False contractions during pregnancy: symptoms, how to distinguish from real ones?

Anastasia Safina (author of the publication)

Hello everyone, I'm Anastasia Safina! Childbirth is still a long way off, but do you occasionally experience strange sensations in your lower abdomen? In many ways, do they resemble contractions and become a serious cause for anxiety and worry? Let me tell you about this phenomenon in more detail. Namely, about false contractions during pregnancy, symptoms, how long before labor they begin, how they occur and what to do if the sensations are too painful.

What are false contractions

False contractions are involuntary contractions of the smooth muscle tissue of the uterus. They are also called Braxton-Hicks contractions - in honor of the British doctor who described the process in 1872 based on scientific papers and clinical practice. “People” give them another name – training contractions. They really seem to “train” the uterus, preparing it for future labor.

The uterus is a hollow muscular organ consisting of three layers: endometrium, myometrium and perimeter. The middle layer (myometrium) is smooth muscle tissue that is capable of contraction. It is regular intense contractions that help expel the fetus and placenta during childbirth. False contractions during pregnancy are a completely natural process that you do not need to be afraid of. More often than not, it does not cause discomfort to the woman. But each organism has its own individual characteristics, so in some cases it is worth being mentally and physically prepared for unpleasant sensations.

When do they start?

Many expectant mothers ask me how long before birth false contractions begin.

On average, Braxton Hicks contractions appear from 28 weeks of pregnancy, less often - earlier, at the beginning of the second trimester. They continue until full term and normally do not lead to labor. Often pregnant women mistake training contractions for labor that has begun, arrive at the maternity hospital, and then in the emergency department the process stops.

Such contractions at 37 weeks of pregnancy and later are called precursor contractions. They help shorten and soften the cervix and signal that the moment the baby is born is close. They appear in combination with other precursors of labor, for example, a noticeable drooping of the abdomen, easier breathing, or the release of a mucus plug.

Six main harbingers of childbirth

Precursors of childbirth are certain changes that begin to occur in a pregnant woman’s body 2-4 weeks before birth. These changes are explained by the processes of preparation for the passage of the child through the birth canal. The main precursors of childbirth are the following:

Abdominal prolapse. If previously a pregnant woman’s belly protruded forward as much as possible in the navel area, now the most protruding point may move slightly to the bottom. This occurs because the baby turns into a cephalic position and descends into the mother's pelvic cavity. Thanks to this, the fundus of the uterus also drops a little lower, making room for the diaphragm and making breathing easier for the pregnant woman. Such changes in the position of the fetus are clearly visible even visually by changes in the shape of the abdomen.
Increased pressure on the intestines and the urge to go to the toilet. The descent of the baby and uterus into the pelvic area creates even more pressure on the intestines. Frequent visits to the toilet in the run-up to your due date is a natural cleansing for the body.
Reducing the number of movements. About a week before birth, the baby begins to move less. This is explained by the fact that its head is already fixed in the pelvic bones, and its large size does not allow wide movements. In addition, the child saves strength for the upcoming difficult test.
Changing a woman's reaction to external stimuli. Close people may notice that the pregnant woman has become more excitable or, conversely, inhibited. Many women withdraw into themselves for no objective reason about a week before giving birth.
Removal of the mucus plug. The cervix is also preparing for childbirth and begins to slowly dilate. When the gap becomes large enough, the mucus plug cannot hold on and comes out. The plug is a mucous mass similar to jelly. Its color can vary from transparent yellow to brownish red. Small streaks of blood are allowed. Typically, the mucus plug comes off when there are a few days left before delivery.
Training contractions. In the last few weeks of pregnancy, a woman may feel training contractions. In this way, the uterus prepares for future births and periodically contracts. While this force is not enough for the baby to be born, the woman may experience quite unpleasant pain. It is very important to monitor such training contractions, since their intensity should not increase, and the interval between them should not decrease.

Why do they arise?

It is impossible to determine exactly why false contractions occur. The nature of their occurrence is still unknown, despite more than a century of studying the phenomenon.

Some women do not feel training contractions throughout the entire period, while others sometimes experience very painful sensations. Scientists are inclined to conclude that tangible muscle contractions of the uterus are a signal from the body that you need to pay attention to some problem or reconsider your lifestyle. For example, follow a drinking regime, spend more time in the fresh air, get enough sleep, etc.

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Main symptoms

I will list the main signs:

Sensations occur in the lower abdomen or lower back. The pain is not sharp, slightly pulling or squeezing. To understand what such contractions are like, remember what sensations you experienced in the first days of menstruation.
The uterus seems to “turn to stone.” If you place your palm on your stomach, you will notice a lot of tension.
The duration of the contraction is several seconds, less often 1-2 minutes. On average, there can be 5-6 contractions per hour. Irregular: occurs at different intervals each time. They often appear in the evening and disappear by night. May last for several days in a row.
They do not cause discomfort; you can carry out your usual activities with them throughout the day.
With each contraction the intensity drops. Normally, they go away on their own, without any procedures or medications.

