Braxton Hicks vs real labour

“Is this it?” is one of the most common questions of late pregnancy, because your uterus does a lot of rehearsing before the real performance. Those practice tightenings are called Braxton Hicks contractions, and telling them apart from true labour is easier once you know what to look for — though even experienced midwives will tell you it isn’t always obvious, so you’re in good company if you’re unsure.

Braxton Hicks are your uterus tightening and relaxing as it tones up for birth. You might feel your bump go hard for a bit and then soften again. The key features are that they’re irregular (they don’t settle into a steady rhythm), usually not painful (more of a tightening or squeezing than real pain), they don’t get stronger or closer together over time, and they often ease off if you change position, have a walk, rest, or drink some water. They can start from the second trimester and become more noticeable as you approach your due date.

True labour contractions behave differently. They come at regular intervals and gradually settle into a pattern; they get longer, stronger and closer together over time; they usually build to real pain that you can’t easily talk through; and they don’t ease off when you move around or rest — if anything, they keep coming regardless. Labour may also come with other signs, like a “show” (a plug of blood-tinged mucus), a persistent low backache, or your waters breaking.

A simple way to sort them out is to time them. If you’re not sure, note when each tightening starts and how long it lasts over an hour or so. Braxton Hicks will stay random and settle; real labour will get into a rhythm and build. A widely used guide for when to head to hospital in a straightforward pregnancy is the “5-1-1” rule — contractions about five minutes apart, each lasting around a minute, for at least an hour — but your midwife will give you advice for your situation.

Some things mean you should call your maternity unit straight away, whatever the timing: your waters breaking (note the colour, as green or brown needs an immediate call), any bleeding heavier than a show, regular painful contractions before 37 weeks (which could be premature labour), or a change in your baby’s movements. When in doubt, ring — they would always rather hear from you than have you second-guess at home.

So if you’re getting tightenings and wondering, take a breath: if they’re irregular and fade, they’re almost certainly just practice. If they’re regular, building and won’t quit, this may well be the real thing — and either way, a phone call to your midwife settles it.