Braxton Hicks contractions, also known as practice contractions or false labor, are sporadic uterine contractions that occur during pregnancy, but before going into childbirth. They typically begin in the second or third trimester,[1] but they may start as early as the sixth week of pregnancy.[2]
Braxton Hicks contractions are often mistaken for labor, and are believed to allow the pregnant woman's body to prepare for labor.[2] The presence of Braxton Hicks contractions does not mean a woman is in labor, nor even that labor is about to commence.[2] Another common cause of pain in pregnancy is round ligament pain.
The timing between contractions is regular and the contractions begin to occur closer together over time
Strength of contractions
Are typically not very strong
Become stronger over time
Length of contractions
Last for an uncertain and variable amount of time
Last between 30–90 seconds, growing longer as labor progresses
Location of pain
Pain is typically in the front of the abdomen
The pain starts in the back and moves around to the front
Change with movement
May stop if the woman moves
Will continue and/or become stronger regardless of the woman's movements
Pathophysiology
Although the exact causes of Braxton Hicks contractions are not fully understood, there are known triggers that cause them, such as when a pregnant person:[2][3]
is dehydrated
has a full bladder
has just had sexual intercourse
has been exercising (running, lifting heavy objects)
is under excessive stress
has had her belly touched
There are two thoughts for why these intermittent uterine muscle contractions may be occurring. The first is that these early ‘practice contractions’ could be helping to prepare the body for true labor by strengthening the uterine muscle.[2] The second is that these contractions may occur when the fetus is in a state of physiological stress, in order to help provide more oxygenated blood to the fetal circulation.[2]
Signs and symptoms
The determination of Braxton Hicks contractions is dependent on the history and physical assessment of the pregnant woman's abdomen, as there are no specific imaging tests for diagnosis.[2] The key is to differentiate Braxton Hicks contractions from true labor contractions (see Table 1 above).
Most commonly, Braxton Hicks contractions are weak and feel like mild cramping that occurs in a localized area in the front of the abdomen at an infrequent and irregular rhythm (usually every 10-20 minutes), with each contraction lasting up to 2 minutes.[2][1][3] They may be associated with certain triggers and can disappear and reappear; they do not get more frequent, longer, or stronger over the course of the contractions.[2] However, as the end of a pregnancy approaches, Braxton Hicks contractions tend to become more frequent and more intense.[2]
On a physical exam, some uterine muscle tightening may be palpable, but there should be no palpable contraction in the uterine fundus and no cervical changes or cervical dilation.[2] Braxton Hicks contractions do not lead to birth.[2]
More concerning symptoms that may require assessment by a healthcare professional include:[2]
Any bleeding or fluid leakage from the vagina
Contractions that are strong, frequent (every 5 minutes), and/or persisting for an hour
Changes or significant decreases in fetal movement
Management
Although there is no specific medical treatment for Braxton Hicks contractions, some alleviating factors include:[2][3]
Adequate hydration
Drinking warm milk or herbal tea
Eating a small meal
Urination to empty a full bladder
Rhythmic breathing
Lying down on the left side
Adjusting movement or activity level
Relaxing and destressing (e.g. a massage, nap or warm bath)
Trying other pain-management techniques (e.g. practices from childbirth preparation class)
History
Braxton Hicks contractions are named after John Braxton Hicks, the Englishphysician who first wrote about them in Western medicine.[4] In 1872, he investigated the later stages of pregnancy and noted that many pregnant women felt contractions without being near birth.[4] He examined the prevalence of uterine contractions throughout pregnancy and determined that contractions that do not lead to labor are a normal part of pregnancy.[4]
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