Braxton Hicks vs Real Contractions

What Braxton Hicks are

Tommy's describes them simply: "Braxton Hicks happen when the womb contracts and relaxes. Sometimes, they are known as false labour pains." They are one of the ways your body prepares for labour, and you are most likely to feel them in the second or third trimester.

The defining difference from labour is not how they feel — it is what they do. Unlike true labour contractions, Braxton Hicks do not cause the entrance of your womb (the cervix) to open. Nothing is progressing.

Two things are worth knowing before you start counting anything. First, not everyone notices them, and Tommy's is explicit that you should not worry if you do not have them. Second, they are not a countdown — feeling a lot of them does not mean labour is close, and feeling none does not mean it is far away.

What they feel like

Tommy's collects descriptions from people who have had them: "mild menstrual cramps or a tightening across the stomach that comes and goes." One person describes it as "a mild stitch that goes almost as quickly as it comes. Not painful but you are definitely aware it is there."

On its page about stomach pain in pregnancy, Tommy's characterises Braxton Hicks as "often irregular (more than 10 minutes apart), short-lasting, uncomfortable more than painful."

They may be uncomfortable, but Tommy's is clear that they should not be painful. If what you are feeling is genuinely painful, that is a reason to ring rather than to reassure yourself.

The comparison, side by side

Braxton Hicks

• Weak, short-lasting and irregular.
• More uncomfortable than painful.
• "Do not become longer, more painful or closer together over time."
• Come and go.

Labour contractions

• Get longer and stronger.
• Come at regular intervals.
• Come more often.
• Are painful, and increase in intensity.

The NHS says the same thing from the other direction. On labour: "your contractions tend to become longer, stronger and more frequent as your labour progresses." On Braxton Hicks: they "generally do not last that long, do not happen very frequently and do not build up."

Strip everything else away and you are left with one question: are they building? A single tightening tells you nothing. An hour of tightenings that are the same length and the same distance apart at the end as at the start is the Braxton Hicks pattern.

Why they get confusing near your due date

Because they change. Tommy's is honest about this: "As your due date gets nearer, Braxton Hicks contractions can sometimes seem to get stronger or happen more often. This is why some people mistake them for the real thing."

There is also a genuinely ambiguous phase of early labour. The NHS calls it the latent phase: "this is when your cervix becomes soft and thin, and starts opening." It "can take hours or sometimes days", and you will probably be advised to stay at home during it. So "I am not sure" is a normal state to be in, not a failure of observation.

What brings them on

Tommy's lists four triggers: being very active, having a full bladder, having sex, and dehydration. That is useful, because three of them are things you can change.

Its suggestions for easing them follow directly: change position; lie down if you have been active; walk about if you have been sitting; relax with a warm bath or a nap; drink water.

People often use these as a home test — the idea being that Braxton Hicks stop when you change what you are doing and labour contractions do not. That is a reasonable rule of thumb and it matches the trigger list, but it is worth being straight that no national source presents it as a diagnostic test. If tightenings settle when you rest and drink, that is consistent with Braxton Hicks. If they do not, you have not proved anything either way — you have simply reached the point where a phone call is the sensible next step.

When to call

Call your midwife or maternity unit if:

• You think you are in labour (the NHS says this plainly — you do not need to be certain).
• You are having regular contractions coming every 5 minutes or more often (NHS).
• You have strong contractions every five minutes that last 60 seconds or more (Tommy's).
• You are less than 37 weeks pregnant and having any regular tightenings at all. Tommy's says to call in that situation, and so does the NHS.
• You are simply not sure. Tommy's: "It's always best to contact your midwife or maternity unit for advice if you are not sure whether you are having Braxton Hicks or labour contractions."

Call urgently — do not wait to see what happens — if:

• Your waters break, or you have a gush or trickle of fluid.
• You have any vaginal bleeding.
• Your baby is moving less than usual, or the pattern has changed.
• Contractions last longer than 2 minutes each (NHS).
• You are having 6 or more contractions every 10 minutes (NHS).

Call your local emergency number (999 in the UK and Ireland, 911 in the US and Canada, 000 in Australia, or 111 in New Zealand) if you collapse, have a seizure, or have sudden severe abdominal pain with heavy bleeding.

If you are under 37 weeks

The threshold for calling is lower, and deliberately so. The NHS defines premature labour as labour before the 37th week and notes that "about 8 out of 100 babies will be born prematurely." Before 37 weeks, contact your midwife or maternity unit if you have regular contractions or tightenings, period-type pains, a gush or trickle of fluid from your vagina, or backache that is not usual for you. The NHS adds that you can also call "if you're unsure or worried about anything."

What actually helps

• Time an hour, not a tightening. Note the start time and length of each one. What you are looking for is a trend, and a single contraction cannot show you one.
• Change something. Drink water, empty your bladder, and either lie down or walk about, depending on what you have been doing.
• Do not wait for certainty before ringing. Maternity units expect these calls, and the NHS advice is to call if you think you are in labour.
• Keep watching movements. A change in your baby's movements is a reason to call regardless of what the tightenings are doing.