Are they real contractions or false contractions? How to distinguish them?

Am I having real contractions, the labor contractions that will lead me to give birth to my baby, or are they false contractions? How can I distinguish them?

This Hamletic doubt is common to all expectant mothers who are approaching the days of childbirth. Especially if you are pregnant for the first time, it becomes difficult to understand if they are the real ones or not, and even in this case experience counts for a lot.

False contractions are also called  Braxton Hicks contractions  and can be similar to real contractions, with the difference that… the former don’t lead to labor, the latter do.

Real contractions follow a recognizable pattern, while Braxton-Hicks contractions vary in duration and frequency. Braxton-Hicks contractions also tend to be less painful and usually only cause discomfort in the front of the abdomen.
Braxton-Hicks contractions simulate real contractions to prepare the body for childbirth. However, they do not lead to labor. True contractions only occur when labor is actually starting.

Recognizing true contractions is very important in order to be able to go to the doctor if you are far from the due date, or go to the hospital to give birth if the time has come.

The real contractions

Contractions occur when the muscles around the uterus contract and relax. They can occur at any time during pregnancy. But “real” contractions only happen when labor begins.

They are painful contractions and the pain tends to increase over time.

The location of the pain can vary from woman to woman, but is usually located around the abdomen and lower back. In some women, the pain spreads to the hips and thighs.

Labor typically begins with regular, persistent contractions. These cause the cervix to dilate   in preparation for the birth of the baby

The false contractions

False contractions can also occur long before labor and Braxton Hicks contractions and  prodromal contractions belong to this category .

These contractions can start as early as about 6 weeks of pregnancy, but are usually not noticed until the second or third trimester. While it’s not clear what triggers them, their function is to prepare a woman’s body for labor.

Braxton-Hicks contractions tend to occur sporadically. They vary in frequency, duration, and intensity , but usually occur more frequently during the later stages of pregnancy.

Braxton-Hicks contractions do not cause the cervix to expand and do not lead to labor.

How to distinguish between true and false contractions?

Many women mistake Braxton-Hicks contractions for real contractions especially when they occur in the third trimester.

Here are some key differences to help you tell them apart:

  • Duration : True contractions last about 30-70 seconds and occur at regular intervals. Braxton-Hicks contractions don’t follow a specific pattern.
  • Frequency : True contractions become more frequent as labor approaches. Braxton-Hicks contractions do not increase in frequency.
  • Pain : In general, true contractions are more painful than Braxton-Hicks contractions which cause discomfort but not actual pain.
  • Location : True contractions are felt throughout the abdomen and lower back, and the pain can spread to the legs. Braxton-Hicks contractions usually only cause discomfort in the front of the abdomen.
  • Movement : Changing position or moving often stops Braxton-Hicks contractions. However, movement does not affect true contractions.

When to notify the doctor?

Learning to distinguish between contraction types can help a woman know when to contact her ob-gyn or midwife. In any case, it is always preferable to contact your doctor when you are not sure of the type of contraction.

If these are real contractions, it is important to notify your gynecologist and go to the hospital.

Contractions are likely to be the right ones if they occur in a regular pattern and gradually increase in frequency. True contractions tend to become painful, and the pain often spreads to the abdomen and lower back.

Other signs that labor is starting are:

  • loss of mucus plug
  • vaginal bleeding (it is a good idea to go to the hospital immediately if bleeding occurs)
  • breaking of the waters 

As delivery approaches, the baby makes efforts towards the cervix. This can happen from a few weeks to a few hours before labor.

Another sign is an increase in vaginal discharge (leucorrrhea), which can occur from a few days before labour.

If regular and painful contractions appear before the third trimester, or in any case before 37 weeks of pregnancy, it is important to contact your doctor immediately or go to the hospital because it could be a sign of preterm birth .

For any doubts about the type of contractions, the reference is always the gynecologist or midwife who follows the woman. One more check is always better than one less!

Kathryn Barlow is an OB/GYN doctor, which is the medical specialty that deals with the care of women's reproductive health, including pregnancy and childbirth.

Obstetricians provide care to women during pregnancy, labor, and delivery, while gynecologists focus on the health of the female reproductive system, including the ovaries, uterus, vagina, and breasts. OB/GYN doctors are trained to provide medical and surgical care for a wide range of conditions related to women's reproductive health.

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