Braxton Hicks/False Labor vs. Labor Contractions/True Labor

When you're in the last stage of pregnancy, contractions act as a natural alarm clock for your body, alerting you that you're in labor. While most of them are real contractions with a consistent pattern, at times, it's just a series of irregular uterine contractions, called Braxton Hicks contractions.

Since both types of contractions feel quite similar to each other, it can sometimes be hard to recognize the difference between them, especially if you're pregnant for the first time. If you're not sure whether you're having Braxton Hicks contractions or real ones, here's a quick look at both types, along with how to identify the difference between them.

What are Braxton Hicks Contractions?

Before you go into 'true' labor, you may experience sporadic uterine contractions at any time during pregnancy. These are Braxton Hicks contractions, also referred to as prodromal, practice, or false labor. Since these contractions are difficult to distinguish from real labor contractions, they are known as false labor contractions. These contractions are generally painless but can sometimes be very painful, making you think that you're in labor when you're not.

According to an NCBI study, false labor contractions can start around six weeks into gestation, but they usually are not felt until the second or third trimester. They can start anywhere in the second trimester (around the 20th week) but are more common during the third trimester. While the trigger for Braxton Hicks contractions is unknown, their primary function is to tone up the uterus for real labor and improve blood flow to the placenta. Think of them as warm-up exercises for your uterine muscles!

On average, Braxton Hicks contractions tend to last 30-60 seconds, but they can also sometimes last as long as two minutes or more. They are irregular, unpredictable, non-rhythmic, and different from real labor pains in intensity, frequency, and duration. Some women describe them as feeling more like mild menstrual or muscle cramps than actual contractions. Braxton Hicks contractions tend to increase in intensity and frequency as you get closer to your due date, resembling real labor contractions.

When you're in false labor:

• Contractions come and go at irregular intervals. They do not increase in strength or frequency. They start strong and get weaker as time goes by.
• Contractions subside or stop altogether when you rest, walk around, change position, or empty your bladder.
• The pain is only in the lower abdomen.

What are Real Labor Contractions?

When you go into real labor, the Braxton Hicks contractions subside, and you start having real labor contractions. It happens when your body releases oxytocin, a hormone that stimulates your uterine muscles to tighten and relax. Actual labor comes after pre-labor, a series of bodily changes, including cervical effacement and dilatation, the fetus's descending into the pelvis, a sensation of increased pressure on the pelvic and rectal area, and a rapid increment in the number of false contractions.

Unlike Braxton Hicks contractions, real labor contractions increase in frequency, intensity, and duration over time. They are much stronger, more painful, and frequent than false labor contractions. Many women compared the feeling with a wave; the pain slowly rises, peaks, and gradually decreases. The pain usually peaks with the tightening of uterine muscles and eases when they relax. While Braxton Hicks contractions can occur at any time throughout pregnancy, real labor contractions only happen when you enter into active labor - which typically starts with persistent, regular contractions.

Also Read: 11 Early Signs & Symptoms of Labor

For many women, real labor contractions begin at around the 40th week of pregnancy, and for others, they start before the 37th week, leading to premature labor. The primary purpose of these contractions is to dilate and efface the cervix in preparation for birth. They play a vital role in pushing the baby downward into the birth canal for delivery. Real contractions feel painful to some women right from the start, but others may find them quite similar to Braxton Hicks contractions.

When you're in true labor:

• Contractions come at regular intervals. They get closer together over time, lasting about 30-70 seconds each. They progressively get stronger.
• Contractions intensify with any activity and don't fade away with simple measures such as walking, resting, or changing positions.
• Pain is felt initially in the lower back, which later spreads to the abdomen and sometimes radiates to the hips and thighs.
• You may have a blood-streaked show (discharge of the mucus plug), experience water-breaking, and a slight increase in blood pressure.

How to Differentiate Between True and False Labor?

Now that you understand what real and false labor contractions feel like, you would have already been familiar with some differences between the two. However, you must be aware of the key differences to understand when real labor starts and when you should head to the hospital. The following table outlines the core differences between Braxton Hicks and real contractions:

If you are still uncertain whether you are experiencing true or false labor, get in touch with your doctor. They will check and tell you right away whether it's the big day or not!