Any woman experiencing her first pregnancy wonders how she will know when it’s time: time to call her labor coach, time for her husband to toss the hospital bag in the car, time to call her doctor, time to call a taxi, time to go to the hospital. You might imagine that the magic sign will be the point at which you begin experiencing uterine contractions but that could be as early as the 20th week. That’s why it is important to know about the different types of contractions, when and why they occur, and when to be concerned.
The contractions that begin around the 20th week and occur randomly until the onset of labor are called Braxton-Hicks contractions. These are usually painless and have been described as the feeling of a belt-tightening around the belly. In these contractions, the uterus hardens in preparation for childbirth.
As you progress toward your due date, the Braxton-Hicks contractions may become a little more intense and may also begin to help your cervix dilate and/or efface. However, these practice contractions do not come at regular intervals and are not strong enough to actually deliver your baby.
Feeling a contraction of any sort may cause you to be concerned about whether it is a sign of preterm labor, which is defined as labor beginning between about 20 weeks and 37 weeks. Contractions that come with preterm or premature labor may be regular or irregular, but will usually be accompanied by other symptoms such as the passage of the mucous plug (a gelatinous mass); a flow or trickle of amniotic fluid; pain or pressure in the lower back; pain or pressure in the pelvis; or pink or brown discharge.
If you experience the symptoms of preterm or premature labor, tell your doctor or nurse-midwife they will examine your cervix to determine if labor has really begun (or is about to begin). Depending on the severity of the symptoms, treatment for preterm labor may include bed rest alone, home uterine monitoring, and possibly medications to halt the contractions.
Once you have reached full term, ask your doctor or midwife in advance how closely-spaced the contractions should be before you head for the hospital. The contractions will most likely feel like Braxton-Hicks contractions as labor begins, allowing you to practice any relaxation techniques you may have learned before the contractions intensify enough to be painful. An increasing ache or pain in the lower back is also a very common symptom of real labor.
Doctors usually recommend that you find a way to keep your mind off the contractions as labor begins because it isn’t to your advantage to go to the hospital when you still have hours to go or worse when the contractions you feel are not real labor but just a false start. If this pregnancy is your first, you probably even have time to cook a casserole to freeze for when you come home from the hospital (or for your husband to eat while he’s home alone!). Taking a warm shower helps relieve early labor pain and helps you to relax until you’re ready for your trip to the hospital.
As with any pregnancy concerns, ask your doctor if you have any questions about contractions or any other worrisome symptoms you may experience.