Braxton Hicks or Early Labor?

One of the questions I get asked by my clients often is, how do I know if I’m having practice contractions, also known as Braxton Hicks contractions, or if I’m in early labor? Braxton Hicks contractions, even though referred to as practice contractions are still preparing your body for labor. These contractions can be quite uncomfortable for some people and are often confused as the start of early labor. If you feel your belly during these contractions you will notice that your belly hardens with each contraction. However, these contractions will be very irregular. If you try timing these contractions you will find that they are all over the place. You may have a few that are 10-15 minutes apart, then one that is 20 minutes apart, then not have one for an hour. These “practice contractions” will stop with position change, with drinking a glass of water, or just resting and putting your feet up. Braxton Hicks contractions are not consistent and there is no pattern to them. This is the major difference between Braxton Hicks and early labor.

Early labor usually starts in the evening or at night. This is when our bodies and minds are most relaxed. Lights are usually dim and it’s a calmer atmosphere. Early labor contractions will be consistent but very manageable in the beginning. Some people will actually sleep right through early labor until the contractions become more intense and wake them up. You will most likely experience lots of pressure in your lower back and pelvis and your belly will harden with each contraction. You will still be able to walk around and talk during these contractions, but it may be difficult to get comfortable. Nothing you do will stop these contractions from coming. Position change may make them feel more intense. If you feel that the contractions are not slowing down or stopping, this is when you should use your contraction timing app, a clock, or a timer to figure out how far apart they are. Time them for 1 hour then take a break. Try not to stress yourself out with the timing. Use the time between timing contractions for resting, taking a shower, getting something to eat and drink, snuggling with your partner, playing a board game, or watching a movie, you will need to save your energy for the more intense part of labor. If contractions seem to be getting more intense or if you feel they may be more frequent than before, time them again for 1 hour. A great rule to follow is 5-1-1, once your contractions are 5 minutes apart, lasting 1 minute, for at least 1 hour, it is time to call your provider, unless advised otherwise. This is usually when they will advise you to head to the place you will give birth or when your midwife will come to your home for a home birth. If at any time the contractions seemed to have stopped or slowed down significantly, you may be experiencing Braxton Hicks contractions.

During early labor, some people may experience ROM, the rupture of membranes, also known as your water breaking. This could be a big gush of warm liquid called amniotic fluid, or it can be a small trickle, feeling kind of like a period gush. The fluid will continue to leak. Movement and contractions tend to make it leak more. Some people are unsure if it is urine leaking or their amniotic fluid. Urine has a distinct smell and this is sometimes how you can tell the difference. Your provider should be called if you think that your water may have broken. Using the T.A.C.O. or C.O.A.T. acronym, take note of the Time, Amount, Color, and Odor (if any) of the fluid as your provider will ask these questions. If you are unsure if it’s your water that has broken, your provider may ask you to come in so they can do a swab to test if it is amniotic fluid. 

Some people may also experience something called a bloody show during early labor. This would be a brown or red-tinged discharge. This is caused by your cervix opening, also known as dilating, which may also cause your mucus plug to become dislodged. This discharge may also look like small jelly-like pieces, one big jelly-like clump, or a stringy bloody discharge of jelly-like mucus. If you notice a bloody show you should call your provider. In some cases people never experience ROM (breaking of waters) or bloody show during early labor, this often happens in the later stages of labor. This is why it is important to periodically keep track of how far apart and how consistent your contractions are.

If you are able to, try laboring at home during the early stages of labor. If you are able to carry a conversation and move around between contractions, chances are you are in early labor and you have plenty of time to relax at home. Home is usually where we feel the most comfortable. When you feel comfortable and you are surrounded by the love of your partner and/or family, labor will progress smoother and faster. Oxytocin, the hormone that promotes labor is highest when we feel loved, comfortable, safe, and relaxed. It can be scary to labor at home, especially for a first-time parent. If at any time you feel unsure or have questions, a call should be made to your provider. You and your provider will decide when it’s a good time to head to the place you will give birth. Some people may notice that contractions slow down on the car ride to the hospital or birth center, or even once they arrive there. This is normal and happens because your birthing brain has had a change in atmosphere, your body and mind want to make sure you are safe and comfortable before your labor progresses and you give birth. Once you are settled into your room you will start to relax again. When your Doula arrives, they can help you get back into a rhythm and recreate a calm atmosphere for your labor and birth.