After practicing obstetrics for 20 years, there are certain questions that came up time and again from expectant moms. One of the most common questions was: What are Braxton Hicks contractions?
The diagnosis of Braxton Hicks contractions is made after other explanations for uterine contractions, such as premature labor, abruption, dehydration, ruptured membranes, multiple gestations, chorioamnionitis, and pyelonephritis have been ruled out.
This post may contain affiliate links, you can catch our full disclaimer at the bottom of this post.
Braxton Hicks contractions were first described by John Braxton Hicks in 1872. He noticed many women having painless contractions during pregnancy and well before their due date.
One term I have seen used to describe these contractions, which I find concerning, is “Practice Contractions”. I notice this term online; however, it is not used among clinicians in the field of obstetrics and can lead to a false sense of security.
Definition of Labor:
Labor is defined as uterine contractions associated with cervical change: effacement and dilation.
What is important to know about uterine contractions is that the uterus is a muscle and will contract in response to stimuli that cause uterine irritability.
*The reason for this article, is to emphasize the importance of distinguishing between Braxton Hicks contractions and real labor contractions.
What are Braxton Hicks contractions?
Braxton Hicks contractions have the following characteristics:
- Very occasional tightening of the uterus
- No pattern
- Often painless
- When clinically evaluated, Braxton Hicks contractions are not associated with cervical change.
What can cause Braxton Hicks Contractions?
- Increased activity mother or fetus
- Changes in maternal position (lying on the back can cause contractions)
- A full bladder can sometimes trigger Braxton Hicks, so urination may end the contractions.
*The key difference between Braxton Hicks Contractions and labor contractions
is that BHC’s are infrequent, irregular, often painless and do not cause cervical change.
Does every pregnant woman feel them?
Signs and symptoms during pregnancy differ from one woman to another. There are some women who truly do not feel Braxton Hicks contractions. Many will state that it is a tightening across the uterus. If there is low back pain associated with uterine contractions this is considered a characteristic of labor pain. If you experience low back pain with uterine contractions you should call your doctor immediately if you are not full term.
We know Braxton Hicks contractions can be painless because prenatal care providers occasionally will palpate a contraction during a prenatal visit and expectant mothers do not always feel them.
The term Braxton Hicks contractions are usually applied to sporadic uterine contractions after 20 weeks of pregnancy.
How to relieve Braxton Hicks contractions?
There are a few potential steps you can take to relieve Braxton Hicks contractions:
- Drink fluids. Drink one to two large glasses of water. If dehydration is the cause and it often is, your contractions should stop. If your urine is concentrated, drink water until clear.
- Decrease your activity. Sometimes you can overdo it. If you have been on your feet a long time or exercising, sit down or lie down and rest.
- Lie on your left side. Lying on your back can cause more uterine activity.
*Call your doctor while you are resting and hydrating so you will know what to do if the contractions do not subside. Frequency, duration, and intensity are all important factors, so have this information available when you call.
When should I call my doctor?
If you read about Braxton Hicks Contractions, you will always see a variation of the following statement:
“If you have any concerns about contractions during your pregnancy contact your prenatal care provider.”
When contractions require an evaluation, the only way to distinguish Braxton Hicks contractions from premature labor is by performing a physical exam of the cervix for signs of cervical change. An exam will determine if there is thinning of the cervix (effacement) and/or cervical dilation.
In addition to a physical exam to evaluate cervical change, an ultrasound may also be ordered by your doctor if there is any concern about cervical length.
Measuring the cervix using ultrasound gives an accurate assessment of cervical length and can determine if the internal opening to the cervix is dilated.
If you are getting close to your due date and are experiencing contractions, you should be aware of the signs of early labor.
The following are signs that often accompany true labor contractions:
- Lower backache, or pain in your abdomen or pelvis
- Loose stools
- Brown-tinged mucous
- Watery discharge
- Increased urination
Braxton Hicks contractions are real contractions and where they end and premature labor begins has been and continues to be a difficult distinction.
Treating contractions with hydration and left-sided rest in the office may be all that is required to get Braxton Hicks contractions to subside.
What to read next: