Braxton Hicks vs Real Labor Contractions: How to Tell the Difference
Braxton Hicks vs Real Labor Contractions: How to Tell the Difference
The Question That Wakes You at 3 AM: Is This It?
Your belly tightens. You feel it harden. It's uncomfortable—maybe even painful. Your heart races. Is this labor? Are you having contractions? Or is this a Braxton Hicks—those "practice contractions" you've heard about? You check the clock. You time the contractions. They seem regular. But then they space out. They stop. They weren't that painful. You fall back asleep unsure. This happens multiple times in pregnancy, and it's incredibly frustrating. Understanding the difference between Braxton Hicks and true labor contractions helps you know when "it's go time" versus when your body is just practicing.
What Braxton Hicks Contractions Actually Are
Braxton Hicks are your uterus literally practicing for labor.
Definition
Braxton Hicks are involuntary uterine muscle contractions that occur throughout pregnancy, most noticeably in the second and third trimester. Named after John Braxton Hicks (who described them in 1872), they're essentially your uterus "rehearsing" for labor.
Why They Happen
Your uterus is a muscle. Like any muscle, it contracts and relaxes. Braxton Hicks are these practice contractions—your uterine muscle strengthening and preparing for the work of real labor.
When They Start
Braxton Hicks can start as early as second trimester (weeks 13-16) but are more commonly felt in third trimester (after week 28). Some people feel them earlier; some don't feel them at all.
How Common They Are
Very common—most pregnant people experience them. You might not feel all of them (especially earlier in pregnancy), but your uterus is contracting regularly throughout pregnancy.
Why Called "Practice Contractions"
Because they don't dilate your cervix. They don't progress toward labor. They're literally practice—your uterus getting ready for the real thing. They usually stop by themselves or with rest, hydration, or position change.
What Real Labor Contractions Are
Real labor contractions are fundamentally different from Braxton Hicks.
Definition
Real labor contractions are uterine muscle contractions that progressively dilate your cervix, moving it from closed (0cm) to fully open (10cm). Unlike Braxton Hicks, they progress and don't stop on their own.
Progressive Nature
Real labor contractions have a specific pattern: they get stronger over time, last longer (starting 30-60 seconds, progressing to 60-90 seconds), and come at increasingly regular intervals (eventually 3-5 minutes apart). They don't go backward—they progressively move toward birth.
Cervical Dilation
Only real labor contractions dilate your cervix. Your provider can check cervical dilation to distinguish real labor from false labor. Braxton Hicks don't change your cervix.
Physical Location
Real labor often starts in the back (lower back pain) and moves toward the front of the belly. Contractions radiate. Braxton Hicks typically only affect the front of the belly and feel more like tightening than radiating pain.
Characteristics of Braxton Hicks Contractions
Here's how to identify Braxton Hicks:
Usually Painless or Mildly Uncomfortable
Braxton Hicks feel like tightening or hardening of the belly, not pain. You might feel discomfort, but it's usually not the "labor pain" you've heard about.
Irregular Timing
Braxton Hicks don't follow a pattern. One happens at 2:00, the next at 2:15, the next at 3:00. They're sporadic, not regular.
Don't Increase in Intensity
Over the course of an hour, Braxton Hicks don't get progressively stronger or longer. They remain relatively consistent.
Stop with Movement, Hydration, or Position Change
Walk around, drink water, change positions—Braxton Hicks often stop or decrease. Real labor contractions continue despite these interventions.
Feel Like Tightening, Not Pain
You feel your belly harden and tighten. It's the sensation of muscle contraction. Real labor is more painful and radiating.
Don't Cause Cervical Dilation
Only your provider can confirm this, but Braxton Hicks don't change your cervix. You'll stay at 0cm dilation.
Usually Only Affect Front of Belly
Braxton Hicks are typically felt across the front of the belly. Real labor pain radiates from back to front.
Characteristics of Real Labor Contractions
Here's how to recognize real labor:
Progressive Pain
Real labor pain gets stronger over time. Each contraction is more intense than the last. By active labor, contractions are genuinely painful—the kind of pain you can't walk or talk through.
Regular Pattern
Real labor follows a pattern. Contractions come every 10, then 8, then 5 minutes apart. You can predict when the next one is coming.
Start in Back, Move to Front
Many people feel real labor as back pain that radiates around to the front of the belly. This is different from Braxton Hicks.
