Am I going into labour?

In the last few weeks of pregnancy, you will likely be experiencing an increased frequency of abdominal tightening, called Braxton-Hicks contractions. It can be difficult for expectant mothers to tell the difference between real labour pain and Braxton-Hicks contractions and I am often asked how to distinguish between them. The following article explains the differences.

How to tell if contractions are real
Real contractions follow a consistent pattern, while Braxton-Hicks contractions vary in duration and frequency. Braxton-Hicks contractions also tend to be less painful and usually only cause discomfort in the front of the abdomen.
Braxton-Hicks contractions simulate real contractions to prepare the body for labour. However, they do not lead to labour. Real contractions only occur when the body is genuinely going into labour.
Recognizing the difference between these types of contraction is important for understanding when labour has begun and when to contact us.
Real labour contractions
Contractions occur when the muscles around the uterus tighten and relax. They can occur at any time throughout pregnancy. But "real" contractions only occur when labour is starting.
Real labour contractions can be painful, and the pain tends to intensify. It usually peaks when the muscles tighten and eases when they relax.
The location of the pain varies, but real contractions typically cause a dull ache around the abdomen and lower back. In some women, the pain spreads to the sides and thighs.
Labour typically starts with regular, persistent contractions. These cause the cervix to expand in preparation for birth.
Braxton-Hicks contractions
Contractions can also occur before labour. These are Braxton-Hicks contractions, sometimes known as prodromal/false labour.
These contractions can begin around 6 weeks into gestation, but they are not usually noticeable until the second or third trimester. While the trigger for these contractions is unclear, their function is to prepare the body for labour.
Braxton-Hicks contractions tend to occur sporadically. They vary in frequency, duration, and intensity, but they usually occur more frequently during later stages of pregnancy.
Braxton-Hicks contractions do not cause the cervix to expand and do not lead to birth.
How to tell the difference
Patients often mistake Braxton-Hicks contractions for real labour contractions, especially when they occur in later stages of pregnancy. Here are some key differences between the two:
Consistency: Real contractions last around 30–70 seconds and occur at regular intervals. Braxton-Hicks contractions do not follow a consistent pattern.
Increasing frequency: Real contractions become more frequent as labour approaches. Braxton-Hicks contractions do not increase in frequency.
Intensity of discomfort: In general, real contractions are more painful than Braxton-Hicks contractions. While they can be uncomfortable, Braxton-Hicks contractions do not typically cause pain.