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Braxton Hicks Contractions

In 1872, an English doctor named John Braxton Hicks described the nature of contractions that occur in pregnant women before full term labor. These contractions now bear his name.

By the second trimester of any normal pregnancy, the woman may begin to experience contractions of the uterus that range in sensation from fluttery to rather painful. Some women describe feeling as though their baby is "balling up", but this sensation is actually generated by the uterus. These mini-contractions, known as Braxton Hicks contractions, are often compared to menstrual cramps in their intensity and can be very alarming to pregnant mothers.

Second trimester Braxton Hicks contractions are more likely to be experienced by women who have undergone one or more pregnancies. They are much more likely to occur in first pregnancies during the third trimester.

Though the misnomer "false labor" is sometimes applied to Braxton Hicks contractions, false labor is determined when the cervix is slightly dilated and never occurs before the final trimester. Braxton Hicks contractions actually begin very early on in the first trimester, but women are almost always unable to feel the contractions until the second trimester. The contractions are sometimes known as "practice contractions" and are thought to play a part in toning the uterus for actual labor. They rarely presage actual labor.

Braxton Hicks contractions can last anywhere from 20 seconds to two minutes and vary widely in intensity. They tend to be irregular, though as labor approaches they may begin to occur at measured intervals similar to true labor contractions. The contractions may cause the entire uterus to become hard and uncomfortable but are usually not particularly painful.

Braxton Hicks contractions can be brought on by almost anything - movement of the mother, movement of the baby, someone else touching the woman's abdomen, or slight dehydration are all considered to be causal factors. Women can often halt a round of Braxton Hicks contractions by a short walk followed by a rest and by drinking fluids.

Distinguishing Braxton Hicks From Actual Labor

  • Duration of contractions: True labor contractions come regularly, about 4-6 minutes apart, and usually become more intense. Braxton Hicks contractions tend to be irregular and do not grow closer together over a period of several minutes. In other words, if contractions taper off or ease up in any way, they are most likely Braxton Hicks contractions.
  • Location of pain: In true labor, contractions generally begin at the top of the uterus and radiate over the entire uterus and through the lower back into the pelvic region. The discomfort associated with Braxton Hicks contractions can be felt anywhere in the body, most commonly in the lower abdomen, the lower back, or the groin. True labor is felt all over the uterus and surrounding area, beginning in the back or top of the uterus; Braxton Hicks should only be felt in the frontal part of the uterus. Sharp pains or pains that occur at distinct intervals should be regarded with extreme caution.
  • Strength of contractions: With true labor, contractions tend to start out weaker and grow stronger rather rapidly. Braxton Hicks episodes often start out with a strong contraction and are followed by several shorter, weaker contractions.
  • Position changes and hydration: True labor pain does not dissipate with rest or hydration. Braxton Hicks contractions will lessen with mild activity, rest, or fluid intake.

In Summary

Preterm labor signs can be subtle. If gestation is less than 35 weeks and contractions begin, the woman should pay close attention to the duration, intensity, and location of the contractions.

If the contractions do not lessen in frequency and intensity after rest and fluids, or if they persist at regular intervals for more than one hour, the woman should call her ob/gyn to determine the best course of action.

If gestation is 36 weeks or more during a first pregnancy, the possibility of early labor is much higher than with subsequent pregnancies. Caution should be taken as first pregnancies are more likely to end in early labor.

Bottom line is simple: if anything - anything - seems suspect, a pregnant woman should call her practitioner. That's why they make the big bucks.

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