Braxton Hicks contractions

What are Braxton Hicks contractions?

Braxton Hicks contractions are intermittent uterine contractions that start in early pregnancy, although you probably won't notice them until sometime in the second trimester or third trimester. Some women never notice them. They're named for John Braxton Hicks, the English doctor who first described them in 1872.

"Braxton Hicks contractions are a normal and expected occurrence for most women," says Shannon Smith, M.D., an ob-gyn at Brigham Faulkner Ob/Gyn AssociatesOpens a new window in Boston and member of the BabyCenter Medical Advisory Board.

As your pregnancy progresses, Braxton Hicks contractions tend to happen more often, but until your last few weeks, they'll probably remain infrequent, irregular, and mostly painless.

However, sometimes Braxton Hicks contractions are hard to distinguish from early signs of preterm labor, so play it safe and don't try to make the diagnosis yourself. If you're having regular contractions and haven't reached 37 weeks yet, or if you have any of the signs of preterm labor listed below, call your doctor or midwife immediately.

By the time you're within a couple weeks of your due date, it's likely that your cervix has begun to "ripen," or gradually soften in preparation for labor. Braxton Hicks contractions may get more intense and more frequent, and they may cause some discomfort.

Unlike the earlier painless and sporadic Braxton Hicks contractions, which cause no obvious cervical changes, these later Braxton Hicks may help your cervix efface and dilate (thin out and open). "Your body is in training and preparing for the big event – labor!" says Dr. Smith.

What causes Braxton Hicks contractions?

Braxton Hicks contractions are caused by the tightening and relaxing of the muscle fibers in the uterus. We don't know why this happens, but we do know that they're more often triggered:

• At the end of the day
• When you're dehydrated
• When you have a full bladder
• During or after physical activity or sex

What do Braxton Hicks contractions feel like?

When you have any kind of contraction, whether Braxton Hicks or true labor contractions, you'll feel your uterus, lower abdominal area, or groin tighten or squeeze, then relax.

Some women say Braxton Hicks feel like mild menstrual cramps. Others describe a strong tightness (stomach tightening) that can even take their breath away. Some women perceive them as the baby "balling up" and some note a change in the shape of their bellies during Braxton Hicks contraction.

Typical Braxton Hicks symptoms:

• Have no regular pattern
• Vary in intensity, but taper off rather than getting progressively stronger
• Are uncomfortable, but not usually painful
• Are infrequent
• May stop when you move or change position
• Are felt only in the front of the abdomen

How can I tell the difference between Braxton Hicks contractions and true labor?

"It can be hard to tell the difference between true labor and false labor," says the March of Dimes.Opens a new window

In the days or weeks shortly before labor, Braxton Hicks contractions may become rhythmic, relatively close together, and sometimes more uncomfortable, possibly fooling you into thinking you're in labor. But unlike true labor, Braxton Hicks contractions usually don't grow consistently longer, stronger, and closer together.

Here are some key differences:

If it's the real thing, you may also have other signs of labor, such as your water breaking, losing your mucus plug, or having bloody show.

"Most women can tell when they are in labor, but sometimes it's hard to tell when labor begins," explains the American College of Obstetricians and GynecologistsOpens a new window (ACOG). If you think you're in labor, or aren't sure, call your doctor or midwife.

Are Braxton Hicks painful?

Braxton Hicks contractions aren't usually painful, but they can be uncomfortable. To ease discomfort:

• Change your activity or position. Sometimes walking provides relief. Most of the time, resting eases contractions.
• Drink some water, because Braxton Hicks contractions can sometimes be brought on by dehydration.
• Do relaxation exercises or take slow, deep breaths. This won't stop the Braxton Hicks contractions, but it may help you cope with the discomfort. (You might be able to practice some of the pain-management strategies you learned in your birth class.)
• Drink a warm cup of tea or milk.
• Take a warm (but not hot) bath for up to 30 minutes.
• Empty your bladder.

When should I call my doctor about Braxton Hicks or pain?

If you haven't reached 37 weeks, call your provider right away or head to the hospital if your contractions are becoming more rhythmic, painful, or frequent, or if you have any of these signs of preterm labor:

• Abdominal pain, menstrual-like cramping, or rhythmic low back pain that doesn't stop with rest
• Regular contractions (at least six per hour, or every 10 minutes – even if they don't hurt)
• Vaginal bleeding or spotting

You may also want to contact your healthcare provider if you notice:

• An increase in vaginal discharge
• A change in the type of discharge – for example, if it becomes watery, looks like mucus, or is bloody (even if it's only pink or blood-tinged)
• Pressure in the pelvic or lower abdominal area (like your baby is pushing down)
• Low back pain, especially if you didn't have it before or if it's dull or rhythmic

If you're past 37 weeks, ask your provider when you should call to let them know you're having contractions.

Also, always call your provider or go to the hospital if:

• Your water breaks (even if you aren't having contractions).
• You have vaginal bleeding (more than just spotting).
• Your contractions are coming five minutes (or less) apart.
• You have constant, severe pain.
• Your baby's movements are decreased, weaker, absent, or suddenly excessively active.

Learn more:

• Round ligament pain
• Stages of labor and delivery