Contractions: What Do You Need To Know Before Labor?

Pregnant woman with contractions

Contractions can be exciting—the green light that labor and the baby are almost here!—as well as scary—cue the imminent pain, sweat, and tears. There’s no denying that the stages of labor can be intense for women, and the first step to managing contractions is to understand them. This post will cover:

  • What are contractions?
  • What is the difference between real contractions versus false labor ones?
  • What do you need to go to the hospital?

What’s actually happening in a contraction?

During a contraction, the uterine muscles temporarily tighten and then relax, which serves two main purposes:

  1. Make the cervix thin and dilate
  2. Help the baby descend during delivery

Uterine contractions aren’t limited to only pregnancy. The uterus contracts over the course of the menstrual cycle, becoming more pronounced during your period when the uterine muscles contract to help shed the uterine lining. While not nearly as painful as contractions during labor, contractions during menstruation can also be painful and uncomfortable. However, that menstrual pain and even cramps during pregnancy is likely due to increases in progesterone levels. But, during labor, the hormone oxytocin leads to uterine contractions, which makes it different.

Where do you feel contractions?

Contractions will usually be felt throughout the lower back and as pelvic pain throughout that lower abdominal region.

How do you time contractions?

Start timing contractions from the beginning of a contraction until the beginning of the next one. This measurement is contraction frequency. So, if you’re first contraction began at 1:00 P.M., and the next contraction begins at 1:12 P.M., your contractions would be about 12  minutes apart.

How long do contractions last?

Contraction length—meaning how long the contraction itself lasts—will become longer the further along in labor you are. Here’s what you could expect during each of the stages:

woman in bed
Contraction Length Contraction Frequency Contraction Strength Contraction Feels  Like…
Stage 1 30 – 45 seconds 5 – 30 min apart, might be irregular Begins mild and becomes progressively stronger Lower back pain, menstrual cramps, and/or pressure in pelvis
Stage 2 45 – 60 seconds 3 – 5 min apart Stronger than the first stage Stronger, longer, and more intense than early labor
Stage 3 60 – 90 seconds 30 seconds – two minutes apart Very strong and intense Highly intense, can also experience hot flashes, chills, nausea, and vomiting with contractions.

It’s important to know that as labor progresses, not only do  contractions become longer, the space between them shorten and become more frequent. Note both the contraction frequency and length because they usually have a pattern or regularity; if they don’t, make a note of this to a medical professional.

How can you tell the difference between false labor and true contractions?

False labor, or Braxton Hicks contractions, can be worrisome because both involve uterine muscles contracting. BUT, true labor contractions mean labor and delivery are imminent whereas false ones do not (as the name implies). Here are the main differences between true and false labor contractions:

Braxton Hicks (False Labor) True Labor Contraction
  • Resolve with changing position or activity
  • Persists regardless of activity
  • Irregular frequency, no rhythm
  • Regular frequency
  • Can last anywhere from a few seconds to a few minutes
  • Gradually will increase in length, lasting between 30 – 90 seconds depending on stage of labor
  • Don’t escalate in intensity, generally weak
  • Progressively increase in intensity, will become very sharp and strong
  • Localized in an isolated area of the abdomen, typically higher in the abdomen)
  • Felt throughout the abdomen, lower back, and pelvic areas

Are there contractions after the baby is born?

If you deliver your baby via vaginal birth, contractions can resume in the postpartum stage—with lower intensity than during transition—to deliver the placenta.

At this point, some women may consider keeping the placent. Although there isn’t a medical benefit to consuming or saving it, some women choose to keep the placenta attached to the infant, aka a lotus birth, which you can talk to your doctor about before the stages of labor begin.

When do I go to the hospital?

It’s recommended to go to the hospital when the contractions are strong and about five minutes apart. You may hear about the “5-1-1” rule. The rule recommends that women go to the hospital when contractions are five minutes apart, last for one minute, and have been that pattern for one hour.

Aarthi Gobinath, PhD

Aarthi Gobinath earned her PhD in neuroscience from the University of British Columbia. Her research covers the ways that stress affects the male and female brain differently.

She tackled the issue of sex bias in research by looking at why standard treatments for depression don't always work in the case of postpartum depression. Her work has been covered by Vice and Massive Science.

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