor pains, on the contrary, are regular, their strength gradually increases, they become longer and more painful, and the intervals between them are reduced. That's when you can already say that the birth began for real. In the meantime, false contractions are going on, it is not necessary to go to the maternity hospital - you can easily survive them at home.

Abdominal prolapse

Approximately two to three weeks before birth, the baby, in preparation for birth, presses the presenting part (usually the head) against the lower part of the uterus and pulls it down. As a result, the uterus moves lower into the pelvic region, its upper part ceases to put pressure on the internal organs of the chest and abdominal cavity. In the people it is called - the stomach dropped. As soon as the stomach drops, the expectant mother notices that it has become easier for her to breathe, but, on the contrary, it becomes more difficult to sit and walk. Heartburn and belching also disappear (after all, the uterus no longer presses on the diaphragm and stomach). But, having dropped down, the uterus begins to put pressure on the bladder - naturally, urination becomes more frequent.

For some, uterine prolapse causes a feeling of heaviness in the lower abdomen and even slight pain in the area of the inguinal ligaments. These sensations arise due to the fact that the child's head, moving down, irritates the nerve endings of the pelvic organs.

During the second and subsequent births, the belly drops later - right before the birth. It happens that this harbinger of childbirth is not at all.

Removal of the mucous plug

This is one of the main and obvious harbingers of childbirth. During pregnancy, the glands in the cervix produce a secret (it looks like a thick jelly and forms the so-called cork), which prevents various microorganisms from entering the uterine cavity. Before childbirth, under the influence of estrogens, the cervix softens, the cervical canal opens slightly and the cork can come out - the woman will see that there are mucus clots on the linen that look like jelly. Cork can be of different colors - white, transparent, yellowish-brown or pink-red. Often it is stained with blood - this is completely normal and may indicate that childbirth will occur within the next day. The mucus plug can come out all at once (at once) or come out piecemeal throughout the day.

Weight loss

Approximately two weeks before delivery, weight loss may occur, usually by 0.5–2 kg. This happens because excess fluid is removed from the body and swelling decreases. If earlier during pregnancy, under the influence of the hormone progesterone, fluid in the body of a pregnant woman accumulated, now, before childbirth, the effect of progesterone decreases, but other female sex hormones - estrogens - begin to work hard, they remove excess fluid from the body of the expectant mother.

In addition, the expectant mother often notices that at the end of pregnancy it became easier for her to put on rings, gloves, shoes - this means that swelling on the hands and feet has decreased.

Change of stool

Right before childbirth, hormones often act on the intestines - they relax its muscles, as a result, stool disorder begins. Sometimes such frequent (up to 2-3 times a day) and even loose stools are mistaken for an intestinal infection. But if there is no nausea, vomiting, discoloration and smell of feces, or any other symptoms of intoxication, you should not worry: this is one of the harbingers of the upcoming birth.

And on the eve of childbirth, you often don't feel like eating at all. All this is also the preparation of the body for natural childbirth.

Mood changes

Many women experience mood changes a few days before giving birth. The expectant mother gets tired quickly, she wants to have more rest, sleep, even some kind of apathy appears. This state is quite understandable - you need to gather strength to prepare for childbirth. Often, just before giving birth, a woman wants to retire, looking for a secluded place where you can hide and focus on yourself and your experiences.

What should I do if there are any signs of childbirth? Usually you don’t need to do anything, because the harbingers are completely natural, they just say that the body is rebuilding and preparing for the birth of a child. Therefore, you should not worry and go to the hospital as soon as, for example, training contractions have begun or the mucous plug has come off. We must wait for real labor pains or outpouring of water.

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How to distinguish real contractions from training ones?

Shemyakina Natalya Nikolaevna, head of the obstetric department of the Leleka maternity hospital will help you figure it out.

Training contractions, or as they are also called, fake, or Braxton-Hicks contractions, are irregular contractions that do not have increasing intensity. The uterus may tone up, but normally, it should pass quickly.

For example, the tone appeared once in half an hour and the uterus relaxed rather quickly. Then the tone reappeared only after two hours and again passed. These are training contractions, they do not increase in intensity and do not become more frequent.

Training bouts are physiologically provided by our body. So the uterus is preparing to do the hard work in the process of childbirth. Normally, training contractions appear in terms of pregnancy close to childbirth - from the 37th week of pregnancy.

The appearance of training contractions in the early stages of pregnancy is not the norm

The uterus can tone up with an active lifestyle, physical activity, with a change in body position, but this tone should quickly pass. Normally, the uterus should not often come into tone. And even more so, contractions, as such, should not be until the 37th week of pregnancy.
Braxton Hicks contractions in the early stages are a threat of preterm labor. If a woman has contractions periodically during the day: after an hour, after 2, then again after an hour, (even if they are not regular), for periods up to 37 weeks, such a tone should alert the expectant mother.
Because this is not the norm, but the threat of premature birth. This is an occasion to contact a specialist and change your rhythm of life, put on a bandage. The causes of premature birth are most often internal, caused by hormonal disorders and a violation of the physical health of a woman. But significant physical activity and stress can also cause premature birth.

Labor pains

Unlike training pains, labor pains are regular. The uterus comes to tone first once every 15 minutes, and after a while - once every 7-10 minutes. Contractions gradually become more frequent, longer and stronger. And already occur every 5 minutes, then 3 and finally every 2 minutes.

True labor pains are contractions every 2 minutes, 40 seconds. If within an hour or two the contractions intensify - pains that begin in the lower abdomen or in the lower back and spread to the stomach - most likely, these are real labor pains.

Training contractions are NOT so much painful as unusual for a woman. When the expectant mother sees how the stomach comes into tone, its shape changes and it becomes dense, like an inflated ball. This might scare you a little. But a woman must understand that in real, labor pains, there must be a clear periodicity, intensification and acceleration over a certain period of time. Real fights never stop, but practice fights do. The uterus then comes to tone, then relaxes.
Women often confuse contractions with tone, which is caused by other physiological processes in the body. For example, increased intestinal peristalsis, intestinal infections, colic, etc.

What else should alert a woman?! If within an hour or two the uterus periodically comes into tone and mucous, bloody (streaked with blood or brown) discharge appears, then most likely there are structural changes in the cervix - it opens. Also an important sign to seek help is the discharge of the mucous plug long before childbirth. Her departure in terms of childbirth, a week or two before childbirth is normal.

Tracking labor pains

There are several methods for determining the types of contractions. A woman can do this herself, writing down the frequency and duration of contractions on paper or tracking them using special programs for a computer and phone. Or you can contact a doctor at antenatal clinic or at the maternity hospital, where a specialist will conduct fetal monitoring (fetal CTG). With the help of 2 sensors, the fetal heartbeat, uterine contractions are monitored and it is determined whether these are training contractions or labor.
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