What are Braxton Hicks contractions?
Some time towards the middle of your pregnancy, or maybe even earlier, you may notice the muscles of your uterus (womb) tightening. If you place your hands on your bare bump when this is happening, you can feel how hard your uterus becomes.
Each tightening usually lasts for about half a minute, and probably won't cause you any discomfort. You may have this sensation once or twice an hour, a few times a day (Cheng and Caughey 2009). Not all of us feel these contractions. They get their name from John Braxton Hicks, the English doctor who first described them in 1872.
You may be aware of Braxton Hicks contractions from as early as 16 weeks (Shepherd et al 2004:238). However, without you realising, your uterus has been contracting gently on and off since about seven weeks (Murray and Hassall 2009:191). The bigger your uterus gets, the more you notice the tightening sensations when they happen.
What do Braxton Hicks contractions do?
Braxton Hicks contractions may just be a sign that your uterus is keeping its muscle fibres toned. It could be that these contractions keep your uterus in good condition and ready for the rigours of labour.
Some experts think the contractions also affect your cervix. In early labour, your cervix starts to get shorter and more stretchy (Walsh 2004:430), ready to dilate and make way for your baby. It's possible that Braxton Hicks contractions give your cervix a bit of a rehearsal for the stretching stage.
Other experts think that Braxton Hicks contractions don't affect your cervix. They believe that your cervix doesn't change until the very last days of your pregnancy (Murray and Hassall 2009:192; Baker 2006:53), or once you're in labour itself (Cheng and Caughey 2009).
What's the difference between Braxton Hicks and labour contractions?
Most women who are pregnant for the first time will ask their midwives or friends this question. The answer is often maddeningly vague, along the lines of: "You'll know real labour when it starts." Fortunately, there are differences between Braxton Hicks contractions and labour contractions that can help you tell them apart.
Braxton Hicks contractions:
- are infrequent, usually happening no more than once or twice an hour, a few times a day
- often stop if you change activity, so, walk around if you've been sitting, and vice versa
- are usually irregular, and if they are regular they only stay that way for a short spell (McCormick 2009:466)
- do not last long, usually less than a minute (McCormick 2009:466)
- continue to be unpredictable and non-rhythmic
- do not increase in intensity (Cheng and Caughey 2009)
Compared to Braxton Hicks contractions, labour contractions are usually:
- noticeably longer
- more regular
- more frequent
- more painful
- keep on going, increasing in frequency, duration, and intensity as time goes on (Cheng and Caughey 2009)
You may experience what is called false labour. This is when Braxton Hicks contractions come more rhythmically, perhaps every 10 to 20 minutes in late pregnancy (Murray and Hassall 2009:191).
False labour can be hard to tell apart from early labour, particularly if the tightening of your uterus feels uncomfortable. However, during false labour your cervix won't have started to change yet (Murray and Hassall 2009:191). Your midwife will be able to tell by carrying out a vaginal examination.
What if the Braxton Hicks contractions become painful?
As your pregnancy progresses, these contractions may become more intense and even painful at times (McCormick 2009:466). When this happens, they may feel like the real thing. But however strong they feel at the time, if they ease off, they are probably Braxton Hicks.
You may find it helpful to think of Braxton Hicks as practice contractions you can use to rehearse the breathing exercises you'll learn in your antenatal class.
You may notice that Braxton Hicks contractions come more often when you do even light activity, such as carrying the shopping. If you feel discomfort, it sometimes helps to lie down, or, conversely, to get up and take a walk. It's the change in activity that can help to ease pain (Cheng and Caughey 2009). A warm bath sometimes helps, too.
When should I call my doctor or midwife?
If you are less than 37 weeks pregnant, call your doctor or midwife if your contractions are accompanied by:
- watery discharge or bloody vaginal discharge
- lower back pain or cramping
These are signs that you may be going into premature labour (Baker 2006:173).
After 37 weeks, call your doctor or midwife if:
- you think your baby's movements have slowed down
- you think your waters have broken
- you have any bleeding
Check out other pregnancy symptoms you should never ignore.
If your contractions become longer, stronger, more regular and more frequent then your labour may be starting. Your midwife will probably have talked to you about what to do when you think labour has started, but if you're in any doubt give her or the hospital delivery suite a call.
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