Am I in Labor? Or is This False Labor (Braxton Hicks)?

True labor occurs when you feel contractions at regular intervals that get closer together, lasting 30-90 seconds, and increase in strength. The sensations from true labor commonly start in your lower back and wrap around your front abdominal area, but this may not occur for everyone. This sometimes feels like strong menstrual cramps that cause the front of your body to tighten and your belly to become hard. Other signs of labor that you should call your healthcare provider about include:

• Painful and/or strong contractions that occur regularly about 3 to 5 minutes apart. They typically become more regular and stronger as time goes on.
• Vaginal bleeding or “bloody show” and/or changes in vaginal discharge
• Fluid trickle, leakage, or a gush of “water breaking”
• Dull low back pain and/or pressure on the pelvis and rectum

If you are experiencing any of these symptoms, contact your healthcare provider, as they may indicate that labor has begun.

Braxton Hicks contractions, sometimes called false labor, are how your uterus prepares for the work of labor. This is commonly felt as a tightening sensation on the front side of your body. They can start as early as 6 weeks gestation though they are typically not felt until the second or third trimester. Braxton Hicks are uncoordinated contractions that are generally relieved with rest and hydration and can occur earlier and more frequently in subsequent pregnancies. You can think of this as strength training for your uterus to prepare for true labor. They may feel uncomfortable, but they should not be painful.

There is debate about whether Braxton Hicks contractions and false labor (sometimes called prodromal labor) are the same, as the terms are often used interchangeably. Generally speaking, prodromal labor differs from Braxton Hicks in that it can mimic true labor with coordinated, regular, and painful contractions that follow a pattern but do not result in cervical changes. Prodromal labor tends to occur later in pregnancy, though for some people, it can last weeks before labor actually begins.

Some other things that differentiate Braxton Hicks contractions from true labor:

• Braxton Hicks contractions do not increase in frequency, duration, or intensity, and the pattern of cramping is irregular and unpredictable
• They may last less than 30 seconds or up to two minutes
• They get weaker over time. True labor contractions strengthen over time
• They do not result in cervical dilation or effacement (stretching and thinning of the cervix)
• They are often only felt in the front abdominal area or may feel like period cramps. True labor contractions wrap around the lower back to the front of the abdomen
• They change or subside with movement. In true labor, movement can make contractions stronger

Gas pain can make the abdomen feel hard and distended, which can easily be confused with contractions. Unlike labor, gas pains, cramping, and bloating do not have a pattern or rhythm and typically remain constant until you have passed gas or had a bowel movement. They should also not be accompanied by any of the other signs of true labor. If you are experiencing regular gas pain and discomfort, talk to your healthcare provider about over-the-counter options such as simethicone (see “What can I do about it”) to reduce your discomfort.

What can I do about it?

A medication called simethicone, found in medications like Gas-X, helps dissolve gas bubbles in the gastrointestinal tract. This medication is not absorbed into the body, is safe for pregnancy, and can quickly relieve gas pain and pressure. It can be purchased in tablet, capsule, or liquid form. Ask your healthcare provider about a pregnancy-safe brand they recommend.

Gentle movements like walking, yoga, and stretching may alleviate some of the discomforts of gas and bloating. This can also help ease Braxton Hicks contractions if you have been sitting for extended periods of time.