The closer your due date gets, the more your thoughts are likely to focus on the upcoming birth and the contractions you’ll experience. What do they feel like? How strong will they be? How will you know when it really starts? In this article, you’ll find the most important information about the different types of contractions during pregnancy and childbirth.
What are contractions?
Contractions are contractions of the uterine muscle that occur during pregnancy and childbirth. But a contraction isn’t just a contraction—they vary depending on the stage of pregnancy or labor. Each type has a different purpose: either preparing your body for birth or helping labor progress. You’ll likely notice differences in intensity and frequency. Because every woman experiences pain differently, it isn’t always easy to clearly distinguish between types of contractions. Still, knowing their typical characteristics can be helpful, since not all contractions mean labor has started. Learning to tell them apart can give you confidence and help you decide when it’s time to head to the hospital.
Contractions before birth
Braxton Hicks contractions or premature labor
These are referred to as early labor or preterm contractions, which can occur before the 36th week of pregnancy . You can recognize them by the fact that they occur more than three times per hour at relatively short intervals, and the pain gradually intensifies. They may be accompanied by watery or bloody discharge. Caution is advised with preterm labor, and you should definitely inform your doctor or midwife if you notice premature contractions. Not all contractions are a sign of early labor, as the cervix usually begins to open at around five to six contractions per hour. Nevertheless, premature labor is often a body's warning signal during physical and/or emotional overload and a clear sign that you should allow yourself rest and relaxation. Your doctor will likely also recommend magnesium for premature contractions, as it has a relaxing effect. If there is otherwise a risk to you or your baby, they may also administer a labor suppressant to reduce the contractions.
Braxton-Hicks contractions or practice contractions
Practice contractions, also known as Braxton-Hicks contractions, will likely occur during your pregnancy, several weeks before the actual birth. Even if they feel unfamiliar at first, these contractions are completely normal and no reason to worry . From the second trimester—approximately between the 20th and 35th week of pregnancy—your uterine muscle tissue "trains" in preparation for childbirth . Contractions occur irregularly and no more than three times per hour, lasting between 30 seconds and one minute. They are not painful, so some expectant mothers may not notice them consciously. You might feel your belly tighten and then relax again shortly afterward—this is a sign of Braxton-Hicks contractions, also known as false labor. If they occur more than three to four times per hour or more than ten times per day, or are accompanied by discharge or bleeding, you should contact your doctor or midwife to be safe.
Braxton Hicks contractions and lightening pains
Braxton-Hicks contractions can occur in the third trimester, starting around the 36th week of pregnancy. They indicate that birth is imminent within a few weeks and help prepare your body. You can recognize early labor by the fact that it occurs at irregular intervals and is relatively painless. You may experience it as a strong pulling sensation in your back and groin area or notice increased pressure on your bladder.
Often, contractions transition seamlessly into lightening pains as birth approaches. Their purpose is to guide your baby's head into your pelvis and bring it into the birth position . Lightening pains can also occur from around the 36th week of pregnancy. They differ quite noticeably from Braxton-Hicks contractions, as they are significantly more painful, and you will likely feel the pressure of your baby's head on your pelvic floor. If your growing baby bump makes breathing or eating difficult, lightening pains and your baby’s changed position can bring relief. It’s also often easy to see from the outside when lightening pains are moving the baby's head into the pelvis: your baby bump may visibly drop. Lightening pains start the countdown to birth; often, only a few days remain until the time comes. If you find these contractions very painful or feel unwell, you can calmly apply the breathing techniques you learned in the Childbirth Preparation Course . A warm bath can also provide relief.
Contractions during and after childbirth
Some women worry that they might confuse Braxton-Hicks contractions with true labor pains and therefore miss when labor actually begins. However, this concern is usually unfounded. True labor pains are much harder to ignore, significantly more intense, and occur at more regular intervals. You can also recognize them by the fact that they often occur around your estimated due date and may be accompanied by mild diarrhea. Although every woman’s experience is different, most mothers later report that they could distinguish true labor pains from Braxton-Hicks contractions without any trouble because of the increased intensity.
