How to tell if contractions are real

Pregnancy
Real contractions follow a consistent pattern, while Braxton-Hicks contractions vary in duration and frequency. Braxton-Hicks contractions also tend to be less painful and usually only cause discomfort in the front of the abdomen.

Braxton-Hicks contractions simulate real contractions to prepare the body for labor. However, they do not lead to labor. Real contractions only occur when the body is genuinely going into labor.

Recognizing the difference between these types of contraction is important for understanding when labor has begun and when to contact a doctor.

Here, we discuss these types of contraction and how to tell the difference between them.

Real labor contractions

Braxton hicks vs real contractions
Contractions can occur at any time in pregnancy.

Contractions occur when the muscles around the uterus tighten and relax. They can occur at any time throughout pregnancy. But “real” contractions only occur when labor is starting.

Real labor contractions can be painful, and the pain tends to intensify. It usually peaks when the muscles tighten and eases when they relax.

The location of the pain varies, but real contractions typically cause a dull ache around the abdomen and lower back. In some women, the pain spreads to the sides and thighs.

Labor typically starts with regular, persistent contractions. These cause the cervix to expand in preparation for birth.


Braxton-Hicks contractions

Contractions can also occur before labor. These are Braxton-Hicks contractions, sometimes known as prodromal, or false, labor.

These contractions can begin around 6 weeks into gestation, but they are not usually noticeable until the second or third trimester. While the trigger for these contractions is unclear, their function is to prepare the body for labor.

Braxton-Hicks contractions tend to occur sporadically. They vary in frequency, duration, and intensity, but they usually occur more frequently during later stages of pregnancy.

Braxton-Hicks contractions do not cause the cervix to expand and do not lead to birth.

How to tell the difference

Braxton hicks vs real contractions back pain
A woman can feel pain in the abdomen, lower back, and legs during a real contraction.

People often mistake Braxton-Hicks contractions for real labor contractions, especially when they occur in later stages of pregnancy. Here are some key differences between the two:

  • Consistency: Real contractions last around 30–70 seconds and occur at regular intervals. Braxton-Hicks contractions do not follow a consistent pattern.
  • Increasing frequency: Real contractions become more frequent as labor approaches. Braxton-Hicks contractions do not increase in frequency.
  • Intensity of discomfort: In general, real contractions are more painful than Braxton-Hicks contractions. While they can be uncomfortable, Braxton-Hicks contractions do not typically cause pain.
  • Location of discomfort: A woman tends to feel real contractions throughout the abdomen and lower back, and the pain can spread to the legs. Braxton-Hicks contractions usually only cause discomfort in the front of the abdomen.
  • Effect of movement: Changing positions or moving in other ways often stops Braxton-Hicks contractions. Movement does not affect real contractions.


When to see a doctor

Learning to tell the difference between types of contraction can help a person know when to contact a doctor. However, consult a doctor if there is any uncertainty.

Real contractions are a sign that labor is beginning, and contacting a doctor is essential.

Contractions are likely to be real if they occur in a regular pattern and gradually increase in frequency. Real contractions also tend to become painful, and the pain often spreads across the abdomen and lower back.

Other signs that labor is starting include:

  • vaginal bleeding that is a bright red color
  • the water breaking

In the buildup to labor, the baby may move down toward the cervix. This can happen from a few weeks to a few hours before labor.

Another sign is an increase in vaginal discharge, which can occur days before labor.

If regular, painful contractions occur before the third trimester, it is important to contact a doctor. This could be a sign of preterm birth.


Takeaway

Real contractions are a sign of labor. Braxton-Hicks contractions are not, and they do not lead to birth.

Real contractions are generally more intense and follow a consistent pattern, while Braxton-Hicks contractions do not. A woman usually feels pain from real contractions around the abdomen, lower back, and sometimes in the legs.

Recognizing other signs of labor, such as the water breaking, can be helpful in understanding the difference between types of contraction. It is important to contact a doctor if signs of labor occur or if there is any uncertainty.

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