Braxton Hicks Contractions


Braxton Hicks contractions are irregular uterine contractions that occur during pregnancy. Learn what Braxton hicks feel like, what causes it, how to differentiate Braxton hicks from true labor contractions and how to ease Braxton hicks.


Popularly called as false labor pains, it was named after John Braxton Hicks, a British doctor, who first studied contractions during pregnancy in detail. Although Braxton Hicks is common in all pregnancies, a normal pregnancy can proceed without the pregnant women experiencing Braxton Hicks contractions at all.

When during pregnancy does Braxton Hicks occur?

Braxton Hicks contractions begin as early as 6 weeks of pregnancy, though it is felt by a pregnant mother mostly in the second and third trimesters. Studies suggest that the onset of experiencing Braxton Hicks happens by the third trimester in a first pregnancy and it may be around 20 weeks or earlier in subsequent pregnancies. As pregnancy progresses, Braxton Hicks get stronger and frequent that towards the late third trimester it is usually mistaken for true labor. 

What causes Braxton Hicks?

Braxton Hicks occurs when there are alternate contraction and relaxation of the uterine muscle fibers. It remains unknown what exactly causes Braxton Hicks. However, a few random triggers known to kick-start Braxton Hicks are:

  • A full bladder
  • Sexual intercourse
  • Dehydration
  • Intense activity

What does Braxton Hicks feel like?

When Braxton Hicks happen, women feel the muscles around the lower abdomen or uterus tighten and relax, similar to menstrual cramps. It begins in one area and does not spread to adjacent areas. It is usually not painful though it can be uncomfortable. 

In a column titled, ‘Perinatal lessons from the past’, Professor Peter M Dunn quotes the following words of John Braxton Hicks on this phenomenon:

It was a source of difficulty to the older obstetricians to explain how that, at a certain time, namely, at the full period of pregnancy, the uterus, passive up till then, began all at once to acquire a new power, that of contracting; forgetful that, long before the full period had arrived, the uterus has the power to expel the foetus, and under mental excitement or local stimulation, attempted to do so frequently. But after many years’ constant observation, I have ascertained it to be a fact that the uterus possesses the power and habit of spontaneously contracting and relaxing from a very early period of pregnancy, as early, indeed, as it is possible to recognise the divergence of consistence—that is, from about the third month ...”

How does Braxton Hicks help labor and pregnancy?

Braxton Hicks is believed to prepare the body for labor, even though it by itself is not a sign of true labor beginning. Acting as practice for labor, it tones the muscles of the uterus in preparation of birthing. Also, Braxton Hicks may play a role in cervical softening but do not cause cervical dilation. In studying the triggers of Braxton Hicks contractions, the possibility of the triggers causing fetal distress has been noted. As a result, Braxton Hicks promotes blood flow to the placenta and thus, increases the supply of oxygen-rich nutrients in the fetal circulation. 

How to differentiate Braxton Hicks contractions from true labor contractions?

Braxton Hicks towards the end of pregnancy may often confuse a pregnant woman if true labor has begun. Here are the marked differences between Braxton Hicks contractions and real labor contractions:

Braxton Hicks Contractions

Braxton Hicks Contractions

Labor Contractions

1. Occur at irregular intervals

1. Occur at regular intervals (Ex., every 5 minutes)

2. Not usually painful

2. Gets painful in time

3. Feels like contraction and relaxation of the pelvic muscles

3. Feels like tightening from the top of the uterus so as to push the baby through the birth canal. During a contraction, uterus gets hardened and gets back to normal in-between two contractions

4. With time, the intensity of contractions fades and do not get closer

4. Becomes increasingly stronger and closer, like from 5 minutes apart, to 3 minutes apart, to 2 minutes apart and so on

5. Subsides with a change in position or after peeing

5. Changes in position have no effect on the contractions


How to ease Braxton Hicks contractions?

Braxton Hicks do not hurt for most women. However, in order to ease the discomfort associated with Braxton Hicks, the following actions may be helpful:

Change in position: Taking rest if contractions occur during intense activity or taking a casual walk if it occurs during rest, may alleviate Braxton Hicks.
Stress-relief: A stress-relieving activity like a warm bath, soothing music, or a relaxing nap can bring Braxton Hicks down.
Rehydration: Braxton Hicks may act as a sign of dehydration. Replenishing the body with water and fluid intake can make the contractions better. 

When should one seek medical help?

While Braxton Hicks do not need medical assistance, if one experiences one or more of the following signs, it must be immediately reported to the health care provider:

1. Vaginal bleeding
2. Fluid discharge from the vagina
3. Intense contractions that get increasingly closer (every 5 minutes for one hour)
4. Less than 10 fetal movements in 2 hours
5. Contractions become so strong that it makes sleeping or walking difficult

References
Raines DA, Whitten R. Braxton Hicks Contractions. StatPearls Publishing. 2018.
https://www.ncbi.nlm.nih.gov/books/NBK470546/

Peter M Dunn. John Braxton Hicks (1823–97) and painless uterine contractions. Arch Dis Child Fetal Neonatal Ed 1999;81: F157–F158.Peter M Dunn. John Braxton Hicks (1823–97) and painless uterine contractions. Arch Dis Child Fetal Neonatal Ed 1999;81: F157–F158.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1720982/pdf/v081p0F157.pdf

The American College of Obstetricians and Gynecologists. How to Tell When Labor Begins. 2011.
https://www.acog.org/Patients/FAQs/How-to-Tell-When-Labor-Begins

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