Continue Despite Movement
Walking, changing position, drinking water—nothing stops real labor contractions. They continue regardless.
Accompanied by Other Signs
Bloody show (blood-tinged mucus), amniotic fluid leak, or other signs might accompany real labor contractions.
Cause Measurable Cervical Change
Your provider checks and finds your cervix is dilating (1-2cm, then 3-4cm, progressively opening). This confirms labor.
Your Instinct Usually Knows
By the time you're in true labor, you usually know. Something feels different. The pain feels different. Your body feels like something is happening.
The Gray Area: When You're Not Sure
Sometimes it's genuinely hard to tell. Here's what to do:
Call Your Provider
Seriously. That's what they're there for. Describe what you're feeling. They'll ask questions to help differentiate. They might want to check you.
Go to Hospital if You're Unsure
There's no penalty for going to hospital for "false labor." Better to check and be wrong than to miss labor. Hospital staff can confirm whether you're in labor.
Expect Possible Disappointment if Sent Home
If you go to hospital and it's false labor, you'll be sent home. This is disappointing and frustrating. But it's also safe—better to go early than miss labor.
Prodromal Labor Complicates Things
Prodromal labor is contractions that feel like labor but don't dilate your cervix—it's labor rehearsal that's more intense than typical Braxton Hicks. You might have hours of contractions that don't lead to active labor. This is real, it's uncomfortable, and it's not "false labor" but also not yet real labor.
When Intermittent Contractions Are Still Labor
Early labor can be very irregular. Contractions might be 5 minutes apart, then 15 minutes, then 3 minutes. If they're progressively getting stronger or if your cervix is dilating, it's labor—even if the pattern is weird.
Other Signs Labor Is Starting
Contractions aren't the only sign:
Bloody Show
Loss of your mucus plug (which seals your cervix) causes bloody show—pink, red, or brown-tinged mucus. This can happen days before labor or at labor onset. It's a sign your cervix is changing.
Amniotic Fluid Leak
Your water breaks or you notice fluid leaking. This is a clear sign labor is starting (or about to). Contact your provider immediately.
Nesting Instinct Surge
Sudden burst of energy, need to clean, organize, prepare. This "nesting" can precede labor by hours or days.
Cervical Changes
Your provider can feel that your cervix is softening, effacing (thinning), or dilating. These changes indicate labor is beginning.
Baby Position Changes
You might feel the baby "drop" lower in your pelvis as they prepare for birth. You might feel different movements or less movement as baby settles into position.
Diarrhea or Digestive Changes
Your body clearing out in preparation for labor. Some people experience loose stools days before labor.
Frequently Asked Questions
Q1: Can Braxton Hicks lead to real labor?
Braxton Hicks don't cause labor to start, but they can precede labor. You might have hours of Braxton Hicks that gradually progress into real labor.
Q2: How long can you have Braxton Hicks?
From second trimester through end of pregnancy. Some people have them for weeks before active labor begins.
Q3: What if I go to hospital for Braxton Hicks?
You'll be evaluated. They'll confirm it's not labor and send you home. This happens frequently. No judgment.
Q4: Is there a way to stop Braxton Hicks?
They usually stop on their own. Walking, hydration, position change, rest—these often help them resolve.
Q5: Can you have both Braxton Hicks and be in early labor?
Yes. Early labor can feel irregular at first. You might have some Braxton Hicks mixed with early labor contractions.
Q6: How will I know for sure when it's real labor?
Your provider will. Call them, describe symptoms, they'll help determine if it's real labor.
Q7: When should I definitely go to hospital?
Water breaking, vaginal bleeding (not just show), severe pain, fewer than expected fetal movements—definitely go. With contractions, when in doubt, call your provider.
Trust Your Body and Your Provider
The line between Braxton Hicks and early labor can be blurry. Your body might not cooperate with textbook descriptions. Contractions might be irregular. Your pain tolerance might make real labor feel different than you expected.
When in doubt, call. That's what your provider is there for. There's no prize for figuring it out on your own. There's no shame in going to hospital for false labor. Better to check than to miss it.
And know this: once labor truly begins, you usually know. Your body will tell you. Trust it.
Explore SoulSeed's complete pregnancy guides for more on labor, delivery, and what to expect. You're preparing for one of life's biggest moments. 💙
