Understanding When Contractions Begin in the Third Trimester

As your due date approaches,   you may be wondering, “When will labor start?” Ideally, actual labor won’t start until closer to your due date, but you may feel some contractions during the later stages of pregnancy. These non-labor contractions are called Braxton Hicks contractions. 

Read on to learn the difference between Braxton Hicks and labor contractions, as well as what causes Braxton Hicks. Plus, learn the signs of labor and when labor contractions may indicate a pregnancy complication, like premature birth.

 

Braxton Hicks and Labor Contractions

According to the American College of Obstetricians and Gynecologists (ACOG), Braxton-Hicks syndrome is a common condition in the later stages of pregnancy that can cause discomfort even though they’re not true labor contractions, often leading women to believe they’re in the early stages of labor when they’re not.

Unlike labor contractions, Braxton Hicks contractions have the following characteristics:

  • Symptoms tend to subside with rest, walking, changing position, and drinking water.
  • They don’t follow any patterns, they don’t get stronger, they don’t get closer to each other.
  • These pains are most often only felt in the abdomen, but labor contractions usually move from back to front.

If you’ve given birth before, you may notice that Braxton-Hicks contractions start earlier. “You may feel some abdominal tightness or discomfort from time to time, but that’s because your uterus is working and practicing for birth,” says Paul du Trail, MD, director of maternal-fetal health at Touro Hospital in New Orleans.

Braxton Hicks contractions are usually irregular, slightly uncomfortable, and last from 30 seconds to 2 minutes. There’s no need to contact your health care provider if you experience occasional Braxton Hicks contractions. Most people start noticing them after the 20th week of pregnancy.

 

What causes Braxton Hicks contractions?

Braxton Hicks are thought to be your body’s way of preparing for birth – it’s basically your uterus warming up! There are many factors that can make you more likely to develop Braxton Hicks syndrome.

Overwhelmed

While you may not want to slow down in your third trimester, overdoing it can cause your uterus to start practicing contractions. “If you overdo it, it can trigger Braxton Hicks contractions,” says Dr. Putterman. Luckily, Braxton Hicks contractions usually subside when you put your legs up and relax.

Dehydration

Dehydration can also cause Braxton Hicks contractions, so be sure to drink plenty of water. “When patients call us about labor, one of the first things we tell them is to drink a glass of water,” says Dr. Putterman. “If you don’t feel better, you may need to come in and get checked out.”

Additionally, a full bladder can also trigger Braxton Hicks contractions, so make sure you urinate frequently.

Sexual relations

Sexual intercourse has also been shown to cause Braxton-Hicks contractions, possibly because orgasm causes uterine contractions. Additionally, prostaglandins in semen can cause uterine contractions during penile-vaginal intercourse.

These contractions should subside soon after they started, but be sure to contact your doctor if symptoms persist, become stronger, or fall into a predictable pattern.

 

What are the signs of labor?

Ideally, true labor won’t begin until full-term, around week 39. According to ACOG, most people start labor between weeks 38 and 41 of pregnancy, so contractions at this time could be a sign that they’re real.

According to ACOG, signs of true labor include:

  • You may experience pain in your back or pelvis
  • Contractions may feel like menstrual cramps.
  • Contractions follow a regular pattern and become longer, stronger and more closely spaced apart as time goes on.
  • No matter how active you are, labor will continue.

Unlike Braxton Hicks contractions, real labor contractions are effective, which means they work hard to soften and open the cervix and move the baby toward the birth canal.

Contractions will start out irregularly but will soon become more regular. “If you’re in true labor, contractions will gradually get shorter, longer, and stronger,” says Dr. Putterman.

In most cases, your health care provider will recommend going to a hospital or birthing center once your contractions have lasted about a minute and are four to five minutes apart, though your provider may recommend a different threshold depending on your risk factors, distance from the hospital, and other personal considerations.

 

Labor pains before birth

False labor contractions (also called “false labor” or “predator labor”) are different to Braxton-Hicks contractions in that they only occur right before labor begins. As a result, they are often mistaken for true labor contractions and can be very uncomfortable.

Signs of false labor are similar to Braxton-Hicks pains in that they mainly involve a tightness sensation in the abdomen and do not increase in intensity or frequency.

However, unlike Braxton Hicks, they can last longer (up to a minute) and occur more frequently (about five minutes apart), creating a clearer pattern and mimicking labor contractions. Another feature that distinguishes prodromal contractions from Braxton Hicks contractions is that prodromal contractions often do not stop, even when you change your activity.

 

Contractions due to pregnancy complications

Labor can also start early if you have a preterm birth. Preterm birth occurs when labor begins before completing 36 weeks of pregnancy. Certain factors increase the risk of preterm birth. According to the National Institute of Child Health and Human Development, these include:

  • Twin pregnancy (pregnancy of two or more fetuses)
  • History of preterm birth
  • Short cervix
  • Infect
  • High blood pressure
  • Vaginal bleeding
  • Congenital anomalies in the fetus
  • Placenta previa
  • Risk of uterine rupture
  • diabetes
  • Blood clotting disorders
  • Being too fat or too thin
  • Under 18 or over 35
  • Smoking, alcohol, and drug use
  • Emphasize

Premature contractions are characterized by a pattern of contractions or tightening of the uterine walls (not just occasional pain) that doesn’t go away. “If you’re experiencing multiple contractions over a period of several hours, you should come in and get evaluated,” says Dr. Bert Putterman, an obstetrician-gynecologist at Texas Children’s Hospital in Houston.

Premature labour can lead to premature birth, which can lead to problems for the unborn baby like breathing problems, low birth weight, impaired vision, etc. It is therefore important to immediately check for symptoms of premature labour, such as painful labour pains and vaginal bleeding.

Persistent contractions are also a sign of a problem. Even during labor, your body takes short breaks between contractions, so if labor doesn’t stop, it could be a sign of a dangerous complication, like a uterine rupture.

Additionally, ACOG recommends going to the hospital immediately if your water breaks (with or without contractions), you experience heavy vaginal bleeding, severe pain and persistent contractions, or if you notice weakened fetal movements.

 

Can I induce labour myself?

If you’re looking forward to giving birth, you may be wondering how to induce labor at home. However, it’s usually best to wait as long as possible. Important fetal development is still occurring in the final weeks of pregnancy, and trying to induce labor on your own could end badly.

However, if your body is ready to give birth, several things can create favorable conditions for birth. These include:

  • Specific movements (such as pelvic tilts or sitting on a birthing ball)
  • Sexual relations
  • walk

When you’re ready to start labor, talk to your doctor about how to induce labor at home.

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