Labor Contraction or Braxton-Hicks?

What is a labor contraction? It is, most simply, the tightening and releasing of a muscle. When giving birth, the muscle in question is the uterus. So a contraction can be described as a tightening and releasing of the uterus for the purpose of opening (dilation) and effacing (thinning out) the cervix to allow the baby to descend from the birth path into your waiting arms.

And now for a little lesson in female reproductive system anatomy: the uterus is composed of two layers of muscle fiber, one that runs horizontally and another that runs vertically. It's the job of the vertical fibers to pull up on the uterus while the horizontal fibers push the baby down further into the birth canal. This is a very important point, so read carefully. A labor contraction in itself is not painful. No, it's not. It's your reaction that makes it painful. Yes, we create our own pain. I sense your skepticism, so I'll elaborate further.

Let's talk about those uterine muscle fibers again. Let me preface by saying that this discussion presupposes that a woman perceives that a contraction will be painful. So what does a person do when anticipating pain? She tenses up. Wrong move. Seriously, the wrong move. Why? 

When the vertical uterine fibers pull up and the horizontal fibers push down, the cervix is supposed to dilate and efface so that the baby descends effortlessly. But when a woman tenses, her cervix tenses too.  So as the uterus is doing its job and the horizontal fibers are pushing down, they don't meet a relaxed cervix. It's like meeting a brick wall instead.  And what the result when someone runs into a brick wall? Yep, you guessed it. Pain.

It's the same principle that applies in a drunk driving accident. Have you ever wondered why the drunk driver walks away but the family of four is in critical condition? It's because the drunk driver was relaxed. He wasn't anticipating the collision, so he stayed relaxed. When the other family saw his car barreling at them, they tensed, understandably.

Did you also know that a woman in a coma is perfectly capable of giving birth? The body knows how to have a baby with no conscious effort. The labor contraction by itself will be enough to expel the baby. No "purple pushing" required.  An excellent resource on the benefits of relaxation for birth is HypnoBirthing : The Mongan Method.

And now that we've concluded our session on the female reproductive system, is a labor contraction necessarily a sign of labor? No, they are not. Many women feel contractions as early as the first trimester. In my first pregnancy, I had regular contractions from 16 weeks onward and with my second from 11 weeks. These contractions are termed Braxton-Hicks.

But essentially, they are the same as a true labor contraction. The difference is that they don't change the dilation or effacement of the cervix. However, the muscle at work is the uterus and you are feeling it tighten and subsequently relax just like the real thing.

So how can you tell the two kinds apart? That's an excellent question. In both my pregnancies, contractions were never a good indicator. The night my second child was born, I awoke with contractions 2 minutes apart. My husband was concerned that I was truly in labor, but I wasn't as I had awoken every night that week with contractions 2 minutes apart.

But this was the real thing. So how did I know? Well, there are many things you can do to test the waters, as it were. Some things to note are:

How frequent are they?

Time contractions from the beginning of one to the beginning of the next. True labor develops into a regular rhythmic pattern; if it is irregular, then it's probably not the real thing.

How long does each one last?

Again, look for a pattern. They usually start small (15-30 seconds) and progressively increase in duration (up to 60-90 seconds). If they're all over the place, put your feet up and make someone wait on you hand and foot-milk it for all it's worth until you know for sure.

Are the contractions influenced by your activity?

Get up and walk around for a bit. If they decrease, you can sit down. If they increase and become regular, you may be having a true labor contraction.

Where do you feel your labor contraction?

A true labor contraction tends to start in the back and radiate around to the front of your abdomen. It encompasses your entire abdomen, especially the top. Remember the structure of the uterus we talked about previously? That's exactly why the real ones feel this way-one set of fibers pulling up and another pushing the baby out.

Hopefully this primer on a contraction in pregnancy has been enlightening and will help you to not only recognize a true labor contraction but also relinquish your fear surrounding them.

Here's the bottom line: whenever you're in doubt, check it out. Corny but true. Call your care provider whenever you feel the need-that's why you have them.