Braxton Hicks: False vs. Real Labor

Medically Reviewed by Zilpah Sheikh, MD on October 11, 2023
6 min read

Braxton Hicks contractions are "false" labor pains. If you're pregnant , you might have these before true labor. They’re your body's way of getting ready for the real thing. But they don’t mean labor has started or is about to begin. 

Some people describe Braxton Hicks contractions as tightening in their belly that comes and goes. Many say they feel like mild menstrual cramps. Braxton Hicks contractions may be uncomfortable, but they don’t cause labor or open your cervix.

Unlike true labor, Braxton Hicks contractions:

  • Don’t last longer as they go on
  • Are felt only in your belly

You may have Braxton Hicks contractions during your third trimester of pregnancy or as early as your second trimester. While they may concern you, these contractions are normal and nothing to worry about.

Dehydration is the most common cause of Braxton Hicks contractions. Other triggers include:

  • Illness that causes nausea or vomiting
  • Your baby's movement
  • Your activity, especially lifting something or having sex
  • Having a full bladder (needing to pee)

 

To figure out whether your contractions are the real thing and you're going into labor, ask yourself these questions.

How often do the contractions happen?

  • False labor: Contractions don't have a pattern and don’t get closer together.
  • True labor: Contractions come at regular times and last about 30 to 70 seconds. As time goes on, they get stronger and closer together.

Do they change with movement?

  • False labor: Contractions may stop when you walk or rest. They may go away if you change positions.
  • True labor: Contractions continue even after you move, change positions, or try to rest.

How strong are they?

  • False labor: Contractions are usually weak and don't get much stronger. Or they may be strong at first and then get weaker.
  • True labor: Contractions get stronger at a steady pace.

Where is the pain?

  • False labor: You usually won't feel pain, but you may have some discomfort in the front of your stomach.
  • True labor: Contractions may start in your lower back and move to the front of your stomach. Or they may start in your abdomen and move to your back.

What are the other symptoms?

  • False labor: You'll usually have no other symptoms.
  • True labor: You may lose your mucus plug (a clump of mucus that blocks the opening of your uterus). Also, your water may break or you may have bleeding.

Abdominal pain can be caused by other symptoms or infections that are common when you're pregnant. Some include:

Urinary tract infection (UTI)

Bacteria in your urinary tract cause most UTIs. Anyone can get one, but they're most common in women. 

If you're pregnant, you're more at risk for a UTI from about week 6 through week 24. As your uterus grows, it rests on your bladder, which can block the flow of your pee. Pain in the lower area of your stomach or near your bladder can be a symptom of a UTI.

UTIs can sometimes cause a kidney infection if they go untreated. This is a big concern if you're pregnant, as a kidney infection can lead to preterm labor (giving birth too early) and low birth weight. 

If you think you might have a UTI, tell your doctor right away. If your UTI is treated early, it won't hurt your baby.

Gas or constipation

When you're pregnant, higher levels of the hormone progesterone in your body relax your digestive tract and make it work more slowly. That can cause gas, bloating, and constipation (trouble pooping). Instead of being able to get rid of waste, it builds up and gets harder in the lower part of your stomach. 

Constipation can start as early as your first trimester and last until 3 months after having your baby.

Your stomach may feel swollen, but constipation doesn't cause the baby any harm.

Talk to your doctor if you're constipated for more than a few weeks. Don't use laxatives or other medications unless they're approved by your doctor.

Placental abruption

Your placenta (a temporary organ that gives nutrients and oxygen to your baby) develops in your uterus while you’re pregnant. Placental abruption happens when the placenta separates from the wall of your uterus too soon, before your baby is ready to be born. It can block nutrients and oxygen from your baby and cause you to bleed heavily.

Your risk of placental abruption is highest in the last trimester.

You should be seen by a doctor right away if you have any symptoms of placental abruption, including vaginal bleeding, sudden back or stomach pain, or uterine contractions. Not seeking immediate care can be life-threatening for you and your baby.

Round ligament pain

Sharp, shooting pains on the sides of your belly are called round ligament pain. This happens because the ligaments that support your uterus and attach to your pelvis get stretched as your uterus grows.

Round ligament pain tends to happen with movement, like standing up, rolling over, coughing, sneezing, or even peeing. The pain may also move into your groin. It typically lasts only a few seconds or minutes.

To ease round ligament pain, you can:

  • Change your position or activity. If you're lying down, it might help to lie on your opposite side.
  • Support your belly when you stand or roll over. 
  • Move more slowly.
  • Try to rest. 
  • Take a very warm bath or use a heating pad.

Early in your pregnancy, talk to your doctor about what may or may not be expected and when you might need to call them.

If you're not sure if what you're feeling is labor, call your doctor or midwife. They should be available at any time to answer questions and talk about your concerns.

Call your doctor or midwife right away if you have:

  • Any vaginal bleeding
  • Constant fluid leaks or if your water breaks (this can be gushing or trickling fluid)
  • Strong contractions every 5 minutes for an hour
  • Contractions that you can’t "walk through"
  • A distinct change in your baby's movement or if you feel fewer than 10 movements every 2 hours
  • Any signs of true labor before 37 weeks of pregnancy

 

You don't have to do anything for these contractions. If they’re making you uncomfortable, try one of these tips:

  • Drink water.
  • Take a walk. False labor contractions often stop when you change position or get up and move.
  • If you've been active, take a nap or rest.
  • Relax by taking a warm bath or listening to music.
  • Get a massage.

 

Braxton Hicks contractions are a way your body prepares for labor and are normal during pregnancy. Knowing the different causes of abdominal pain while you're pregnant and how these contractions differ from true labor can help you and your doctor decide the next steps you should take.

How do you tell the difference between Braxton Hicks and baby movement? 

Your baby can move during Braxton Hicks contractions, but every baby is different. Some may move more of less, so it's important to keep track of how much your baby moves and speak with your doctor immediately if you notice they are not as active.

Why am I having so many Braxton Hicks contractions? 

These contractions can happen more often and become stronger as you get closer to your due date. You're also more likely to have them after being physically or sexually active and in the afternoon or evening.