Pregnancy
Braxton Hicks vs Real Labour: How to Tell the Difference
By Raised Editorial ·
It is the midnight panic of the third trimester: Is this it, or is this just a practice run? Here is exactly how to tell the difference between Braxton Hicks contractions and the start of real labour.
You are 37 weeks pregnant. It is 11 PM, and suddenly your belly tightens into a hard knot. Ten minutes later, it happens again. The panic—and excitement—sets in. Is it time to grab the hospital bag?
For many first-time parents, distinguishing between "practice" contractions and the real thing is incredibly confusing. The medical term for these practice rounds is Braxton Hicks contractions.
Here is a breakdown of the myths versus the reality of how your body prepares for birth, and how to tell when it is finally time.
Myth 1: Braxton Hicks are just "mild cramps"
The Reality: Braxton Hicks contractions are the muscles of your uterus flexing and practicing for the marathon of birth. While some people describe them as a mild, painless tightening (like a belt being pulled snugly around your stomach), they can absolutely be uncomfortable, especially late in the third trimester.
The defining feature of Braxton Hicks isn't necessarily that they are painless; it is that they are irregular.
Myth 2: If it hurts, it must be real labour
The Reality: Pain is subjective, but pattern is not. The most reliable way to tell the difference is the pattern of the contractions.
- Braxton Hicks: These are erratic. You might have one, then another 8 minutes later, then nothing for an hour, then one 20 minutes later. They do not get progressively closer together, and they do not get consistently stronger.
- Real Labour: True labour contractions are rhythmic and progressive. They get longer, stronger, and closer together over time. They demand your attention and eventually make it impossible to walk or talk through them.
Myth 3: Walking around will help real labour start
The Reality: Movement actually helps you diagnose what type of contraction you are having.
If you are having Braxton Hicks contractions, changing your activity will often make them stop. If you have been on your feet all day, sitting down with a large glass of water will usually calm the uterus. If you have been sitting, going for a short walk might stop them.
Real labour contractions do not care what you are doing. If it is true labour, the contractions will continue and intensify whether you are walking, resting, or drinking water.
Myth 4: Real labour always starts at the front of your belly
The Reality: Braxton Hicks contractions are almost always felt entirely in the front of the abdomen.
True labour, however, very often begins in the lower back and wraps around to the front of the abdomen, like a tight band. Some describe the early stages of true labour as feeling like very intense menstrual cramps accompanied by a heavy, aching back.
When to Stop Guessing and Call
If you are ever unsure, do not sit at home stressing. The American College of Obstetricians and Gynecologists (ACOG) advises that midwives and obstetricians expect these calls—it is literally their job to help you figure it out.
However, regardless of contraction patterns, you should call your healthcare provider immediately if:
- You think your water has broken (even if you have no contractions).
- You experience vaginal bleeding that is more than just light spotting.
- You notice a significant decrease in the baby's movements.
- You are experiencing strong contractions before 37 weeks (a sign of preterm labour).
If you drink some water, lie down, and the contractions fade away, you can put the hospital bag back by the door. Your body is just doing an excellent job warming up.