How do you get to labor and delivery? Practice, practice, practice.

You might not be ready for the baby just yet (still haven't picked out that nursery color?), but your body is certainly gearing up for the big day — and you're reminded of that each time you feel your uterus tightening up.

What are Braxton Hicks contractions?

Braxton Hicks contractions are a bit like a dress rehearsal: Your uterine muscles are flexing in preparation for the big job they'll have to do in the near future. Keep in mind that while they can be hard to distinguish from the real thing, they're not efficient enough to push your baby out the way actual labor contractions are.

What do Braxton Hicks contractions feel like?

Braxton Hicks contractions start as an uncomfortable but painless tightening that begins at the top of your uterine muscles and spreads downwards. They cause your abdomen to become very hard and strangely contorted (almost pointy). Once you get closer to your estimated due date, they will become more frequent and intense. 

If you're a novice mom-to-be in your first pregnancy, you may not notice them as much (or even at all) or wind up feeling them as intensely as those who are pregnant for the second time. But even first-timers are sometimes aware of them.

When do Braxton Hicks contractions start?

Braxton Hicks contractions can begin any time after week 20 of pregnancy in the second trimester, though they're more noticeable in later months, in the third trimester. They'll increase starting around week 32 all the way until real labor starts. 

What causes Braxton Hicks contractions?

Your pregnancy hormones are hard at work, sending messages to your body to slowly start the process of childbirth.

How long do Braxton Hicks contractions last?

Braxton Hicks contractions generally only last between 15 and 30 seconds, though they can be as long as two minutes.

What is false labor?

False labor is literally just that — the sensation that you’re going into labor when you aren't really, complete with uterine contractions usually in the form of Braxton Hicks that catch you off guard.

What are the signs of false labor?

In general, false labor signs include:

  • Braxton Hicks contractions that cause mild to moderate uterine pain similar to menstrual cramps.
  • Contractions that come and go and don’t get stronger over time.
  • Contractions that subside with a change of position, movement, rest or a glass of water.

True vs. false labor: How can you tell the difference?

To help you distinguish between true and false labor, which usually means Braxton Hicks contractions, look for the following signs of each to see what you might be experiencing if you're not sure. The difference is usually connected to the frequency, intensity and location of the contractions.

True labor

  • Your contractions occur at regular intervals, follow a pattern, and get stronger, longer and closer together over time. Contractions that are consistent and intensify over time are real. False labor contractions, on the other hand, are less regular and weaken over time. True labor contractions usually last about 30 to 70 seconds each, and they don't ease up with a change in activity or position. Each one feels like a very strong menstrual cramp. The purpose of true labor contractions is to thin and dilate the cervix, whereas false contractions (Braxton Hicks) are just practice for the real thing. Real contractions may also be accompanied by other common labor signs, including a pinkish or blood-streaked discharge known as bloody show. 
  • Your contractions are accompanied by a trickle that doesn't stop. Your water has likely broken, which is a sure sign of real labor. Amniotic fluid is odorless, so if you detect a sour smell, it’s just urine (and false labor).
  • You have nausea or diarrhea (or both) with your contractions. Alas, true labor sometimes also comes with an upset stomach. False labor doesn't.

False labor

  • You notice contractions in the front of your belly but the pain goes away when you change positions. True labor contractions usually start in the lower back and shift to the front — and they don’t get better when you switch positions, move around or rest.
  • You have no discharge or it's brownish in color. When you're really in labor, you might see red or pink discharge called bloody show.
  • Your contractions are irregular and infrequent and only last about 15 to 30 seconds (two minutes at most). While the pain is real, this labor is probably not. Instead, it’s likely false contractions at work, toning your uterine muscles and prepping your cervix for birth. True contractions last a good bit longer, often 30 to 70 seconds, and come more regularly and frequently over time.

Is it normal to have no Braxton Hicks contractions?

Having no Braxton Hicks contractions is completely normal, and it won't be a problem when it comes time to deliver your baby.

Some pregnant women, especially first-timers, don't notice their Braxton Hicks. Others may not know what they are when they do feel them.

While they're quite intense in some women, especially those who've had a baby before, they can be so mild in others (just a slight tightening of the abdomen) that they're overlooked. 

In any case, don't worry if you're not experiencing Braxton Hicks, as you simply may not be tuned in to them, or you may get them later in your pregnancy. Some women feel Braxton Hicks in the second trimester, others in the third. Once you get closer to your due date, they can become stronger and more frequent (though not always!). Regardless, feel free to check in with your doctor to get your questions answered and for reassurance that all is humming along normally.

What you can do about Braxton Hicks contractions

  • Drink up. Even minor dehydration can cause these practice contractions.
  • Move. Try changing your position during a painful contraction — if you're sitting, stand up (and vice versa). Walking and resting can both make a difference too.
  • Visualize. Use these contractions as a chance to practice the breathing and visualization techniques you've learned in your childbirth education class. (Your partner or coach can practice too!)

When to call the doctor

Don’t hesitate to call your health care provider if you feel uncomfortable, concerned or unsure about any pre-labor or pregnancy symptoms (or lack thereof) or don't know whether what you're feeling are labor contractions or Braxton Hicks. Labor signs can be confusing, and preterm labor can be particularly tricky to pinpoint, so it’s always best to talk to your doctor or midwife.

If your practitioner tells you to come in, it might turn out to be a false alarm and an unnecessary trip — but you’d be far from the only mom-to-be who’s gone to the doctor's or hospital thinking she was in labor when she wasn't. Pre-labor can last for a few hours or a month or more, and signs and symptoms can be different for every person (and every pregnancy).

Since it isn't always easy to tell whether you're in labor on your own, get your practitioner’s help. That’s what she’s there for. And sooner or later, you’ll hear those magic words: "This baby is on the way!"