False Versus True Labor Pains

Expectant mother timing her contractions while sitting on couch at home
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Not all contractions that occur during the final weeks of pregnancy are a sign of labor. We typically refer to these as "false labor." False labor is characterized by contractions that come and go with no pattern or consistency, usually in the last two to four weeks before your due date. While these contractions may be uncomfortable, false labor does not tend to be truly painful or get stronger over time.

There is no reason to be embarrassed if you mistake false labor pains for real ones, particularly if there is any risk of preterm delivery. While there are ways to distinguish false alarms from the real thing, the maxim "better safe than sorry" always applies. Don't hesitate to contact your healthcare provider at any time in your pregnancy if you have questions or concerns. Learn more about false labor.

False Labor Contractions

False labor pains are called Braxton Hicks contractions. Sometimes referred to as practice contractions (because you can practice your breathing exercises when they happen), Braxton Hicks contractions can occur as early as the second trimester but most often happen during the third. They are not "accidental" contractions, but a way in which the body prepares for delivery by softening and thinning the cervix.

Braxton Hicks contractions tend to last 30 to 60 seconds, on average, but can sometimes persist for two minutes or more. They are different from true labor pains in that they are irregular in their frequency and intensity. Braxton Hicks contractions tend to be more uncomfortable than painful (although some women do experience pain) and feel more like mild menstrual cramps than actual contractions. In addition:

  • False labor contractions can vary in intensity, feeling intense at one moment and less so at the next.
  • They don't appear in any regular pattern.
  • They may soften or stop suddenly if you walk or change positions.
  • They tend to taper off gradually and disappear.

Certain triggers can set off false labor, such as when the adult or baby is especially active or when there is excessive pressure placed on the uterus (such as can happen with a full bladder or following sex).

True Labor Contractions

In contrast to Braxton Hicks contractions, true labor pains are rhythmic. Once they start, they and continue with increasing frequency and intensity. Moreover, they will feel more painful than uncomfortable, especially as contractions persist. And unlike false labor pains, true contractions do not stop if you move, shift positions, or lay down.

Prior to the start of labor, there may be some early warning signs to watch out for:

  • Breathing and urination may suddenly be easier as the baby begins to drop.
  • Vaginal discharge or mucus may have a brownish, pink, or reddish tinge (known as the bloody show).
  • You may experience an upset stomach or diarrhea.
  • You may experience a slight increase in blood pressure.
  • Your mucus plug may come out all at once or break off over several days.

Some people also report a sudden burst of energy and the desire to start preparing the home for the new baby. This is known as the nesting instinct and occurs as much in humans as it does in animals (caused by the increased production of estradiol). The nesting instinct can happen anytime during the pregnancy but is most common prior to the onset of labor.

How to Tell the Difference

As with pregnancy itself, everyone experiences labor in their own way. Some have pain and other complications; others don't. When faced with a contraction, either near or well before your due date, you can usually tell which type it is in five ways.

False Labor True Labor
Contractions are irregular. Contractions come regularly and are spaced closer together over time.
Contractions taper off. Contractions get stronger the longer they last.
Contractions are felt in the front of the body. Contractions start in the back and move to the front.
Walking has no effect on the contractions. Walking makes the contractions worse.
Cervix doesn't change with contractions. Cervix opens and thins with contractions.

If you are uncertain—or if there is severe bleeding, cramping, or pain—call your doctor or head to the nearest emergency room. While it may be nothing, it's best to have it checked out in case you're experiencing premature labor or another complication.

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  • Cunningham F, Leveno K, Bloom S et al. Williams Obstetrics, 24th edition. McGraw-Hill Education; 2014.

By Robin Elise Weiss, PhD, MPH
Robin Elise Weiss, PhD, MPH is a professor, author, childbirth and postpartum educator, certified doula, and lactation counselor.