Labor pains
Early labor contractions give the starting signal for birth and also mark its longest phase . From the 37th week of pregnancy, you may experience early labor pains that open the cervix up to 10 cm. The contractions initially occur irregularly, then become more intense and return every two to ten minutes. Each early labor contraction lasts about one and a half minutes, and many women compare them to intense menstrual cramps that grow stronger over time. Try to breathe as calmly and deeply as possible during early labor and track the intervals between contractions. This way, you can monitor labor’s progress and estimate when it’s time to go to the hospital—or, if you’re planning a home birth, when to call your midwife.
Labor contractions
With pushing contractions begins the climax of birth , the so-called ejection phase . Once the cervix is fully dilated, pushing contractions follow immediately after the opening contractions. As soon as you feel these intense contractions at very short intervals, it’s time to push your baby through the birth canal. Even if the contractions in this final Birth phase are very exhausting, the thought of holding your baby in your arms shortly afterward will surely give you unexpected strength once again.
Afterbirth contractions
Immediately after you have given birth to your baby, the so-called afterpains begin.
These can last up to an additional 15 minutes and ensure that the Placenta , with which your baby was connected throughout the entire pregnancy, is expelled . Afterbirth pains are significantly milder than pushing pains and are comparable to severe menstrual cramps.
Afterpains or Braxton Hicks contractions
Even if it may sound strange at first: in the days after birth , contractions can continue. Afterpains help the uterus contract back to its original size and stop bleeding after birth. With a second, third, or fourth child, afterpains are often more intense because the uterus has to work harder to shrink back to its original size. If you are breastfeeding, you may also feel afterpains more strongly: during Breastfeeding , postpartum contractions triggered by the release of the labor-promoting hormone oxytocin are also known as breastfeeding contractions.
What do contractions feel like?
A question many women ask themselves before giving birth is what labor pains will feel like and whether they will involve severe pain. Unfortunately— or perhaps fortunately—this question is difficult to answer in advance. The sensation of labor pains and the intensity of pain during childbirth are completely individual and depend, among other things, on the mother’s physical and mental condition. If you feel tense and the thought of childbirth literally gives you a stomachache, a hypnobirthing course might be right for you. It teaches breathing and relaxation exercises as part of preparing for a fear-free birth. One approach in hypnobirthing is, for example, to refer to contractions as waves. The idea is to remove the painful, negative connotation that the term contractions can evoke. If you want to learn more about what hypnobirthing is all about, you’ll find the most important information about this form of childbirth preparation in our article „ Hypnobirthing – Fearlessly into the birth ".
When should I head to the hospital?
Especially with a first child, parents are often unsure when the right time has come to head to the hospital or, in the case of a home birth, to inform the midwife. In retrospect, most report that they went to the clinic far too early. A good guideline is the intervals and duration of contractions . If you notice regular contractions every ten minutes or less, and they last longer than 30 seconds, it’s likely time to go to the hospital for the final phase of labor. If you’re unsure, you can also simply call the delivery ward or your midwife. The birth experts can help you assess how far along your labor is. You should head to the hospital without hesitation in the event of premature water breaking, vaginal bleeding, pain beyond contractions, fever or elevated body temperature, visual disturbances, nausea, or dizziness.
Your midwife or hospital staff will check your contractions either by palpation or using a contraction monitor (or CTG for cardiotocography). They can also feel how far your cervix has already opened. Depending on how far along labor is, you will be taken directly to the delivery room or may need to wait a little longer. If you arrive at the hospital very early, it’s also possible that you will be sent back home initially. This is absolutely not a problem; if in doubt, you’ll feel more reassured afterward and be better able to gauge the contractions ahead.
Even if the thought of upcoming contractions and the pain of childbirth makes you feel a little uneasy, each type of contraction serves its own purpose and brings you one step closer to your baby. The right preparation and a positive outlook can help you approach contractions with less fear and go into labor more relaxed.
