Braxton Hicks contractions

What are Braxton Hicks?

Named after the English doctor, John Braxton Hicks, they are a type of contraction, but they don't signify the start of labour. Essentially, it's when the muscles of the uterus contract – typically for between 30 to 60 seconds at a time, but occasionally for up to two minutes, causing a squeezing feeling across your belly. Sometimes your bump has a funny, 'rigid' look to it as this happens. They usually subside within 20 minutes to an hour.

What do Braxton Hicks feel like?

Most women describe a feeling of a band tightening across their bump. The sensation is mostly high up and at the front, rather than in the pelvis or lower back (like labour contractions). Some women feel nothing at all, but notice that their bump has gone rigid and changed shape slightly. Each one tends to last less than a minute and shouldn't be too uncomfortable. There's no need for pain relief, but as you near your due date, you may find that they become a little more intense. Some women describe a very mild ache, like light menstrual cramps, but often, the contractions are undetectable.

Do bear in mind, though, that the definition of 'painful' varies from person to person. If you're feeling a bit miffed that, instead of mildly uncomfortable contractions, you're experiencing quite intense crampy ones, take heart in the fact that you won't be the only one. And if you truly are concerned about their intensity or frequency, call your midwife or GP.

When do Braxton Hicks contractions start?

Technically, they can start at around week six or week seven of pregnancy but you don't tend to notice them until around the middle of your pregnancy when your uterus is much bigger, in the second to third trimester. Most women who experience them feel them from around week 20 and you'll notice an increase in frequency as your due date nears.

Do Braxton Hicks contractions hurt?

They tend to just be uncomfortable, rather than truly painful, so if you're closer to your due date don't dash to throw your hospital bag in the car until you're sure. Many a first-time mother has looked back on her Braxton Hicks from the very much more painful throes of second stage labour and laughed at the memory of wondering if 'this could be it'.

While not as painful as true labour, they are often still not a pleasant feeling (in comparison to a shoulder massage and a box of Ferrero Rocher, say), so you can feel entitled to wince a bit and put your feet up when they occur.

Why do they happen?

Experts are divided as to their purpose – some believe they help tone the uterine muscle, promote blood flow to the placenta and increase oxygen levels sent to the baby, others think their purpose is to help soften the cervix in preparation for labour and birth.

Alternatively, it could just be your body having a right royal laugh at your sanity's expense. They're often known as 'practice contractions', and they're handy preparation for the real thing. You can practise not swearing at your other half when you are doubled over – or practise your breathing exercises without feeling quite so foolish. So they aren't wasted.

How do you tell the difference between Braxton Hicks and real contractions?

Many a red-faced mum-to-be has been turned away from the delivery ward thanks to these oh-so-helpful practice contractions, especially during the latter stages of pregnancy, when they can increase in frequency and strength – what's sometimes referred to as 'false labour'.

NICE guidelines actually state that all first-time mums should be offered antenatal education about the signs of labour, consisting of:

• How to differentiate between Braxton Hicks contractions and active labour contractions

• The expected frequency of contractions and how long they last

• Recognition of amniotic fluid ('waters breaking')

• Description of normal vaginal loss

Typically, they differ from the real thing in that they're irregular in intensity and frequency and their timing is unpredictable and non-rhythmic – they tend to turn up, do their erratic thing and then taper off. Plus, they're usually not truly painful, just uncomfortable.

In contrast to Braxton Hicks, real contractions are:

• Longer

• More frequent and easier to predict

• Noticeably more intense

• Get closer together as they progress

• Become progressively more painful and don't stop if you change position or do something different (see below)

What can I do to alleviate them?

You can, of course, simply ride them out – but if you want to try to alleviate the feeling, it helps to think about what triggered them.

Common triggers include being active, someone touching your bump, having a full bladder, being dehydrated or having sex (so don't get overly fruity when you need a wee and are gasping for a cuppa). Seriously though, changing what you're doing can often help, particularly if it's one of the following:

• Go for a wee

• Change positions – get up and walk around, if you've been sat down for a while

• Have a couple of glasses of water (particularly helpful with regard to the first point)

• If you've been doing something strenuous, sit down and give yourself a break for a while

• Have a soak in a warm bath (but avoid really hot water)

Although they can be a little uncomfortable sometimes, don't panic. The contractions are completely harmless to your baby and nothing to worry about unless they seem to be turning into something else. Again, if you have any concerns, give your midwife a call. They'll be able to advise you and hopefully put your mind at rest.

When should I worry?

Sometimes Braxton Hicks can become stronger and more regular and, if you're 37 weeks or more, it could be one of the early signs of labour. Unlike the practice version, though, actual labour contractions don't subside after a period of time, but become stronger, more frequent and, well, painful, in all honesty.

Warning signs to look out for if you're experiencing contractions include:

• Lower back pain/cramping

• Bloody or watery vaginal discharge

• Regular contractions coming less than 12 minutes apart

• Heaviness in your pelvis and the urge to push

• Diarrhoea

• Nausea

If you're less than 37 weeks pregnant these could be signs you're going into premature labour and you should contact your doctor or midwife immediately.

If you're beyond 37 weeks, the above symptoms could mean D-Day has arrived.

Should you experience any of the above or you think your waters have broken, you're bleeding or you have noticed a change in your baby's movements, you should still also speak to your doctor or midwife immediately, regardless of what else is going on.

Should I worry if I don't get them?

No. Like morning sickness, heartburn and all the other pregnancy aches and pains, not everyone gets them (or at least they don't notice them) and there's no need to worry if you don't. Not experiencing them over the course of your pregnancy won't affect your labour, and it may be that you have had them, but haven't noticed – especially if it's your first pregnancy.

What if I'm waiting for the real thing?

If you've reached the 40-week mark and are patiently (or not) awaiting the real deal, here are a few things that could help to get labour started: