• Braxton Hicks Contractions vs. True Labor – What’s the Difference?

    How to tell if you’re really in labor

    You've heard the story before. A woman close to her due date starts feeling contractions, so she rushes to the hospital. After being examined and waiting in the hospital to see if the contractions progress, she's told to go home because she wasn't really in labor.

    If you're pregnant, it's important to know the signs of labor. This can help you distinguish between Braxton Hicks contractions (false labor) and true labor.

    Braxton Hicks contractions

    Many women experience Braxton Hicks contractions as their due dates approache. These are normal uterine muscle contractions that happen during pregnancy, though they aren't really signs of labor.

    They can continue for hours or days, but they don't progress, cause your cervix to dilate or lead to birth.

    These contractions can become more frequent and intense later on in pregnancy and are often the cause of women visiting the hospital before labor starts.

    Unlike true labor contractions, Braxton Hicks contractions:

    • Are usually irregular and unpredictable
    • Are felt only in the abdomen, rather than all over
    • Don't become more frequent or intense over time
    • Aren't accompanied with other signs of labor, such as light vaginal bleeding and water breaking

    Many times, changes in position or increased activity can cause Braxton Hicks contractions to slow down or stop.

    If you aren't sure what type of contractions you are having, call your doctor.

    True labor signs

    While the signs of labor can vary a lot from woman to woman – even from pregnancy to pregnancy for the same women – certain symptoms do indicate that labor has started.

    Familiarize yourself with the following signs of true labor so you'll be better able to tell when your labor begins.

    The main signs of actual labor include:

    • Regular uterine contractions that get more painful and get closer together over time
    • Persistent lower back pain, sometimes accompanied with a premenstrual feeling
    • Continuous abdominal pain
    • Water breaking (clear amniotic fluid leaking or gushing out)
    • Slight bleeding from the vagina (more than spotting)

    Also, the pain from the uterine contractions generally begins in your upper abdomen and can radiate into your lower back.

    Write down what you’re feeling

    When you begin to feel contractions, you should write down (or have your spouse or significant other write down):

    • Their frequency – how much time passes from the beginning of one contraction until the beginning of the next contraction
    • Their length – how long each contraction lasts
    • Their intensity – for example, if you guess one contraction what about a "3" out of 10 and the next one's a little stronger, is it a "3.5" or "4"? Precise numbers aren't critical; a general estimate will do.

    In true labor, contractions develop into a regular pattern, with shorter intervals between them. They usually last more than 30 seconds and get longer and stronger with time. They will continue regardless of whether you change position or increase or decrease your physical activity.

    Writing things down will help you know for sure whether they are really getting stronger and closer together.

    Some women have contractions for days leading up to childbirth, while others feel only slight pressure and minor pain.

    As your contractions change

    If your contractions get longer, stronger and closer together, it's probably time to go to the hospital. There your doctor can examine your cervix to determine if you're actually in labor.

    During labor, your cervix will dilate, as well as become thinner and softer as your body prepares for your baby’s arrival.

    Think you’re in labor?

    If you think you might be in labor, call your doctor.

    Monitoring your signs and symptoms may help you determine when labor begins. But you can't know for sure until you get to the hospital to be examined.

    Symptoms you should call your doctor about

    Whether or not you are in labor, always contact your doctor if any of the following occur:

    • Severe persistent headache
    • Changes in vision, such as spots, flashes of light or blind spots
    • Pain or burning when urinating
    • Decrease in fetal movement
    • Nausea and vomiting
    • Fever

    And if your at 37 weeks of pregnancy or earlier and are experiencing labor symptoms, you could be in preterm labor.

    Learn more

    Read more about labor and delivery and what to expect at Wellmont's birthing centers.


    The American Congress of Obstetricians and Gynecologists – www.acog.org

    American Pregnancy Association – www.americanpregnancy.org


    Braxton Hicks contractions. American Pregnancy Association website. Available at: http://americanpregnancy.org/labor-and-birth/braxton-hicks/. Updated January 2014. Accessed January 5, 2015.

    False labor. American Pregnancy Association website. Available at: http://www.americanpregnancy.org/labornbirth/falselabor.html. Updated January 2014. Accessed January 5, 2015.

    Labor and birth. Women's Health – US Department of Health and Human Services website. Available at: http://womenshealth.gov/pregnancy/childbirth-beyond/labor-birth.html. Updated September 27, 2010. Accessed January 5, 2015.

    Revision Information

    This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.

    Copyright © 2012-16 EBSCO Publishing. All rights reserved.

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