Labor Contractions: Types & Timing

Contractions are nature’s way of telling your body that baby is on the way. Knowing the different types and timing is key to a safe, fully-supported labor and delivery experience—from Braxton Hicks to PreTerm to True Labor. Let’s dive into the details to ensure you know the deal on your big day.

What are the different types of contractions?

The physiological phenomenon of a contraction is the tightening and relaxation of the muscles of your uterus, which help push your baby out of your uterus. As labor begins, your cervix opens, which is referred to as dilation. Here are the three different types of contractions and what they each signify:

• PreTerm Contractions are regular contractions that result in the opening of your cervix after week 20 and before week 37 of pregnancy and indicate you’re in preterm labor, which can result in premature birth. The earlier this happens, the greater the health risks for your baby, and while it isn't clear what causes preterm labor, certain risk factors might increase the chance.
• Braxton Hicks Contractions (also known as fake or practice contractions) are named after the 19th century English physician John Braxton Hicks, who first noted that many women felt contractions without being close to giving birth. Learn how to tell the difference between Braxton Hicks contractions and real labor contractions.
• True Labor or Real Labor Contractions are, you guessed it, the real deal. Unlike Braxton Hicks contractions, real labor contractions typically begin at around the 40th week of pregnancy, continue to intensify, increase in frequency and don’t let up with a change in position. Other signs of real labor contractions include lower back and belly pain, a brownish or reddish mucus discharge (“bloody show”), and the bursting of your amniotic sac (“water breaking”), which could happen before or during real labor contractions.

What do contractions feel like when they start?

“The feeling of a true contraction has been described as a wave. The pain starts low, rises until it peaks, and finally ebbs away. If you touch your abdomen, it feels hard during a contraction.” The intensity of contractions varies among women and even between pregnancies, and while some liken early contraction pain to menstrual cramps and gastrointestinal discomfort, real labor contractions cause pain in the lower abdomen or the lower back and abdomen, and in some women, down the legs, specifically the upper thighs.

How do contractions change during labor stages?

The duration, intensity and frequency of labor contractions can change, depending on what stage of labor you’re in.

• In Early Labor, each contraction usually lasts about 30 to 45 seconds and may start as much as 20 minutes apart, but will become progressively shorter as this phase ends
• In Active labor, contractions become increasingly more intense, frequent and longer, lasting around 40 to 60 seconds each
• In Transitional labor, contractions suddenly intensify and become more frequent, with each lasting about 60 to 90 seconds and coming about two to three minutes apart
• Finally, in Pushing and delivery (2nd stage of labor), contractions last 60 to 90 seconds, but are sometimes further apart—about two to five minutes—and possibly less painful

When should I go into the hospital with contractions?

While timing is different for everyone, early labor can last for days, and ideally you don’t head to the hospital until you’re in active labor. It’s crucial that you count your contractions to determine when it’s truly time to go and here’s how it’s done. Make sure you’ve got your stopwatch ready.

• Start timing contraction durations. If the tightness of your contractions lasts for 30 seconds or longer, they’re labor contractions.
• Count the time between contractions from the start of one to the start of the next.
• If you’re a first time mom-to-be, head to the hospital when your contractions come every three to five minutes over an hour-long period and last at least 45 to 60 seconds
• If you’ve given birth before, head to the hospital when your contractions come every five to seven minutes and last at least 45 to 60 seconds

How do I induce labor contractions and why would I do that?

Your healthcare provider will recommend steps to induce (e.g., start) labor contractions if your health or your baby’s health are at risk or if you’re two weeks or more past your due date. Under these circumstances, inducing labor is crucial to keep mom and baby healthy.

These widely accepted medical treatments to induce labor can take a few hours or a few days, depending on how your body responds to your treatment:

• Separating the amniotic sac from the uterus wall (aka stripping or sweeping the membranes)
• Ripening the cervix (using prostaglandins to soften and thin the cervix or luminaria to open the cervix)
• Using a Foley bulb (thin tube with balloon at the end inserted into the vagina to widen the cervix)
• Giving you medicines such as oxytocin to help start contractions
• Breaking your water (also called rupturing the membranes or amniotomy) painlessly using a small hook that looks like a knitting needle to break the amniotic sac

And what about naturally inducing labor? We’ve all heard stories about the possible efficacy of spicy foods, sex, long walks, acupuncture, castor oil and herbal options, but there are mixed reviews and inconclusive studies on which of these actually work (if any). While it couldn’t hurt to try some of these, your best bet is to consult your medical provider or pregnancy support specialist.

How do I know if I'm having labor contractions?

Given the likelihood of false starts and the certainty of contraction discomfort, it’s essential that you listen to your body, trust your instincts and save your doctor and doula’s numbers in your favorites. And while identifying, enduring and timing contractions may sound like a daunting task, when the time comes, you can rest assured it will all come together like clockwork. We’ve got even more tips for making your hospital stay labor and delivery as smooth as possible.