What would you like to know about Braxton Hicks?

Did you know your uterus contracts daily even when you are not pregnant? During pregnancy your body goes through many physical and emotional changes that prepare you for birth, breastfeeding and motherhood. By month nine the uterine muscles have stretched and the cervix starts to soften. Before labour begins you may feel cramps that can be picked up on monitors, yet they do not signal the start of labour. They can be strong enough to make you think it is time to head to hospital.

Not every mum-to-be feels Braxton Hicks. The name hints at “predicting” labour, but you cannot know if it will be tomorrow or in one to two weeks. Some women feel them for weeks. During these tightenings your cervix and body prepare for labour, with softening and sometimes thinning of the cervix. In most cases the cervix does not start to open because of these contractions.

What are Braxton Hicks?

Through Braxton Hicks contractions your body gradually gets ready for birth. The cramps are caused by the uterine muscles tightening from time to time. These are not true labour contractions, so they are often called practice contractions, and they mainly appear in the third trimester, typically from 37 weeks. They usually last between 30 seconds and two minutes and may help with the mucus plug coming away.

An older sibling rests their face on Mum’s bump to feel the baby moving

Certain things can trigger Braxton Hicks. You might notice them with more intense movement, when your baby is particularly active, or even when your partner strokes your bump. Dehydration, sex and a full bladder can also bring them on.

You may also hear the term “bump tightening”, which can start from around 20 weeks. We write more about this further down.

Spotting Braxton Hicks

To tell these tightenings from labour contractions, it helps to know a few basic differences. Very important: if you notice any unusual symptom, or you are unsure, contact your midwife or maternity unit straight away. If you feel tightenings before 37 weeks, ask for help.

Braxton Hicks typically:

occur at irregular intervals
are often felt later in the day while resting
are felt mainly across the front of the bump
vary in length
do not get stronger over time
do not become more frequent
are painless or feel like period-type cramps
make the bump feel hard as the uterus tightens
ease with rest or a change of position. nhs.uk+1

What are true labour contractions like?

The first phase of labour comes with regular contractions that grow more frequent, stronger and longer. Early on they may come every 20 minutes and last about 30 seconds. When they are coming every five to ten minutes, it is time to go to hospital.

A mum labours with support from her partner

During labour, contractions:

arrive at regular intervals and get closer together
intensify over time
lengthen in duration
are often felt in the lower back and move forwards
do not stop with a change of position.

Your waters also break during labour. Before 37 weeks this is preterm rupture of membranes and needs prompt assessment to reduce infection risk, since the protective layer between baby and the outside world has gone. Waters can trickle or gush. If you want to read more about the signs of labour and when to go to hospital, see our previous article.

What do Braxton Hicks feel like?

You might notice tightening across the bump that is painless and not really uncomfortable. Some women feel a pulling sensation that comes and goes, while others compare it to period cramps, ranging from mild to quite intense. Some mums-to-be feel them so strongly they assume labour has begun and go in to be checked, which is always fine for reassurance.

What does “bump hardening” mean?

Almost every mum-to-be notices the bump hardening from around 16 weeks. The whole bump can feel rock hard for 30 to 60 seconds, without pain. You can sometimes see the shape change with a tightening, almost like a block, and you may even make out your baby’s outline.

A mum-to-be rests in bed

In the second and third trimesters hardenings can come from round ligament stretching, and Braxton Hicks can appear too. External factors can set them off, for example strong movements, weather changes, stress, fatigue or dehydration. If you feel you have overdone it, walked a lot or lifted an older child, take a rest. After a busy day, hardenings are often more common in the evening once you finally lie down.

Hardenings are normal if they are not too strong, not too frequent, not constant, and not accompanied by bleeding. If any of these occur, contact your doctor without delay. As a general guide, three to four tightenings in under an hour can be normal, adding up to no more than 10–12 in a day.

What helps when your bump hardens?

Resting or lying down can help, as can finding calm if you feel stressed. Hydration is vital in pregnancy, so check your fluid intake and top up regularly. Only take magnesium if it has been recommended by your doctor, who will advise the right dose and when to stop. If tightenings are very frequent, strong, or come with other symptoms, seek medical advice.

Do tightenings before 37 weeks mean trouble?

Activity in the uterus before 37 weeks does not automatically mean preterm labour or miscarriage. In early pregnancy the growth of the uterus or round ligament pain can feel like period cramps, which many mums-to-be notice. Uterine tightenings can start from 16 weeks, often as bump hardenings, and after 20 weeks they may be felt daily.

Even so, treat any cramps, strong pain or bleeding seriously, as they may indicate labour is starting, and contact your doctor immediately. In pregnancy, any symptom that differs from your normal is worth checking with a professional as soon as possible.

References:

NHS — Signs that labour has begun and Best Start in Life: signs of going into labour (includes information on practice contractions and the mucus plug).

Tommy’s (UK charity) — Braxton Hicks contractions and 4 ways your body gets ready for labour.