Even if you didn’t know much about pregnancy and birth when you conceived, you're no doubt familiar with contractions — your body's uncomfortable but essential means of pushing your baby down the birth canal and out into the world.
But you may not have known that there are several types of contractions, and experiencing them doesn’t always mean you’re about to give birth.
From what contractions feel like to how to tell whether you’re actually in labor, here's what you need to know before delivery.
What do labor contractions feel like?
Early labor contractions can feel like gastrointestinal discomfort, heavy menstrual cramps or lower abdominal pressure.
What are the different types of contractions?
There are two kinds of contractions you may experience during pregnancy, including:
- Braxton Hicks contractions (aka practice or false contractions): These can occur any time after the middle of your pregnancy (or not at all). Practice contractions help prime your body for delivery, but they don't actually cause the cervical dilation and effacement that define labor. They also tend to subside when you change positions. False labor contractions are irregular, don't increase in severity or frequency, and resolve when you rest and drink water. They may also be accompanied by other false labor signs.
- Labor contractions: In the weeks before birth, you’ll likely also experience many common signs of real labor that lead up to real labor contractions.
Real contractions vs. Braxton Hicks
You’ll know you’re experiencing real labor contractions vs. Braxton Hicks contractions because actual labor contractions:[1]
- Intensify with activity, rather than ease up, and aren’t relieved by a change in position.
- Become progressively more frequent, intense and generally (but not always) more regular. The contractions usually last about 30 to 70 seconds each — and although each one won’t necessarily be more painful or longer than the last, the intensity builds up as labor progresses. Likewise, the frequency doesn’t always increase in regular, even intervals, but it does increase.
- May produce a brownish, pinkish or blood-streaked "bloody show."
- May be accompanied by an upset stomach, cramps or diarrhea.
- May be accompanied by a rupture of your membranes (commonly referred to as your "water breaking"). However, this only happens in about 15 percent of labors; it's more likely that your membranes will rupture spontaneously during labor or will be ruptured artificially by your practitioner.
Where do you feel labor contractions?
You may feel pain in just the lower abdomen or in both the lower back and abdomen, and the pain may radiate down the legs, particularly the upper thighs.
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The location of contraction pain often depends on the direction the baby is facing. For example, when a baby is head down but has his face looking forward (known as occiput posterior), a mom would likely experience intense back labor with each contraction. As active labor progresses, the contraction pain will change as the baby rotates within the birth canal.
Keep in mind, however, that location of your contractions is not the most reliable indication of whether you’re really in labor, since you can feel false labor contractions in those places too. More accurate signs include the frequency, intensity and regularity of your contractions.
How long is the average labor contraction?
The average contraction can vary in length, intensity and frequency depending on your stage of labor:[2]
- Early labor: Each contraction usually lasts about 30 to 45 seconds. They may start as much as 20 minutes apart, but will become progressively shorter as this phase ends.
- Active labor: Contractions become increasingly more intense, frequent and longer, lasting around 40 to 60 seconds each. You can try following the 5-1-1 rule during this phase: If your contractions are about five minutes apart, lasting about one minute each, for at least one hour, then that's good indication that it's time to call your practitioner and head to the hospital or birthing center, if you're having the baby there.
- Transitional labor: Contractions suddenly pick up in intensity and frequency, with each lasting about 60 to 90 seconds and coming about two to three minutes apart.
- Pushing and delivery: Contractions in this second stage of labor last 60 to 90 seconds, but are sometimes further apart — about two to five minutes — and possibly less painful.
When to call your practitioner about contractions
Your practitioner has likely told you when to call if you think you're in labor (a good rule of thumb: when contractions are five to seven minutes apart).
If you're not sure if you're in real labor but the contractions are coming pretty regularly, pick up the phone anyway. Just don’t wait for perfectly even intervals, which may never come.
Concerned it’s the middle of the night? Don’t feel guilty about waking your doctor — people who deliver babies for a living get plenty of 3 a.m. phone calls and are used to them.
And don’t be embarrassed if it’s a false alarm — you won't be the first (or last) expecting mom to misjudge her labor signs. Besides, it’s always best to err on the side of caution.
Your practitioner will want you to answer a few questions, not only to provide information, but also to hear the tone of your voice. As you talk through the contraction, your doctor or midwife will probably be able to tell whether it’s the real thing — so don’t try to cover up the pain in the name of good phone manners.
Early labor contractions
Early contractions are real labor contractions that come before you're 37 weeks pregnant. If you experience them and they're getting stronger and more frequent, call your doctor right away and/or head to the hospital if you can't immediately reach your practitioner. It may be a sign that you've gone into labor prematurely.
When to head to the hospital immediately
Be sure to call your practitioner right away — and if you can’t get through, head for the hospital — in the following instances:
- Your contractions are increasingly strong but you haven't yet reached 37 weeks; you may be experiencing preterm labor
- Your water breaks, with or without other signs of labor
- Your water breaks and it has a greenish-brown tint
- You feel the umbilical cord slip into your cervix or vaginal canal, which could be cord prolapse
What causes labor contractions?
No one knows for sure what triggers real labor contractions — it is likely a complicated cascade of various factors originating in the fetus, the placenta and the mother. Wherever they begin, they kick off a chain reaction in the mother that paves the way for the work of prostaglandins and oxytocin, substances that kickstart contractions.
Is it okay to have contractions after sex?
You might have noticed that your uterus contracts after you orgasm. Try not to worry — orgasm itself is a contraction of the uterus, after all. Many moms experience contractions after sex that can be powerful and last as long as a half hour.
Unless your practitioner has advised that you avoid orgasm during pregnancy (often because you’re at risk for preterm labor or miscarriage), sex is safe during pregnancy and there’s no reason to be concerned about these types of contractions.
How to start labor contractions
If you've passed the 40-week mark and are officially overdue, you might be wondering how you can start contractions and get this show on the road, already. There are a few techniques that may induce labor naturally, including acupuncture and walking.
While none of these methods are guaranteed to work, you might want to consider giving them a shot, but only with the okay of your practitioner.