Braxton Hicks vs. real contractions: How to tell them apart

Your due date is close, but you still have a few weeks. Yet you keep feeling this weird sensation in your abdomen, almost like menstrual cramps, and you’re wondering if this could be a sign that you're in labor.

Pregnancy is full of new feelings and changes, and one of the most confusing can be contractions. Are they the real deal—or is your body just practicing? These Braxton Hicks contractions can feel like real labor contractions, but they don’t actually indicate that you're in labor.

Understanding the difference between Braxton Hicks contractions and real contractions is key to knowing when it’s time to call your provider and head to the hospital and when it’s okay to stay home and rest.

So, how can you tell them apart? Here’s what you need to know. 

What are Braxton Hicks contractions?

Braxton Hicks contractions, also known as practice contractions, are your body’s way of preparing for labor. But they don’t mean that you are in labor or that labor is about to begin. Braxton Hicks contractions are:

• Irregular and unpredictable
• Often felt in the uterus, where your uterus feels firm
• Usually painless or mildly uncomfortable

Braxton Hicks contractions are very common in the third trimester, although not all women experience them. Each pregnancy is unique, so you might even experience them during one pregnancy and not during another.

What do Braxton Hicks contractions feel like?

Many women wonder if Braxton Hicks feel like cramps, and the answer is sometimes. Braxton Hicks contractions can feel like mild menstrual cramps or a firm tightening sensation around the uterus that is painless. Unlike real labor contractions, they don’t intensify over time or follow a consistent pattern. They are also not painful.

You might notice them more after exercising, when you’re dehydrated or if your bladder is full.

What causes Braxton Hicks contractions?

While we don’t know the exact reason for Braxton Hicks contractions, other than your body’s way of practicing and preparing for labor, the most common cause of Braxton Hicks is dehydration. Even the slightest bit of dehydration can trigger them. Some other common causes may include:

• Being very active
• Fetal movement, such as feeling a kick from your baby in your abdomen
• Having a full bladder
• Lifting something heavy
• Sexual activity
• Sickness (a cold, the flu or vomiting)

What do real labor contractions feel like?

True labor contractions start at the top of the uterus and radiate downward, increasing in intensity and frequency over time. These contractions are your body’s signal that labor is beginning and that your cervix is starting to change in preparation for birth. Pressure from the baby’s head causes the cervix to dilate and thin out.

Just like every child is unique, every labor journey is unique as well. Therefore, the progression of labor will vary from woman to woman and from child to child. There are three stages of labor. The first stage of labor has two phases: early labor and active labor.

Early labor, the beginning phase, is by far the longest part of labor, which tends to be unpredictable and can last anywhere from a few hours to a few days. During this phase, the uterus starts to contract or tighten. However, the contractions are typically mild and often irregular. But as early labor progresses to the active phase, the contractions increase in both intensity and frequency.

Real contractions vs. Braxton Hicks

There are times when it’s difficult to tell if you're in labor, or if you're experiencing Braxton Hicks contractions. When trying to distinguish between the two, there are three main factors: location, intensity and frequency. Here’s how to tell them apart:

1. Frequency and timing

Braxton Hicks contractions:

• Don’t follow a consistent pattern
• Occur at irregular intervals and don’t get closer together
• May stop when you change positions or activities, such as walking

Real contractions:

• Become stronger and last longer over time
• Don’t stop regardless of position changes or activities
• Follow a regular pattern and last about 30 to 70 seconds, becoming more frequent over time

2. Location and sensation

Braxton Hicks contractions:

• Feel like your abdomen is tightening or cramping
• Usually in the lower abdomen and tend to only be focused in one area

Real contractions:

• Begin in your lower back and move to the front of your stomach or may start in your abdomen and move to your back
• Cause pain that can be felt throughout your body

3. Intensity

Braxton Hicks contractions:

• Are usually weak and don’t get much stronger
• Vary in intensity and can vary each time

Real contractions:

• Get progressively stronger and more intense over time
• Talking or moving becomes difficult

When to go to the hospital for contractions

If you’re past 37 weeks pregnant and aren’t experiencing a high-risk pregnancy, it’s good to follow the 511 rule:

• 5: Contractions are regularly five minutes apart.
• 1: Each lasts an average of one minute.
• 1: This pattern continues for a total of one hour.

If you are experiencing these contractions, it’s time to call your OBGYN and (most likely) head to the hospital for the active phase of labor. Be sure and follow any guidance your provider has given you on when to head to the hospital, as individual circumstances may vary.

When to be concerned about Braxton Hicks

Braxton Hicks contractions are normal and common for a woman to experience during pregnancy. While they can be intense and uncomfortable, it’s important to stay calm. If you are unsure whether you’re having Braxton Hicks contractions or if you’re in labor, reach out to your doctor. They can help you determine if you are in labor or if it’s a false alarm.

It can be helpful to track the timing of the contractions and take note of any other symptoms so you can determine if you're in labor or not.

Call your doctor if you have:

• A noticeable decrease in your baby’s movement
• Any signs of true labor before 37 weeks of pregnancy
• Bright red vaginal bleeding
• Consistent fluid leakage or if your water breaks
• Contractions that you are unable to talk or walk through
• Strong contractions less than 5 minutes apart for an hour

These may be signs that you are in labor or potentially have other complications. Your healthcare provider can help provide further guidance and treatment if needed.

How to alleviate Braxton Hicks

Braxton Hicks contractions often feel uncomfortable. Here are a few ways to help relieve any discomfort:

• Apply a heating pad.
• Change positions.
• Do something relaxing, such as taking a warm bath, reading a book or listen to music.
• Get up and take a walk or move if you have been sitting for an extended period.
• Hydrate!
• Rest or take a nap if you've been active.
• Try eating a snack.
• Try getting a prenatal massage.

Preparing for childbirth

As your due date approaches, it’s important to feel confident and prepared. Consider taking a birthing class where you can learn a lot of information about childbirth. Many hospitals offer these courses. Information is the key to feeling as prepared as you can be for this life-changing event.

You can also work with your care team to create a birth plan to give you peace of mind heading into labor and delivery. Remember, while birth plans direct your care team to the important things that matter to you, keeping you and your baby safe is of utmost priority.

Braxton Hicks contractions are a normal part of pregnancy, but knowing the difference between Braxton Hicks contractions vs. real contractions can help you feel more in control.

When in doubt, reach out to your healthcare provider—they’re there to support you every step of the way. You can also navigate your pregnancy with confidence through Pregnancy Care, our virtual pregnancy program for expecting moms.