False alarm: Braxton Hicks contractions vs. true labor

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“This is it! I’m going into labor!” That’s what you may think when you feel your abdomen tighten up repeatedly over a short period of time.

So, before you grab your bag and head to the hospital, learn how to know when you’re having Braxton Hicks contractions and when you should call your doctor.

However, there’s a good chance you’re experiencing false labor, more commonly known as Braxton Hicks contractions. In my experience working with pregnant women, almost all of them will feel Braxton Hicks contractions at some time during their pregnancy. They are named for the English doctor who first described them in 1872. After Dr. John Braxton Hicks noted that many of his patients felt contractions but were not actually in labor, he studied the phenomenon to help clear up the confusion.

Braxton Hicks contractions vs. true labor

Braxton Hicks contractions – which usually start during the third trimester – are thought of as the uterus practicing for labor, but they aren’t a sign you’re actually in labor.

The key difference between Braxton Hicks contractions and the real thing is that Braxton Hicks contractions aren’t coordinated. Real contractions start at the top of the uterus and, in a coordinated fashion, move through the middle of the uterus to the lower segment. Braxton Hicks contractions feel like a tightening of the abdomen and tend to be focused in one area. They don’t always travel through the whole uterus.

The other main distinguishing factor is time. Patients tell me, “I was having contractions every five or 10 minutes, but it only happened for 30 or 40 minutes.” These contractions may appear to be happening in some sort of pattern, but if you’re truly in labor, contractions will not stop and the time between them will get shorter.

Signs you may be experiencing Braxton Hicks contractions:

• They’re uncomfortable, but not usually painful.
  
• Intervals between contractions are irregular.
  
• Duration between each one doesn’t become shorter.
  
• They don’t get stronger over time.
  
• Contractions taper off and disappear.

Signs your contractions may indicate real labor:

• They’re painful.
  
• Intervals between each one become shorter.
  
• Contractions become stronger and last longer over time.
  
• They don’t stop.
  

What triggers Braxton Hicks contractions and how to stop them

The No. 1 cause of Braxton Hicks contractions is dehydration. Even minor dehydration can cause them. You’re a busy woman: work, family, friends, shopping for baby supplies. It’s easy to become occupied with a task and not realize you haven’t had a glass of water in a few hours. Especially in our Texas heat, you need to be vigilant about getting enough to drink. You also may experience Braxton Hicks if you are sick with a cold or flu and are vomiting or feeling nauseated. This often is related to dehydration.

If you come to the hospital to report contractions but aren’t sure you’re in labor, the first thing we’ll do after assessing your baby and checking your cervix is ask you to drink a few big cups of water in a short amount of time. If it’s Braxton Hicks, the contractions will stop fairly soon after you’re rehydrated. We give the same advice to women who call from home with the same concern.

Fetal movement also can trigger Braxton Hicks. Women often say they felt a sharp kick from the baby or a lot of activity right before contractions started.

Your activity also can trigger contractions. Whether you’re moving into a new house or just getting the nursery ready, extra movement – especially lifting – can bring on Braxton Hicks. This is why we tell pregnant women to rest often if they need to move or lift more than normal. On the other hand, some activity also can relieve Braxton Hicks contractions. If you’re sitting down, stand up and go for a walk. Sometimes just changing your position can help.

The 5-1-1 rule, and when to call your doctor

Patients sometimes confess to me, “I hate to bother you with a false alarm.” Don’t worry about it! If you aren’t sure whether you’re having Braxton Hicks contractions or you’re truly in labor, call us. That’s what we’re here for. We want a healthy mom and baby, and if you don’t tell us when something concerns you, we can’t help.

To ease patients’ minds when it comes to contractions, we talk about the 5-1-1 rule that signals you’re in true labor:

• Contractions occur every 5 minutes.
  
• Each contraction lasts at least 1 minute.
  
• Contractions have been ongoing for 1 hour.
  

When you meet the 5-1-1 rule, call your doctor’s office or come in.

Here are a few other situations in which you should call or visit your doctor right away:
As mentioned, don’t hesitate to call your doctor’s office with a question. You will never annoy us! If it’s an emergency, call or go to the hospital immediately. However, if you have a less-pressing question about your pregnancy, my patients have found MyChart to be a convenient option to get answers. If you’re not a UT Southwestern Medical Center patient, ask if your healthcare provider has a similar tool.

MyChart allows you to communicate with your doctor through secure messages. It’s similar to email, but you don’t have to worry about sending your personal medical information through – it’s completely private and safe.

While Braxton Hicks contractions can be uncomfortable and annoying, they are perfectly normal and do not pose a danger to you or your baby. Stay calm and be patient. Even if it’s not labor, it’ll be great practice for motherhood.

If you have further questions about Braxton Hicks contractions or how to know when you’re in labor, request an appointment online or call 214-645-8300.

• Your water breaks: We don’t want you managing it on your own at home. Once your water breaks, you are at increased risk for a number of complications, so we want to monitor you in the hospital.
  
• Decreased fetal movement: Pay attention to any sudden changes in your baby’s activity – they aren’t moving as much or at all. A glass of orange juice or cold water might get your baby moving, but if that doesn’t work, you should see your doctor right away.
  
• Braxton Hicks contractions that start earlier than the third trimester: While they can occur in the second trimester, it may indicate preterm labor. Women who have had multiple pregnancies sometimes start to feel Braxton Hicks late in the second trimester because they are more sensitive and aware of how it feels. These moms may be inclined to shrug them off. However, if Braxton Hicks contractions start before the third trimester, tell your doctor just to be safe.