False Labor Versus True Labor

Expectant mother timing her contractions while sitting on couch at home
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There are contractions that can occur during the final weeks of pregnancy which are not 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 within the last two to four weeks prior to your due date.

There is no reason to be embarrassed if you mistake false labor pains for real ones, particularly if there is the risk of preterm delivery. While there are ways to distinguish false alarms from the real thing, the maxim "better safe than sorry" applies if your contractions are especially severe or scary.

Understanding Braxton Hicks 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 are most often seen 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 more uncomfortable than painful (although some women do experience pain) and feel more like menstrual cramps than actual contractions. In addition:

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

Certain triggers can set off false labor, such as when the mother 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).

What a True Labor Contraction Feels Like

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

Prior 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.
  • You may experience an upset stomach or diarrhea.
  • Your mucus plug may suddenly have a brownish, pink, or reddish tinge (known as a bloody show).
  • Your mucus plug may come out all at once or break off over several days.
  • You may experience a slight increase in blood pressure.

Some mothers will 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.

5 Ways to Tell False Labor From True Labor

As with pregnancy itself, every woman will experience labor in her own way. Some will have pain and other complications; others will be entirely event-free. When faced with a contraction, either near or well before your due date, you can usually tell which type it is in five simple 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 front. 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 uncertain — or if there is severe bleeding, cramping, or pain — don't hesitate to call your doctor or head to the nearest emergency room. While it may be nothing, it's best to have it checked out on the off-chance you're experiencing the signs of premature labor.

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Article Sources

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