Throughout the nine months of pregnancy, it’s common to feel contractions at some point. These are different from labor contractions, as their function is to train the muscles of the uterus for what’s to come, not to dilate the cervix and start labor. Knowing how to tell them apart can give you peace of mind and help you better understand the labor process when the time comes. In the following article, we’ll explain the different types of contractions that occur during pregnancy and labor, and how you can learn to distinguish them. Will you join us?

What are contractions?

Let's start from the beginning by defining what contractions are. Simply put, contractions are movements of the uterus. The uterus is a muscle and, as such, has the ability to contract and relax, and it does so throughout a woman's reproductive life at different times. For example, the uterus moves during orgasm or menstruation to help expel menstrual blood. Uterine movements also occur during pregnancy and childbirth. During pregnancy, these contractions help prepare your body for childbirth . They’re like natural training for the muscles. Labor contractions, on the other hand, are what allow your baby to leave the uterus. Both differ in intensity and frequency, so it’s usually fairly easy to tell them apart. Let’s look at this in more detail.

What are contractions like during pregnancy?

You will probably feel uterine contractions at some point during pregnancy, but they tend to become more noticeable toward the end of the second trimester and throughout the third trimester. These are called Braxton Hicks contractions. Many women are surprised when they first appear, but don’t worry—they are completely normal. The involuntary tightening and relaxing of the uterus serves as training for this muscular organ. Their intensity and frequency are irregular, and they are very brief. In fact, they often disappear if you relax, lie down, or take a shower. They are also not painful contractions; in many cases, you may not notice them at all. The sensation is simply that your belly becomes hard and tense, and then relaxes again. Nothing more ;)

And if they are strong contractions but I haven't reached week 37?

Sometimes, before week 37—the point at which pregnancy is considered full term—contractions can occur that are not Braxton Hicks and may be signs of preterm labor. In this case, they aren’t irregular or low-intensity contractions; instead, they are painful and follow a pattern: the uterus contracts and relaxes more than three times in one hour, at short intervals. Additionally, these contractions may be accompanied by a watery discharge or bleeding. In these cases, it’s advisable to consult your gynecologist or midwife to determine whether it’s preterm labor or a consequence of stress or overload.

In the case of preterm labor contractions, a pharmacological protocol is established at the hospital to try to stop or delay the labor process.

The three stages of labor: dilation, expulsion, and delivery

Before we continue, it helps to understand the stages of labor.

Dilation

As we mentioned earlier, contractions first help train the uterine muscles and then drive the dilation of the cervix, which must reach about ten centimeters for the baby to be born. These are intense and painful contractions that don’t subside; instead, they come and go in a regular pattern. This process is called dilation, and it can take a long time, so staying calm and patient is recommended. Everything will be fine!

Expulsive

After dilation comes the pushing phase, and contractions become even more intense and frequent to help bring your baby down. At this point, you’ll feel a strong urge to push, which helps you know there’s not much longer until you can hold your little adventurer in your arms. This phase can last from a few minutes to several hours. According to the guide prepared by the Ministry of Health, the duration of the expulsive phase depends on each woman (her physical and emotional condition and whether it is her first birth) and on whether or not epidural analgesia is used.

Childbirth

After the birth, a few minutes after having your baby on top of you, you’ll notice the contractions return. These contractions are responsible for delivering the placenta, and once this happens, labor has come to an end. Don’t worry—these contractions are much less painful, comparable to intense menstrual cramps, and you’ll be so focused on your baby that you’ll hardly notice them.

How to recognize if they are labor contractions?

When you’re pregnant for the first time, many questions can come up about childbirth:

When will I go into labor?
What will it be like?
Will it hurt a lot?
Will I be able to do it?

There isn’t one single answer to all of these questions, because each woman experiences labor in a very personal way. However, there is a universal answer to how to know when labor begins: contractions are a very reliable clue. You’ll be able to distinguish them from “false” contractions, or Braxton Hicks contractions, because they have a series of characteristics:

• The intensity and pain of labor contractions are greater and will gradually increase.

• Their duration is longer: while Braxton Hicks contractions last less than a minute—usually only a few seconds—labor contractions last between one minute and a minute and a half.

• The frequency may be irregular at first, but it increases: contractions occur approximately three or four times every 10 minutes.

• And finally, a revealing sign: they do not ease when you change position but continue to occur regularly.

Starting from week 37 of pregnancy, they can occur at any time! One note: although these contractions are more painful, the sensation of pain is individual and depends, among other factors, on the physical and mental state of the expectant mother.

How to know when it's time to go to the hospital?

You don’t need to go to the hospital or call the midwife (if the delivery will be at home) as soon as the first labor contractions appear. In fact, your midwife has probably recommended waiting until contractions last between one minute and one and a half minutes . The theory is simple: the interval and duration of the contractions will tell you when the time has come.

If they are regular, approximately every five minutes, and if it is your first child and they last more than 30 seconds, the time may be near. In subsequent pregnancies, since labor tends to be faster, it is recommended to go to the hospital or call the midwife when contractions occur every ten minutes. It is also advisable in case of premature rupture of membranes, vaginal bleeding, intense pain, fever, visual disturbances, nausea, or dizziness. It may seem like a lot of information, but your doctor will explain everything in detail so you can go to the hospital at the right time.

Once in the hospital, the midwife will be responsible for monitoring your contractions through fetal monitoring or palpation . With your consent, you may also have a vaginal examination to assess how open the cervix is. There's no turning back now! One of the most exciting moments of your life is approaching. You can choose to go through it naturally or with epidural analgesia. Prepare in advance and get informed so you can decide how you want to experience childbirth.

In the postpartum period, other contractions also occur: afterpains.

Contractions do not end with childbirth. Surprised? During the postpartum period, the so-called ... afterpains occur. These are contractions that allow your uterus to return to its usual size and help reduce bleeding after childbirth. They are less intense after a first delivery, but from the second onward, they are usually stronger because the uterus has to contract more powerfully to return to its pre-pregnancy state.