Is It Really Labor?

Distinguishing Between Braxton Hicks and True Labor

PD_Fitness_Wellbeing_67135 You have heard the story before. A woman is nearing her due date and starts feeling contractions, so she rushes to the hospital. After being examined and waiting in the hospital to see if the contractions progress, she is told to go home because she was not in true labor.

If you are pregnant, it is important to be aware of the signs of labor. Doing this can help you distinguish between Braxton Hicks contractions (false labor) and true labor.

Braxton Hicks Contractions

Many women experience Braxton Hicks contractions as their due date approaches. These are uterine muscle contractions that occur during pregnancy that are not signs of labor. They can continue for hours or days, but do not progress, cause your cervix to dilate, or lead to birth. These contractions can become more frequent and intense later on in pregnancy and are often the cause of women visiting the hospital before labor starts.

Unlike labor contractions, Braxton Hicks contractions are usually irregular, unpredictable, and felt only in the abdomen, rather than all over. They do not become more frequent and intense over time, and they are not accompanied with other signs of labor, such as light vaginal bleeding and water breaking. Many times, changes in position or increased activity cause Braxton Hicks contractions to slow down or stop.

If you are unsure of what type of contractions you are having, call your doctor.

Signs of True Labor

While the signs of labor vary widely from woman to woman, and even from pregnancy to pregnancy, certain symptoms indicate that labor has begun. Become familiar with the following signs of true labor so you will be better able to tell when your labor has begun:

  • Regular uterine contractions that get more painful and come closer together over time
  • Persistent lower back pain, sometimes accompanied with a premenstrual feeling
  • Continuous abdominal pain
  • Water breaking (clear amniotic fluid leaking or gushing out)
  • Slight bleeding from the vagina (more than spotting)

During labor, the pain that accompanies uterine contractions generally begins in your upper abdomen and can radiate into your lower back.

When you begin to feel contractions, you should record their frequency, length, and intensity. In true labor, contractions develop into a regular pattern, with shorter intervals between them. They usually last more than 30 seconds and get longer and stronger with time. They will continue regardless of activity changes. Some women have contractions for days leading up to childbirth, while others feel only slight pressure and pain.

If your contractions get longer, stronger, and closer together, it is probably time to go to the hospital. At the hospital, your doctor can examine your cervix to determine if you are in labor. During labor, your cervix will dilate, and become thinner and softer in preparation for your baby’s arrival.

If you think you might be in labor, call your doctor. Monitoring your signs and symptoms may help you determine when labor begins. But, you cannot know for sure until you get to the hospital for an examination.

Whether or not you are in labor, always contact your doctor if any of the following occur:

  • Severe persistent headache
  • Changes in vision, such as spots, flashes of light, or blind spots
  • Pain or burning when urinating
  • Decrease in fetal movement
  • Nausea and vomiting
  • Fever

American Pregnancy Association

The American Congress of Obstetricians and Gynecologists


The Society of Obstetricians and Gynaecologists of Canada

Women's Health Matters


Braxton Hicks contractions. American Pregnancy Association website. Available at: Updated August 2015. Accessed January 6, 2017.

Common symptoms, signs, and laboratory changes in pregnancy. EBSCO DynaMed website. Available at: Updated May 29, 2015. Accessed January 6, 2017.

False labor. American Pregnancy Association website. Available at: Updated August 2015. Accessed January 6, 2017.

Labor and birth. Office on Women's Health website. Available at: Updated September 27, 2010. Accessed January 6, 2017.

Last reviewed January 2017 by Michael Woods, MD  Last Updated: 1/6/2017