What are Braxton Hicks Contractions?

Braxton Hicks contractions are irregular and infrequent relaxation and contraction of muscles of the uterus, also known as false labor pains. These contracts usually start after 6 weeks of pregnancy but does not cause significant pain due to their low intensity and frequency. In some pregnant women, these contractions become much more disturbing and discomforting during the second trimester of pregnancy. However, almost all pregnant women have these contractions during the third trimester of pregnancy.

Braxton Hicks contractions are the physiological process by which the body prepares itself for labor, but they do not specify the time or beginning of labor. These contractions are not an abnormal part of pregnancy. In most cases, they do not cause pain. Pregnant women just feel mild irritation and discomfort similar to that seen during menstrual periods. [i]

Physiology of Braxton Hicks Contractions:

Braxton Hicks contractions play a role in preparing the uterine muscles for the birth process by toning these muscles. That is why they are also known as practice for labor. They also help in the softening of the cervix. These sporadic contractions may increase the blood flow towards the placenta. Oxygenated blood fills the intervillous spaces of the uterus, where pressure is relatively low. Braxton Hicks contractions aid the blood to flow towards the chorionic plate so that oxygenated blood could enter fetal circulation. [ii]

What do Braxton Hicks contractions feel like?

Braxton Hicks contractions begin as a tightening of uterine muscles in the upper portion of the uterus and then spreads in the downward direction. Some women describe these contractions as tightening of the abdomen that is periodic and infrequent. Many women describe these contractions similar to the menstrual cramps. They cause hardening and odd bending or distortion of the abdomen. These contractions feel more intense and frequent as you reach closer to your delivery date.

These contractions are usually more intense and uncomfortable for women with second pregnancy as compared to the women who have become pregnant for the first time. But in some cases, first-time pregnant women may start to feel discomfort during the second trimester of pregnancy.

Read also our article What do contractions feel like

When do Braxton Hicks contractions start?

Braxton Hicks contractions may start early in the pregnancy, but you would not be able to notice them before the 20^th week of pregnancy. These contractions become more obvious after 26 weeks of pregnancy until the end of pregnancy. [iii]

Braxton Hicks Contractions vs. True Labor:

They are different from true labor pains because they are do not increase in duration, intensity, or frequency, which are suggestive signs of labor. These false labor contractions are infrequent, with uneven frequency and duration, and do not follow any pattern or rhythm. They do not cause pain and usually disappear after an interval and then reappear in the future. At the end of pregnancy, these contractions become more intense, and their frequency of occurrence increases, so women start to think that she has labor pains. At that time, they differ from labor pain in such a way that they do not cause dilation of the cervix and do not result in the delivery of the fetus.

Here we are going to compare Braxton Hicks contractions and True Labor:

1. They usually do not cause pain, while true labor is painful.
2. Braxton Hicks contractions have an irregular pattern of occurrence, while true labor occurs at regular intervals.
3. They are confined to your belly or some specific area while true labor starts in the back and spread around the belly towards the midline.
4. They reduce or stop when you change your positions or activity level. A woman can sleep during Braxton Hicks contraction. True labor aggravates with a change in position.
5. These contractions last within a short time that is 30 seconds to 2 minutes, while true labor lasts between 30 to 90 seconds and prolongs with time.
6. Braxton Hicks contractions don’t get close together over time, while true labor gets closer together and stronger with time.
7. Braxton Hicks contractions are weaker, and they lessen or disappear with time, while true labor gets intense with time. [iv]

Causes or Triggers:

Braxton Hicks contractions usually occur due to periodic tightening and relaxing of muscle fibers of the uterus. Exact phenomena of occurrence of Braxton Hicks contractions is not known. But some aggravating factors or triggers have been identified that include:

• Overexertion or hyperactive woman during pregnancy: Moderate exercise such as walking, yoga, or swimming is a good way to remain fit and healthy during pregnancy. A hard or intense workout can cause Braxton Hicks contractions. If you feel cramping or tightening during exercise, discontinue and take some rest to avoid Braxton Hicks contractions.
• Sexual intercourse: Having orgasm during pregnancy may cause a tightening of the belly that may predispose to Braxton Hicks contractions.
• Distention of bladder due to the fullness
• Dehydration: When muscles are dehydrated, they start to cramp up, and this also includes the uterus. Severe dehydration may lead to preterm labor due to excessive contractions of the uterus. Drinking a lot of water during pregnancy is a good way to prevent these problems.
• Urinary tract infections: Pain or discomfort due to UTI can predispose to Braxton Hicks contractions. Consult your doctor if you have a burning sensation during urination.

