Contractions

What are labor contractions?

Contractions are the rhythmic tightening and relaxing of the muscles in your uterus. Healthcare providers sometimes call them surges. Contractions are similar to how you can tighten your hand to make a fist, then release the tension and relax your hand. Uterine contractions help to do the following during childbirth:

• Dilate (open) and efface (thin) your cervix.
• Push the fetus down the birth canal so it can be born through your vagina.
• Compress the blood vessels in your uterus to minimize bleeding after delivery.

But contractions aren’t always a sign that you’re in labor. Braxton Hicks contractions are an example of contractions that aren’t a sign of true labor. If you’re in labor, your contractions:

• Get stronger or more intense over time.
• Occur more frequently or closer together.
• Last between 40 and 60 seconds each time.
• Cause pain across your entire abdomen, sometimes radiating to your lower back and legs.
• Become so intense you can’t walk or talk during one.

It’s a good idea to talk to your pregnancy care provider about contractions and what to expect. They can discuss with you how to time your contractions and when you should head to the hospital (or wherever you plan to deliver).

What do contractions feel like?

Contractions feel different for everyone. Some of the ways people describe them are:

• Very strong and intense menstrual cramps.
• A wave-like tightness that begins at the top of your uterus and moves downward.
• A squeezing or pushing sensation across your entire abdomen.
• So painful that you can’t walk or talk during one.

During a contraction, your uterus hardens. After one or between them, your uterus relaxes and becomes soft. In fact, between them, you may feel relief and be able to hold a conversation.

One of the defining characteristics of labor contractions is that they become progressively stronger, more frequent and longer lasting over time.

How painful are contractions?

While everyone experiences contractions differently, most people say that contractions are painful. The pain also tends to get worse over time. Between each contraction, though, you may not feel any pain at all.

Your pregnancy care provider can talk to you about options for pain relief during labor to help ease the discomfort of contractions.

Are there stages of labor contractions?

Sort of. True labor contractions intensify over time and change through each stage of labor. There are three different stages of labor.

Labor contractions are part of the first stage. The first stage of labor is further divided into early labor and active labor. Contractions begin as mild and somewhat irregular in early labor. Then, they become more intense in active labor.

Are there different types of contractions?

Yes. Not all contractions are true labor contractions. You can have some that are mild and irregular. Things like the stretching of the ligaments in your uterus, gas pain or dehydration can cause false contractions. False contractions can happen at any point in pregnancy, but they tend to happen most often in the third trimester.

True labor contractions build up over time. They may begin as a cramp or feeling of pressure, but within a few hours, they tend to get stronger and come closer together. You’re also more likely to have true labor contractions in the last few weeks of your pregnancy.

How long should contractions last?

Contractions can last anywhere from 20 to 70 seconds depending on what stage of labor you’re in.

During early labor, contractions may:

• Last 20 to 30 seconds.
• Happen every 30 to 60 minutes.
• Feel more like an ache or pressure.

During active labor, contractions may:

• Last between 40 and 70 seconds.
• Happen every three to five minutes.
• Feel so intense that you can’t talk or walk.

Contractions continue until your cervix dilates to 10 centimeters. They even continue after delivery to push the placenta out of your vagina and help compress your blood vessels to stop your bleeding.

When do contractions start?

They can happen at any time in your pregnancy, but you may not notice them until they become stronger and more regular. On average, most people begin feeling contractions around 37 weeks of pregnancy.

How do I know if I am having contractions?

It can be difficult to know if your contractions are a sign of labor, especially if it’s your first pregnancy. Timing them and knowing the differences between true and false contractions are two of the best things you can do to prepare yourself.

Timing contractions

Most healthcare providers will ask that you time your contractions. This helps them see if you’re going into labor. You can use an app on your phone or pen and paper to do this. When timing contractions, start counting from the beginning of one to the beginning of the next. It’s easiest to do this in seconds.

Writing down the time and length of the contraction is extremely helpful for describing your contraction pattern to your provider.

A true labor contraction pattern may look like this:

True vs false contractions

This chart can be helpful in figuring out if you’re having true contractions:

While this chart is a helpful guide, your contractions might be a little different and not fit into this model. If you’re unsure about what you’re feeling, it’s best to contact your provider and tell them about what you’re feeling. They can let you know what to do based on your symptoms and health history.

How do I treat labor contractions at home?

You typically don’t need to head to the hospital or birthing center the first time you feel a contraction. If you’re comfortable, have a healthy pregnancy and are within three weeks of your due date, you can manage contractions at home up until a certain point. Be sure to ask your pregnancy care provider what that point is. If you’re several weeks from your due date and feel contractions, it’s always best to call your pregnancy care provider.

Some things you can do for relief from contractions at home are:

• Take a warm bath or shower.
• Have your partner or a friend massage your back and shoulders to help relax you.
• Try to relax your muscles. Don’t cramp other areas of your body during a contraction.
• Practice deep and slow breathing.
• Sway and rock your pelvis or move in a way that feels comfortable to you.
• Use an ice pack on your lower back.
• Try to distract yourself with a movie, music or other activity you enjoy.

If you can make the contraction go away, it probably isn’t labor.

What contraction timing means I should call my healthcare provider?

Healthcare providers have different criteria for when you should call them or head to the hospital.

Generally, once your contractions last for about 60 seconds and come every three to five minutes, it’s time to go to where you’re giving birth. Be sure to discuss this information with your healthcare provider weeks before your due date.

You should contact your provider immediately if you have any of the following in addition to regular and painful contractions:

• Your water breaks.
• You’re bleeding from your vagina.
• You have a planned or scheduled C-section.
• You have a medical condition that requires careful monitoring during delivery.

What questions should I ask my provider about contractions?

If you’re curious about contractions, you may want to ask your provider the following questions during your pregnancy:

• How do I know if I’m in labor?
• Where will I feel pain during a true contraction?
• How far apart should my contractions be?
• How long should contractions last to be true contractions?
• When should I go to the hospital?
• What are my options for pain relief?
• When would I need to begin pain relief?

Am I contracting or is the baby moving?

Contractions make your entire belly harden and cramp. If you feel just one hard area (especially if it’s surrounded by soft areas), it might be the fetus’s bottom or a limb creating pressure on your uterus.