Later in pregnancy, false contractions can become painful. As a rule, they begin suddenly and end just as abruptly.

Determining the deadlines

The baby may be born within the next 2-3 weeks.
The long nine months of pregnancy are already behind us - at the 37th week, the mother is preparing for childbirth. Surely you already know that doctors count the pregnancy period from the first day of the last menstruation before giving birth. Considering that ovulation and subsequent fertilization of the egg occurs in the middle of the female cycle, the embryonic period (actual, from conception) is usually less than the obstetric period by about 2 weeks. So, the 37th obstetric week is:

about 35 weeks from the date of fertilization;
approximately 32 weeks from the date of missed period;
nine obstetric months of pregnancy;
third trimester of pregnancy.

At this stage, expectant mothers are more concerned about the due date than the pregnancy. The baby may be born right now, or may “delay” until 40–42 weeks. It is possible to accurately determine the date of birth only in the case of a planned cesarean section, when the day of the operation is scheduled in advance.

How to distinguish false contractions from real ones

How not to confuse Braxton Hicks contractions with the onset of labor and not end up in the hospital ahead of time? Just calm down, then listen carefully to your body and prepare a watch with a timer:

False contractions do not have a clear rhythm; they pass smoothly, without acute increasing pain. While true ones are repeated with a certain frequency (more than 7 per hour), they become more frequent and increase in strength.
With practice contractions, you'll be able to sleep through the night. You are unlikely to fall asleep at home with the real ones.
In false contractions, the uterus does not dilate, or it is minimal and does not change in any way for a long time. The real ones promote full dilatation of the uterus up to 10 cm and lead to a period of pushing.
True contractions are often accompanied by bleeding, unlike false ones.
In real contractions, the pain is more pronounced: the stomach and lower back are pulled, the entire uterus is tense, and it “bursts” unpleasantly.
Even if false contractions are “painful,” they can be stopped. Sometimes a simple change of position, proper rest, or a relaxing massage helps.

If contractions mark the beginning of labor, it is impossible to stop them, except to slightly relieve the pain. And you can learn exactly how to do this in the courses of our online school “Easy Childbirth”.

How can you understand that everything that is happening to you is no longer a “rehearsal”, but the real beginning of labor? If you are 38 or 40 weeks pregnant, pain increases rapidly, and the interval between them decreases. There are also more obvious signs. If suddenly there is a rupture of amniotic fluid, go to the emergency department of the selected maternity hospital. During the examination, the doctor will check the degree of maturity of the cervix and its length. On CTG, it will be possible to observe the contractile activity of the uterus, the nature of contractions and the fetal heart rate. The results of the study will show whether labor has definitely begun, what method of birth will be required, and whether the baby in the womb is suffering from a lack of oxygen.

Childbirth at 37 weeks

At 38 weeks, the pregnancy is considered full-term and the fetus is considered mature. It may happen that labor begins at the 37th week; in most cases, doctors consider it premature until the condition of the newborn is assessed. If the baby breathes independently and has normal height and weight (at least 2.5 kg and 45 cm), the birth is considered timely.

As already mentioned, children born before 37 weeks of pregnancy and having a body weight of less than 2500 g and a height of less than 45 cm are considered premature. However, these criteria are very conditional, since many full-term children are born with a body weight of less than 2500 g, while At the same time, a premature baby can weigh more than 2500 g.
Conventionally, there are 4 degrees of prematurity based on body weight:
I degree - 2001–2500,
II degree - 1501–2000,
III degree - 1001–1500 g,
IV degree - less than 1000 g.
Since 1974, WHO has proposed that children born with a body weight of more than 500 g and a gestation period of at least 22 weeks be considered viable.
Elena Pakhar Obstetrician-gynecologist, employee of the Department of Obstetrics and Gynecology of the Russian State Medical University
https://www.9months.ru/rodybase/775/prezhdevremennye-rody

Most often, childbirth at this stage occurs in women who give birth not for the first time, during pregnancy with twins. The main signs of rapid labor:

breaking of water;
regular contractions (more than 5 times an hour).

If such symptoms occur, you should arrive at the maternity hospital as soon as possible. Sometimes, during premature birth, the mother’s body is not ready for the process. The water may break, but there will be no contractions and the cervix will be closed. In this case, doctors resort to medicinal methods of stimulating labor or perform an emergency caesarean section.

The process of natural childbirth can be divided into three stages:

opening of the uterus and contraction of its muscles (contractions);
pushing, during which the baby moves along the birth canal;
birth of a baby;
birth of the placenta, amniotic membranes.

