Are you wondering if you’re experiencing false labour pains? Whether what you’re feeling is Braxton Hicks? It is very common for women, especially first-time mums, to feel apprehensive in the lead up to childbirth.  It’s hard to know what to expect, and what every new sensation, pain, or twinge might mean.

There are many signs that labour could be starting, as well as false signs of labour, such as Braxton Hicks contractions. To help women understand what to expect during real labour and how to identify false labour pains, Miss Karolina Afors, Consultant Obstetrician and Gynaecologist at The Portland Hospital (part of HCA Healthcare UK) has shared her expertise.

The difference between Braxton Hicks contractions and real labour contractions:

Braxton Hicks contractions are also referred to as ‘false labour pains’.  They occur when the womb contracts and relaxes and it can often have a very similar sensation to mild menstrual cramps.

Not all women will experience them, but they are very common and normal during the second and third trimester. They are certainly not something to worry about and your midwife will most likely tell you about them and what to expect early on in your pregnancy.

We are not entirely sure exactly what causes Braxton Hicks contractions, but some factors that can bring them on include:

  • Being dehydrated
  • Having a full bladder
  • Having sex
  • Being very active

There are a few key differences between labour contractions and Braxton Hicks contractions.

Unlike Braxton Hicks contractions, real labour contractions:

  • Are consistent and predictable.
  • Increase in frequency, duration, and intensity.
  • Are painful and can increase in how painful they are. By contrast, Braxton Hicks contractions tend to be slightly uncomfortable but not painful.
  • Worsen over time and carry on for a period of time, compared to Braxton Hicks which will lessen and disappear altogether eventually.

However, towards the end of pregnancy Braxton Hicks contractions can become more difficult to differentiate from labour contractions as they might form more of a pattern and increase in frequency and intensity. Because of this, many women mistake Braxton Hicks contractions for the start of labour. However, Braxton Hicks contractions do not cause the cervix (the entrance to the womb) to dilate which is the case for labour contractions.

There is no known way to stop or prevent Braxton Hicks contractions. However, there are ways to ease them, either by laying down, changing position, going for a gentle walk, running a bath and drinking plenty of water.

If you are ever worried or unsure of whether your contractions are Braxton Hicks or the start of labour, speak to your midwife who will be able to provide medical advice. It is also vital to seek medical advice if you are experiencing any other symptoms.

The following signs could indicate that it is time for your baby to arrive:

Early signs of labour: The latent phase

From contractions and backache to waters breaking, there are many early signs of labour you can look out for, so you can be more sure what you’re experiencing is not false labour pains.

The first stage of labour is also referred to as the latent phase. This is when the cervix becomes soft and thin and begins to dilate in preparation for your baby to arrive. This stage of labour lasts the longest and can take a number of hours and even days before moving onto the next stage.

During this stage, you will most likely be advised to stay at home until things have progressed further. In fact, if you go to the hospital or maternity unit for a check-up during this time, it is possible that you will be discharged back home as long as everything is as it should be. If you have any vaginal bleeding, if your baby is moving less than usual, or you are less than 37 weeks pregnant and think you are in labour, then you need to contact your maternity unit and be assessed by a doctor or midwife.  If you have any concerns during early labour, speak to your doctor or midwife and they will be able to advise on the best course of action.

Most common signs of labour:

Below are the most common signs of labour which indicate your baby is on their way:

Contractions

Onset of contractions is one of the most well-known and obvious signs that labour is starting. Contractions help with opening (dilating) of the cervix and moving your baby down the birth canal.  They cause your womb to repeatedly tighten and then relax and may feel like severe period pains.

During a contraction, the womb (uterine) muscles tighten and harden, which can contribute to an increase in sensation of pain. If you put your hand on your stomach, you can often feel tightening or hardening of muscles across your stomach. Each contraction usually begins gently, builds up to a peak and then tails off.  Once the contraction eases and the muscles relax, pain should temporarily subside.

As labour progresses, contractions become more intense, more frequent, and last longer. As previously mentioned, your midwife will probably advise you to stay at home until your contractions become frequent and more intense. You should call your maternity unit when contractions:

  • Last at least 60 seconds
  • Come every five minutes.
  • Are in a regular pattern.

If you are concerned or not sure about anything, or you experience bleeding or reduced foetal movements, then please speak to your midwife immediately who will be able to help.

The ‘Show’.

Another, lesser-known sign of labour is the ‘show’.  The show is a sticky, jelly-like plug of mucus which sits in the cervix throughout pregnancy.

Just before labour starts, the mucus tends to come away and pass through the vagina, indicating that the cervix is beginning to open. It has a sticky consistency and usually contains a small amount of blood, giving it a light pink or brownish colour. It can pass through in one piece or as several smaller pieces.

However, if you are losing blood or the show is a strong bright red colour, it might need checking by your midwife or obstetrician, therefore it is important to seek medical help straight away.

It is also worth noting that sometimes there is no show at all, and other times, the show passes once labour has already started – it varies from woman to woman.

Waters breaking

From the very beginning of pregnancy, your baby develops inside a protective bag of watery fluid called the amniotic sac. When your baby is ready to be born, this sac usually breaks, causing the fluid inside to pass through the vagina.  When this happens, you might feel it as a trickle, or a sudden gush, depending on how it breaks.

Waters can either break during or just before labour starts.

Amniotic fluid has a watery consistency and is reasonably clear and colourless.  However, it is usual for the fluid to contain a very small amount of blood to begin with.  Make sure to keep an eye on the colour in case it contains a large amount of blood and needs to be checked by a medical professional.

If your waters break naturally during the latent stage of labour, you are usually advised to wear a sanitary pad, never a tampon, so that your midwife can check the colour of the waters.

It is common to go into labour within 24 hours of the waters naturally breaking, but if not, you will be offered an induction because there is an increased risk of infection to you and your baby without the protection of amniotic fluid.

It is vital to immediately tell your midwife if:

  • You are losing blood.
  • The waters are coloured.
  • The waters have a smell.

Backache

Another common sign of labour is ongoing lower backache.

Other signs

Other common, early signs that labour is approaching include:

  • A sudden urge to use the toilet.
  • Diarrhoea
  • Nausea and vomiting

These are all normal signs and not anything to be concerned about.

What to do during the latent stage of labour

During the latent stage of labour, there are ways to alleviate pain and discomfort whilst you wait for things to progress further. For example:

  • You can drink plenty of fluids to keep energy and hydration up.
  • Take a warm bath to ease backache and contraction pain.
  • Have a snack or meal to keep energy levels up.
  • Walk or move around if you feel like it.
  • If your labour starts during the night, try to rest or sleep.
  • Take paracetamol – unless your doctor or midwife advises otherwise, paracetamol is safe to take during labour, although make sure to check the back of the packaging for information on dosage.
  • Try breathing and relaxation techniques to cope with contractions.

If you are expecting a baby and experience any of the signs and symptoms outlined above, please call your midwife or maternity unit and they will advise you on what you can do, and when to go into hospital.

 Article on False Labour Pains by Miss Karolina Afors, Consultant Obstetrician and Gynaecologist at The Portland Hospital (part of HCA Healthcare UK).

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