Contractions 101

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For many women and their partners, contractions can be something they’re most anxious about during their pregnancy. How will the contractions feel? Can they handle the pain? When will they start? Is this the real thing? In this post, we’ll discuss types of contractions & how they feel, how to tell the difference between Braxton Hicks and labor contractions, and how to time them.

Braxton Hicks

Braxton Hicks contractions are intermittent/sporadic uterine contractions that can start in early pregnancy. Many women don’t notice them at all until the well into the second trimester, and some never notice them at all. Braxton Hicks contractions feel like a mild tightening in the belly or pelvic area. They usually don’t cause any pain, and are irregular.

  • Unlike labor contractions, they do not become longer, stronger, and closer together.

  • They can intensify or become more regular if you are dehydrated, so be sure to stay well hydrated!

  • You can also try changing positions/activities to get them to ease up.

  • Braxton Hicks give you an opportunity to practice your breathing exercises and comfort measures.

  • Before 37 weeks, play it safe and check in with your doctor or midwife if your Braxton Hicks are becoming rhythmic, predictable, and painful.

Labor Contractions

Unlike Braxton-Hicks contractions,  true labor contractions do not slow down or stop with drinking water, resting, or changing positions. Instead, they will continue to get longer, stronger, and closer together. Labor contractions work to dilate the cervix. Labor contractions usually will start mildly and sporadically. They may even feel like a dull back ache or menstrual cramps. However, these contractions will increase in strength, frequency, and duration as your labor progresses.

  • Labor contractions are cyclical and you can time them.

  • Changing positions may help them feel less painful, but it won’t slow or stop them.

  • It’s normal to feel excited, anxious, or worried that it’s not the real deal. Many women experience a broad range of emotions when they start labor.

Timing Contractions

Many doctors and midwives will give their patients the 5-1-1 rule as way to know when to call or come to their birthing location. The 5-1-1 rule is when contractions are coming every 5 minutes, each lasting a full minute, and have been happening at this frequency and duration for an hour. Some practices recommend following  4-1-1 (four minutes apart) or even 3-1-1 (three minutes apart). However, listen to your body and trust your instincts and don’t hesitate to call your provider. 5-1-1 is usually around the time that your doula will join you. Everyone is different though, so also feel comfortable calling your doula even if you are unsure that labor has started!

To time the contractions:

    • Use a stopwatch or an app specific to timing contractions.

    • The frequency is measured from the start of one contraction to the start of the next contraction. (i.e 5 minutes apart, etc.)

    • The length or duration of the contraction is determined by timing the contraction from the beginning to the end.

    • Begin timing contractions when they start to demand your attention and you can’t ignore them any longer.

    • Time contractions for 30-60 minutes.  There’s no need to time every contraction during your labor. If you feel the contractions have changed in any way, intensified or seem more frequent, time again for another 30 minutes or so. This will give you an adequate picture of your labor progression.  

Timing contractions can help you decide when to call your provider and your doula and/or labor support people, and when to move to your chosen birth location.

Remember, when in doubt, never hesitate to contact your doula - we're always happy to help answer questions, offer suggestions, and join you for labor support. 

Cait Sobotka is a labor & postpartum doula, and the owner of Chicago Birth & Baby. 

Caitlin Sobotka