As your due date approaches, it’s normal to question whether those tightening sensations are Braxton Hicks contractions or the start of true labour. Braxton Hicks, often called “practice contractions,” can feel uncomfortable but are irregular and usually fade with rest. True labour contractions, on the other hand, are more consistent, grow stronger over time, and don’t go away with movement or a change in position. Knowing the difference is key to preparing for your baby’s arrival and avoiding unnecessary stress. Written by Nicci Coertze, professional doula.
How do you know you are in labour? What are the first signs to watch out for? And how do you know if it’s Braxton Hicks or true labour? Our expert doula explains some the signs to look out for so you know when you’re really in labour.
Signs your body is preparing to go into labour:
- Near the end of your pregnancy (two to three weeks before birth in first-time pregnancies), your baby will move down or ‘drop’ – this is also called lightening. When this happens, you’ll be able to breathe better and will feel less burning in your chest after you eat. If this isn’t your first baby, this may not happen until closer to the time you’ll give birth.
- Increased urge to urinate because there’s more pressure on your bladder.
- Weight loss of 0.5-1.0kg. This is usually “water” being lost.
- Increased backache and pelvic pressure due to baby descending in preparation for birth.
- As your body prepares for birth, you might notice increased vaginal secretions and/or diarrhoea.
- A sudden burst of energy – this usually last for 24 to 48 hours and most women spend this time ‘nesting’ or making sure that everything is in order for the baby’s arrival.
- Ripening of the cervix. This is the cervix softening and thinning in preparation for birth.
How do you know if you are in labour?
Loss of mucus plug/bloody show
While you are pregnant, you have a thick mucus plug in your cervix. As the baby’s birth gets closer, your cervix begins to thin and open (also called ‘ripening’), and the plug may come out. You may notice a pink, red, or brown discharge – this is called bloody show. It is a sign of your cervix changing shape and your body preparing for the birth of your child.
Your water breaks
Your baby is inside a bag of water (amniotic sac) in your uterus. When the baby is ready to be born it’s normal for the bag of water to break. This may happen before labour starts, in the early stages of labour or when the baby is almost ready to be born. When it happens, you may have a little or a lot of water leaking from your vagina. Sometimes women do not know whether this is water from their uterus or urine. If you’re not sure, call your healthcare provider. When your water breaks, remember to record the time it happened, the amount of fluid, colour and the smell of the fluid.
Contractions
When the uterus contracts (get tight), rests and then gets tight again, it is called a ‘contraction.’ During the course of labour, and up until your baby is born, your body will experience many contractions. Pain associated with childbirth mainly comes from these contractions. All the contractions and pushing move your baby down the birth canal, to be born into this world.
What do Braxton Hicks contractions feel like?
Late in your pregnancy, you may have contractions (where the uterus tightens, rests, and tightens again) that are very strong. They may come and go for hours or days and then stop. These contractions are helping your womb (uterus) get ready for birth and are called pre-labour, practice contractions or Braxton Hicks.
What do real labour contractions feel like?
- Lower back pain radiating around to the front and back again.
- Menstrual cramps or gas pains.
- Wavelike in the beginning.
- Becomes more intense as the labour progresses (strong, longer, more painful).
- Usually, you will not be able to talk, laugh or sleep through a contraction.
- Later on, you may also have nausea, vomiting, chills, painful backache, tremors and a sense of desperation.
How do you time your labour contractions?
By learning how to time your contractions, you will know when you are really in labour. Time your contractions when the contractions come closer together and/or the contractions get stronger, or when your water breaks.
It is advisable to time for at least three contractions in a row to see what the pattern is. Write down:
- When each contraction begins and ends.
- How far apart the contractions are.
- How long each contraction lasts.
- How strong the contractions feel.
What should I do if I think I’m in labour?
If you think you are in the early stages of labour, it is best to stay at home. Take a shower, have a light meal, walk around or REST – these are all great ways to cope with early labour. You do not need to go to the hospital or midwifery unit straight away. You should only go to your place of birth if:
- you are bleeding from your vagina.
- your contractions are five to six minutes apart and are also increasing in intensity. (Your healthcare provider may ask you to go to the hospital earlier).
- your water breaks.
It is always a good idea to communicate with your care provider about your specific situation.
How do you know if you have Braxton Hicks or are in false labour?