The duration of natural childbirth is individual for each mother, the average is 10–12 hours for first-time women, 6–8 for repeat births. Labor that occurs faster than the specified time is considered rapid, and if these indicators are exceeded, it is considered protracted.

The birth canal, through which a child has already passed once, is more elastic and stretches better, since after the first birth they are already prepared for the birth of the baby. Consequently, the fetus passes through the birth canal faster. Therefore, during the period of pushing, less effort is required to give birth to a child than for the first time. In addition, the woman already knows what sensations she experiences, when and how to push correctly, and it is much easier for her to correctly direct her efforts, which makes pushing more effective. Thanks to this, the overall duration of labor is shortened. If the first birth lasts on average 10–12 hours, then the second birth is shortened to 6–8 hours. The contraction period lasts about 6–7 hours, the pushing period (from full dilatation of the cervix to the birth of the child) is 15–30 minutes, the afterbirth period (from the birth of the child to the discharge of the placenta) is 10–30 minutes. For women giving birth to their first child, the duration of the first stage of labor is 8-10 hours, the second stage - 1-2 hours. But the duration of the third (successive) period during the first and subsequent births is approximately the same.
Elena Kudryavtseva Obstetrician-gynecologist, Ural Institute of Maternity and Infancy, Yekaterinburg
https://www.9months.ru/podgotovka/5799/vtorye-rody-sovety-vracha

C-section

During spinal anesthesia, the active substance is injected into the spine.
A planned caesarean section at the 37th week is rarely performed in case of worsening pregnancy complications when carrying twins. If the condition of the mother and fetus is stable, the operation is scheduled no earlier than the 38th week. The reasons for a planned cesarean section may be chronic diseases of the mother, a narrow pelvis, multiple pregnancies, sutures and scars on the uterus, partial placental abruption, and others. Doctors can decide on emergency surgery if the condition of the mother or fetus rapidly deteriorates, when delay is fraught with negative consequences. Indications may be:

acute fetal hypoxia;
tight umbilical cord entanglement;
placental abruption;
critical lack of water and others.

The operation begins with anesthesia. Pain relief can be carried out using two methods:

general anesthesia - the mother falls asleep and wakes up after the operation;
epidural (spinal) anesthesia - only the lower part of the body loses sensitivity, the woman is conscious all the time.

Epidural anesthesia is considered preferable and often used, since in this case there is less negative impact of medications on the fetus and the mother’s body. However, it is not always appropriate (for problems with the mother’s spine, severe nervous shock, or mother’s excitement).

At the next stage of the operation, doctors cut the abdominal wall, the wall of the uterus, spread the muscles and remove the baby, placenta, and amniotic membranes. Most often, a small incision is made in the lower abdomen, above the pubis. In an emergency situation, when seconds are counting and the fetus needs to be removed as quickly as possible, a longitudinal incision can be made from the navel to the womb. Then doctors sew up the uterine wall with self-absorbing material. Then sutures are placed on the abdominal wall (self-absorbing - cosmetic or with threads, which are removed after a few days).

How to relieve pain

Sometimes training contractions turn out to be very painful and cause a lot of inconvenience to the woman. Especially if they last all day and periodically occur at night.

Here's what I usually recommend doing if you don't want to endure unpleasant moments:

Take more walks in the fresh air. You will be distracted and will pay less attention to discomfort. In addition, leisurely walking helps to relax the smooth muscles of the uterus, which means the pain will subside.
Go to the toilet, because a full bladder puts pressure on the uterus and promotes contractions.
Take a warm shower or bath to reduce muscle spasms.
Drink water or other liquid to rehydrate your body.
Take a position that is comfortable for you, turn on the other side or on your back if you are lying. The knee-elbow pose and the kneeling pose with support on your hands alleviates spasms.
Have a relaxation session: meditation, Pilates with relaxing music, watching a light movie.
Ask your husband or someone at home to give you a light lower back massage. It also holds back unpleasant sensations.
You can also take an antispasmodic, but only after consulting with your doctor. Use medications only when absolutely necessary. No-shpa or suppositories with papaverine are safe for pregnant women.
Perform breathing exercises. There are many effective techniques. For example, inhale deeply through your nose and then exhale through your mouth. In this case, the inhalation should be slow and calm, and the exhalation should be fast. You can also breathe “like a dog,” taking short, quick inhalations and exhalations.

I talked more about breathing techniques during contractions in the article “How to breathe during childbirth.”

Important: if the intensity of contractions increases and the pain cannot be relieved, it is better to consult a doctor. Especially if the PDR is far away and the period is less than 36 weeks. This may indicate premature birth, and at such a moment you need to be under the supervision of medical personnel.

False contractions are much easier to bear than real ones. And remember that in this way the body prepares for a difficult test of strength - natural childbirth.

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