The Low-Down on Labor Contractions

Contractions happen when the muscles of the uterus rhythmically squeeze down to begin pushing the baby through the birth canal. The process typically begins somewhere in the two weeks before or after the due date.

Experts don't fully know what triggers the uterus to start contracting, but these powerful movements are essential to labor. If a person does not naturally start having contractions, doctors can induce them with medication.

Contractions differ from person to person and even from pregnancy to pregnancy. Some people describe contractions as a dull ache or pressure radiating throughout their back, sides, and pelvis. Others liken contractions to strong period pains or diarrhea cramps.

Most people describe discomfort that comes in waves and gets stronger as labor progresses, intensifying until the baby is born.

Braxton-Hicks, or false labor, is a random tightening of the uterus in the weeks leading up to labor. This is the body's way of preparing for birth, and is not an indication that labor has started.

Not everyone experiences Braxton-Hicks contractions. Those who do often report that they feel like period cramps and can be strong enough to take their breath away.

One easy way to tell Braxton-Hicks from the real thing is to take a walk or change positions. True labor contractions will continue regardless of whether a person is sitting or standing, but false labor may go away.

Braxton-Hicks contractions are also random, meaning they should not come at regular intervals or get closer together, like true contractions do.

There are two things to time when it comes to contractions: duration and frequency. Duration is how long an individual contraction lasts and frequency is the time between contractions, from the start of one contraction to the start of the next.

Mark down the time one contraction starts, when the contraction ends, and when the next contraction starts. Regular contractions, meaning contractions that come at a set frequency and for a similar duration, or contractions that get steadily closer together, indicate true labor

Labor comes in three stages, and contractions continue throughout. In the first stage of labor, contractions help dilate the cervix. They may start out weak and infrequent, becoming stronger and more regular as labor progresses.

Second stage labor is when the baby is born. Contractions are at their most intense and often come with an urge to push.

After the baby is born, contractions start again, though typically less intensely, five to thirty minutes after birth to signal that it's time to deliver the placenta. This is the third stage of labor. Once the placenta is out, labor is over and contractions should cease.

The earliest stage of labor can last for anywhere from less than an hour to days and most people spend the majority of that time at home.

If there are no worrying signs and labor appears to be progressing, the general advice is to come into the hospital when contractions are three to five minutes apart and last at least 45 seconds. Parents can call their doctor when labor begins for more specific guidance.

There are many options for managing pain from contractions. One of the most common is an epidural. Some medical practitioners may administer a mild dose of nitrous oxide.

For parents who want or need an unmedicated birth, many non-pharmaceutical interventions can ease contractions. Changing position can help. Warm water in a birthing tub or shower can help relax the muscles. Fear can intensify pain, so many parents have a reliable birthing partner, doula, or midwife there for support. Taking birthing classes earlier in the pregnancy can also relieve anxiety around labor.

Contractions are not the only labor symptom and they are not even always the first one. Sometimes a backache comes before contractions, though this may go unremarked since backaches are common in pregnancy in general.

If it feels like the belly is lighter or putting less pressure on the lungs, this can be a sign that the baby is moving into position for birth. Bloody or brownish discharge from the vagina can mean that the cervix is beginning to dilate. The water breaking is another key sign.

Contractions are famously painful, but if pain during labor suddenly feels new, sharp, or unbearable it could be a sign of a dangerous complication. Remain calm and get to the hospital.

Other dangerous signs are fever, fast or difficult breathing, convulsions, dizziness, weakness, vomiting, bleeding from the vagina, or a gut feeling that something is wrong.