“False labour” or prodromal labour, is a common experience as you approach your due date. There’s also a difference between Braxton Hicks contractions and prodromal labour, as prodromal labour is more than the quick, tightening feeling of a Braxton Hicks contraction. It is somewhere in between Braxton Hicks and labour contractions. As you may experience multiple “contractions”, you may think you’re in real labour and thus prodromal labour is very confusing and can be frustrating as it feels almost like the real thing! But it isn’t – the contractions may dilate or soften your cervix a bit, but they don’t lead to imminent birth.
False labour is usually erratic in time and intensity and no clear pattern can be established. For a varied amount of time they may come every 3 minutes, then 10, then 5 and then 15 again.
Most of the times it’s felt in front of the uterus and you may even be able to sleep through them, albeit uncomfortably so! If the contractions stop when you use the bathroom, bath or shower, drink water, change positions, or lie down, then they’re probably not the real thing.
The most important difference is that real labour mostly occurs at regular intervals and closer together as time goes on. Generally, contractions during labour last about 30 to 60 seconds, getting longer as labour progresses.
They also increase in intensity, don’t change with movement or position, and are often felt in both the front of the body and the back.
Signs and symptoms of false labour versus true labour
Use our handy table if you are not sure whether you are really labour or not:
| FALSE LABOUR | TRUE LABOUR |
| Contractions do not come more frequently | Contractions come more frequently |
| Contractions are not changed by walking (may stop) | Walking, warm bath, breathing and birthing ball relieves contractions |
| Contractions are strongest in the front | Contractions usually begin in the back and move to the front |
| Contractions do not get stronger | Contractions gradually get stronger and closer together |
| Contractions have no regular pattern/are erratic. | Contractions usually have a regular pattern |
| Usually have no show | Usually have a show |
BabyYumYum FAQs: Braxton Hicks vs True Labour – How to Tell the Difference
What are Braxton Hicks contractions?
Braxton Hicks contractions are irregular, often painless “practice” contractions that can occur throughout pregnancy. They help your body prepare for labour but do not indicate that labour has actually started.
How do Braxton Hicks contractions feel?
Many describe Braxton Hicks as a tightening or hardening of the uterus, which may feel like mild pressure or a light cramp. These sensations often come and go without a consistent pattern.
When do Braxton Hicks contractions typically start?
Some women experience Braxton Hicks as early as the second trimester, although they tend to become more common and noticeable during the third trimester.
What distinguishes true labour contractions from Braxton Hicks?
True labour contractions occur at regular intervals, grow steadily closer together, and increase in intensity. Braxton Hicks contractions usually remain irregular, do not consistently increase in strength, and may ease when you rest or change position.
Can Braxton Hicks contractions be painful?
They can sometimes cause mild discomfort, but they’re generally less painful than true labour contractions. If you do experience significant pain, consider speaking to your healthcare provider for guidance.
What happens to Braxton Hicks if I change position or rest?
Braxton Hicks often lessen or disappear if you lie down, rest, or switch positions. True labour contractions typically continue or intensify, regardless of changes in activity.
Do Braxton Hicks contractions signify that labour is near?
Not necessarily. Braxton Hicks can occur weeks or even months before real labour starts. They’re more of a sign that your body is practising and preparing for eventual labour.
How can I time contractions to see if they’re Braxton Hicks or true labour?
Use a timer or contraction app to track how long each contraction lasts and how far apart they are. If contractions become more regular, consistently closer together, and stronger over time, this is more indicative of true labour.
What should I do if I can’t tell whether they’re Braxton Hicks or true labour contractions?
If you’re unsure, contact your midwife or doctor for advice. They may ask you about your symptoms, assess your contraction patterns, or suggest a visit for further examination.
When should I seek medical attention?
You should seek medical attention if contractions become very painful, occur more frequently than every five minutes for an hour, are accompanied by fluid leakage or bleeding, or if you notice a significant change in baby’s movements.
Can dehydration cause more Braxton Hicks contractions?
Yes, dehydration can make Braxton Hicks contractions more noticeable. Staying well-hydrated may help reduce their frequency or intensity.
What coping strategies can help with Braxton Hicks?
Changing position, resting, taking a warm bath, or practising relaxation techniques can ease the discomfort of Braxton Hicks. If you have persistent concerns or pain, always reach out to your healthcare provider.
Reading Time: < 1 minuteThe 22nd of March 2022 marked the beginning of World Doula Week under the theme “Doulas make a difference.” This is …
