contractionsbraxton hicks contractions
Pregnancy

Take a deep breath: contractions are starting

Contractions or Braxton Hicks are one of the body’s ways of signaling to you that it is ready to give birth. It hurts? Oh, yes. Are there also false labors? not exactly. And: how do you speed up labor? Is it possible to relieve the pain? When to go to the hospital?

Labor is an expression of the contraction of the uterine muscle intended to direct the fetus towards the birth canal.

In true contractions, you will feel a regular rhythmic hardening of the uterus once every few minutes, with a relaxation between each hardening.

Feeling a few individual contractions during the day? Most likely these are simulated contractions (Braxton Hicks).


Until you experience it, you cannot understand what labor pains are. At first, the pains are sometimes similar to period pains, but when you get closer to the birth stage, it is difficult for mothers to remain indifferent – unless they receive an epidural.

What are labor anyway?

Labor is an expression of the contraction of the uterine muscle intended to direct the fetus towards the birth canal.

Why do contractions cause such severe pain?

True, not every contraction of a muscle in the body is accompanied by pain. In summer, unfortunately, it’s different. The reason for this is not entirely clear, and several hypotheses have been put forward:

  • decrease in the level of oxygenation to the muscle. The process can be compared to the chest pains that appear during a heart attack , when there is a blockage of blood vessels and a decrease in the supply of oxygen to the muscle.
  • Pressure exerted by the muscle fibers on nerve endings in the area of ​​the cervix and in the lower part of the uterus. This is the most accepted theory, given the fact that local injection of anesthetic reduces labor pain.
  • Stretching of the cervix during the opening.
  • Stretching of the peritoneum (the membrane that surrounds the walls of the abdominal cavity and organs in the abdominal cavity) in the upper part of the uterus. Its irritation, as in the case of appendicitis, can cause severe abdominal pain.

What do you feel when you have contractions?

It is usually not difficult to recognise contractions, even if this is the first pregnancy.

In real contractions, you feel a regular rhythmic hardening of the uterus every few minutes with a relaxation between hardening and an increase in the frequency of contractions. Sometimes the hardening is accompanied by back pain or pressure in the lower abdomen, and sometimes the feeling of the axis can start from the lower back towards the abdomen and downwards.

Labor pains do not go away if you change position.

How much does it hurt?

The intensity of pain experienced by a woman during labor differs from woman to woman and depends on many factors, including the woman’s pain threshold.

Are there false labors?

not exactly. The pain is real, but it may be the result of labor not leading to labor. They are called  “Braxton Hicks” or simulated contractions . It is true that these are completely contractions, that is, contractions of the uterus, but they are irregular, and their frequency does not increase gradually.

When it comes to several individual contractions during the day, it is likely that these are simulated contractions. If it is very painful and very regular, and of course if the contractions are accompanied by bloody discharge or water loss , you should see a doctor.

And if I’m not sure if these are real contractions or Braxton contractions?

In case of doubt, you should go for a test. During the test, the woman is connected to a monitor that registers the activity of the uterus using a transducer (Toco) placed on the abdomen, in the upper part of the uterus, through which you can get an impression of whether there are contractions, what their frequency is and how long they last.

The doctor will also do an external examination: he will palpate the uterus to find out if it is active. He is also expected to do a vaginal examination to find out if there have been any changes in the cervix.

What week does labor start?

Usually, Braxton Hicks begin towards the end of pregnancy and are used to prepare for birth, however, for some women, contractions may begin before the 37th week of pregnancy. These are early labors.

Since early contractions (as opposed to Braxton’s contractions) can lead to premature birth, you should get tested if the contractions appear in the earlier stages of pregnancy. Sometimes you can feel Braxton Hicks even towards the middle-end of the second trimester of pregnancy.

True labor causes effacement and opening of the cervix. Want to know what signs indicate an imminent birth? We have a guide .

When to go to the hospital?

The time to go to the hospital depends on many factors, so it is difficult to give a clear recommendation.

Among the factors that influence the decision: 

  • The distance to the hospital where the woman wishes to give birth.
  • The congestion on the roads.
  • Birth number.
  • The week of pregnancy.
  • The obstetric history of the woman (for example, has she previously had a caesarean section , is she a carrier of the GBS bacteria ).
  • The intensity of the pains and their frequency.

In principle, if the frequency of Braxton Hicks is more than one every ten minutes, and they are increasing in intensity and frequency, or painkillers are needed, and certainly if there is water loss – it is time to go to the hospital.

How do you check in the delivery room if the contractions are real or simulated?

In the delivery room the criteria are clearer.

You can monitor labor in two ways:

  • External monitoring: the monitoring is done on the woman’s abdomen above the uterine area. Such monitoring makes it possible to assess when the axis begins, when it is at its peak and when it ends. It does not allow assessing the strength of the contraction, but in relation to the Braxton Hicks of that woman.
  • Internal monitoring: one end of a catheter is inserted through the vagina into the uterus, and the other end is connected to a pressure sensor. Such monitoring makes it possible to accurately measure the intensity of the contraction and to calculate “Montebideau units”: a summary of the intensity of all contractions that occurred during 10 minutes of testing.

The beginning of labor appears in Montevideo values ​​that range from 80 to 120 (3 contractions in 10 minutes of 40 millimeters of mercury). There is no clear boundary between prenatal and birth. The process is usually progressive.

In the second stage of labor you can see Braxton Hicks of 80 to 100 millimeters of mercury and a frequency of up to five contractions for 10 minutes. The duration of labor is 60 to 80 seconds, and it does not change throughout the birth. The relaxation between axis allows the fetus to recover and receive oxygenated blood again.

However, it should be noted that today the internal monitoring of the intensity of contractions is rare in delivery rooms in Israel, and monitoring the intensity of contractions using Montevideo units is not common. The reason for this is that the Montevideo calculation requires – as mentioned – the insertion of a sensor into the uterus.

Is there a way to relieve labor pain?

Even if the woman plans on receiving an epidural immediately upon arrival in the delivery room, it is important that you know that this is not always possible, because she may still be in too early a stage of labor.

In the meantime, you can try other ways to make dealing with the pain easier, some of them are more successful, and others less so. These methods include, among others, a shower or bath; Using a TENS device, massage or movement.

In the hospital, of course, the range of options is a little wider and includes, among other things, an injection of pethidine (“blurring”) or the use of laughing gas.

Is there a way in which the woman can feel the contractions herself?

If the woman has already reached the end of her pregnancy, and Braxton Hicks still do not appear, there are several ways that can be tried to encourage childbirth. It should be known that there is no proof regarding the effectiveness of these methods, especially if there are not yet suitable conditions for the development of birth.

Here are some of the methods:

  • Sex (semen contains prostaglandins which together with orgasm can encourage Braxton Hicks).
  • Nipple massage (encourages oxytocin secretion).
  • Alternative treatments such as acupuncture , reflexology or massage.
  • Strenuous walking.
  • Herbal infusions of various kinds and castor oil have also been associated with inducing contractions and the beginning of the birth process, but not only that these are measures that have not been proven effective, but they may even be dangerous. 

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