Contractions are a normal part of pregnancy that occur closer to the baby’s due date, with some women experiencing them earlier than 37 weeks. Labor or uterine contractions happen when the muscles in your uterus tighten up and then relax. While the uterus is contracting, you may feel your abdomen harden and then soften when the uterus relaxes. 

Uterine contractions cause the cervix to thin and dilate or open for childbirth. They also allow the baby to descend into the birth canal. 

You can experience several types of contractions. But only two types determine if you are going into labor or not: true labor and false labor contractions. 

True labor contractions are the ones that indicate real labor is on the horizon. They are more intense, closer together, and don’t go away. False contractions are less regular and not as strong, such as Braxton Hicks contractions or “practice” contractions, which typically happen several weeks before real labor. Although they are painful, they are not a sign of labor. 

Signs and Symptoms

The symptoms of contractions often begin long before you head to the hospital or birthing center. In fact, this activity that’s taking place in your uterus is a strong indication that labor is on its way. 

You can experience a variety of symptoms, but here are the most common signs you’re experiencing true labor contractions:3 

  • Pain in the lower back that radiates to the front
  • Pain in the pelvis and upper belly
  • Pressure in the pelvis
  • Pain that occurs in a regular pattern
  • Contractions that last from 60 to 90 seconds and get longer
  • Contractions that come every 5 to 10 minutes and get closer together over time and grow in intensity
  • Being unable to walk or carry on a conversation
  • Changing positions does not relieve pain

Diagnosing Contractions 

Your doctor can diagnose contractions and determine if they are part of false or Braxton Hicks contractions or if they are true labor contractions.

You may use the following guidelines to diagnose contractions:

  • Timing and frequency of contractions: With true labor contractions, you will experience contractions that are closer together, have a pattern, and last between 60 and 90 seconds. Braxton Hicks contractions or false contractions present themselves with no pattern or regular timing. 
  • Change with movement: No amount of walking, moving, or adjusting will deter true labor contractions. But false contractions often stop when you walk, rest, or change positions. 
  • Strength of contractions: Painful and strong, true labor contractions steadily get stronger. In comparison, false contractions tend to be weak and mild in intensity. 
  • Location of pain: Back labor pain is often a sign that you are experiencing true labor contractions. You will feel the contractions start in the back and move to the front. False contractions stay in the front. 

Your doctor may use an external uterine monitoring system to track contractions if you are experiencing preterm contractions. During active labor, they may use a fetal monitoring machine to track contractions.


The most obvious cause of uterine contractions is your body preparing for childbirth. These are part of early and active labor. 

But they can also happen if your body is not actively preparing for childbirth. These are called Braxton Hicks or false contractions. They can happen for a variety of reasons, including:

  • If you overexert yourself close to your due date either through exercise or just doing too much
  • If you are dehydrated
  • After having sex

And finally, preterm labor can also be a cause of contractions. These contractions happen before 37 weeks and require immediate attention from your doctor. 


Contractions are often categorized by when they occur during pregnancy and how they feel. 

There are two types of contractions: true labor contractions and false labor contractions. However, you can experience different stages of contractions under each category. 

True Labor Contractions

True labor contractions may include preterm labor contractions, early labor contractions, and active labor contractions. 

Preterm contractions begin before 37 weeks and could indicate preterm labor. But preterm labor does not automatically mean you will have a preterm birth.

If you are experiencing any signs of preterm labor before 37 weeks, talk to your doctor immediately. They will determine if your contractions are a sign of active preterm labor. 

False Labor Contractions

False labor contractions generally refer to Braxton Hicks contractions, which can happen during the second and third trimester. These contractions trigger the uterus to tighten and loosen, but they are irregular and infrequent and don’t last as long as real contractions.

These contractions often feel more like mild menstrual cramps. These can happen when you’re active, if the baby is actively moving around, or if any pressure is placed on the uterus. 


Contractions are a sign that the baby is on its way, sometimes sooner rather than later. And as uncomfortable and painful as contractions may be, they are a normal part of pregnancy. The good news? There are ways to cope. 

Early Labor

If your contractions are far apart and are not increasing in intensity, you’re probably in early labor, and you are likely still at home. Most likely, your contractions are at least 10 minutes apart, so they feel manageable. The key to this phase is to alternate rest with activity. Here are some ways to cope with labor at this phase. 

  • Low-impact exercise, such as walking
  • Prenatal yoga that focuses on breathing and preparing for childbirth
  • Practice with your birthing ball during contractions, so you’re ready for active labor
  • Daily relaxation exercises
  • Taking a warm bath
  • Staying hydrated and remembering to eat

Active and Transitional Labor

At this point, you may be headed to the hospital, birthing center, or awaiting your birthing team to arrive at your home. Depending on the length of your contractions and intensity, you will need to adjust these strategies. Some of the following may not be possible if your contractions are close together:

  • Take a warm bath
  • Get on a hands and knees position and practice deep, rhythmic breathing while doing pelvic tilts
  • Use visualization
  • Practice rhythmic breathing by breathing in slowly during a contraction and releasing the tension by exhaling
  • Keep your body moving by walking, swaying, rocking on a birthing ball, or squatting in a birthing position
  • Ask your partner to give you a back massage
  • Practice progressive relaxation by tensing and releasing specific areas of the body, starting from the head down or from the feet and working your way up
  • If you’re in bed, try to lay on your side instead of your back

If you need immediate or expert guidance you can reach out

Dr. Mamta Pattanayak (Obstetrician and Gynecologist)

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