According to some studies and clinical trials, these triggers have one thing in common that is they cause potential stress to the fetus and increase the demand for blood and oxygen to the placenta for fetal requirements. [v]

Why should you be aware of Signs of Early Labor?

To deal with Braxton Hicks contractions and differentiate between the Braxton Hicks contractions and true labor, you should know about the signs of early labor while you are reaching close to the expected delivery date. Early signs of labor include:

• Pain in the pelvis and lower back that wrap the whole abdomen
• Brownish mucous or watery discharge
• Increase in frequency and urgency of urination
• Loosening of stools

If you are observing these signs along with regular and frequent contractions, you are possibly in labor. It is not necessary to meet your doctor or midwife immediately. You can tell them about the symptoms that you are observing and ask them about how long does it take to reach true labor contractions.

At the end of pregnancy, Braxton Hicks contractions are so confusing that a mother having many pregnancies in the past may not be able to identify whether it is true labor or false labor. The most convenient way to avoid confusion and stay calm is to keep yourself in close contact with the doctor or midwife. [vi]

Read also the article Signs Of Labor-How To Know The Signs Of Birth

Should I call my doctor or midwife?

• In case of mild discomfort during the second trimester and early third trimester, you do not need to call the doctor or midwife because these obviously are Braxton Hicks contractions. However, if you feel pressure and pain in addition to discomfort in the lower back, pelvis, and abdomen, you may be having early signs of labor. Such signs before 37 weeks of pregnancy may be considered a sign of premature labor, which needs immediate consultation with the doctor or midwife.
• If you have completed the full term, then you may wait according to the schedule arranged by your midwife or doctor. In case of strong contractions with 5 minutes gap, you should immediately go to the hospital.
• At any time during the course of pregnancy, you should consult the midwife or doctor if you have the following conditions or symptoms:
• Vaginal bleeding
• Constant pain in your abdomen
• If you observe that your baby’s movements have diminished or stopped
• Feeling very sick
• In case of any doubt, do not hesitate to call your midwife or doctor for advice [vii]

How to Get Relieved from Braxton Hicks Contractions?

If Braxton Hicks contractions are causing irritation or discomfort, you can take the following measures:

• Change your position or activity level, take a walk, or take rest if you are active
• Drink a cup of herbal tea or a glass of water
• Eat something
• Take a warm water bath for half an hour
• Attain mental relaxation by breathing deeply, or perform relaxation exercises [viii]

[i] Hill, W. C., & Lambertz, E. L. (1990). Let’s get rid of the term “Braxton Hicks contractions”. Obstetrics and gynecology, 75(4), 709–710.

[ii] Raines DA, Cooper DB. Braxton Hicks Contractions. [Updated 2020 Aug 11]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK470546/

[iii] Lockwood, C. J., & Dudenhausen, J. W. (1993). New approaches to the prediction of preterm delivery. Journal of perinatal medicine, 21(6), 441–452. https://doi.org/10.1515/jpme.1993.21.6.441

[iv] False Labor & Pregnancy. Cleveland Clinic. (2020). Retrieved 10 September 2020, from https://my.clevelandclinic.org/health/articles/9686-true-vs-false-labor.

[v] Raines, D. A., & Cooper, D. B. (2020). Braxton Hicks Contractions. In StatPearls. StatPearls Publishing.

[vi] Signs that labour has begun. nhs.uk. (2020). Retrieved 10 September 2020, from https://www.nhs.uk/conditions/pregnancy-and-baby/labour-signs-what-happens/.

[vii] MacKinnon, K., & McIntyre, M. (2006). From Braxton Hicks to preterm labour: the constitution of risk in pregnancy. The Canadian journal of nursing research = Revue canadienne de recherche en sciences infirmieres, 38(2), 56–72.

[viii] Braxton Hicks Contractions | American Pregnancy Association. American Pregnancy Association. (2020). Retrieved 10 September 2020, from https://americanpregnancy.org/labor-and-birth/braxton-hicks-762.