All About Contractions in Pregnancy

Pretty much every day in our office, we are helping people puzzle out the contractions that normally occur during pregnancy to make certain there is not something more serious going on. Luckily, in most cases, even a wide variety of contraction presentations are nothing to be concerned about, and in many cases, may be remedied by making small changes.

Braxton Hicks Contractions

Braxton Hicks contractions are the most famous of benign pregnancy contractions, so you’ve likely heard of them. Many people don’t know, though, that these “practice contractions” start in the first trimester, when very few people notice them. These contractions are small and uncoordinated, and likely only contract small parts of the uterus each time for just a few seconds. As the pregnancy advances, people start to notice them more as the contractions begin to involve larger portions of the uterus, and last a little longer. In the third trimester, you may experience Braxton Hicks contractions that involve the entire uterus and last for up to two minutes! This is where it starts to get confusing, but it’s usually pretty easy to figure out if your contractions are Braxton Hicks or labor contractions:

  • While Braxton Hicks contractions can be quite uncomfortable, they are usually not very painful
  • Braxton Hicks contractions normally occur sporadically throughout the day, whereas true labor contractions will come in a pattern
  • Braxton Hicks contractions will be variable in intensity and length, but true labor contractions typically get longer, stronger and closer together
  • Braxton Hicks contractions are typically felt higher up on the uterus, or as a tightening of the entire uterus, whereas true labor contractions are usually felt as an intense cramp beginning at the pubic region and pulling up, and/or as lower back pain that wraps around to the front
  • Braxton Hicks will change with activity, and true labor contractions will not
  • Braxton Hicks contractions do not change the cervix

If you are having a lot of Braxton Hicks contractions on a given day, the first thing we’ll ask you to do is hydrate – that often calms them down pretty quickly. A warm bath, emptying your bladder, or taking a rest on the couch are other good ways to calm Braxton Hicks contractions.

irritable uterus contractions

These contractions are a little trickier to figure out than Braxton Hicks, because irritable uterus contractions do often come in a pattern. Many times, contractions will start at about five minutes apart, which sets many people on the labor alert, and may even feel strong, but then they won’t change over many hours, and they won’t dilate the cervix. If you have a contraction pattern that stays the same over time, it is likely to be irritable uterus – but it’s a good idea to have a conversation with your care provider, just in case.

The cause of irritable uterus can be a bit of a mystery, but they more often occur when it’s not your first pregnancy. Dehydration can be the culprit, as well as infections such as a UTI. We have noticed that for some people, herbs that tone the uterus, such as red raspberry, seem to cause or exacerbate irritable uterus.

Irritable uterus contractions can be maddening, as they sometimes occur frequently at the end of pregnancy, and can interfere with sleep. Here are a few ways we recommend to manage these types of contractions:

  • Hydrate well
  • Discontinue any uterine toner herbs, which are often found in “pregnancy teas”, etc.
  • Keep bladder empty
  • Test for possible infections
  • Take steps to reduce stress
  • Avoid foods that irritate your GI tract, and eat small, frequent meals
  • Get into a bedtime routine to help you relax, such as taking a warm bath
  • Consider taking a magnesium supplement in the evening

Warning signs

Be sure to contact your midwife or doctor if you experience the following:

  • Any regular contraction activity that occurs prior to 37 weeks
  • Contractions more frequent than 10 in an hour that do not resolve with hydrating or changing activity
  • Contractions that get longer, stronger and closer together
  • Leaking fluid from the vagina
  • Bleeding from the vagina
  • Decreased fetal movement

Photo credit: Brittany Gamblin Photography