From lightening crotch to fluid retention, there are numerous pregnancy quirks that can hit your body like a freight train. Some women remain unscathed as they breeze through pregnancy, while others manage to experience all the atrocities pregnancy can bring. 

If you’re anything like me, I was somewhere in the middle. 

Braxton Hicks are high on the list of pregnancy symptoms that confuse expectant mums most, making it hard during the later stages of pregnancy to distinguish between real labour and the practice run. Also known as tightenings or false labour, Braxton Hicks can actually occur as early as the first trimester.

During my recent pregnancy with August, I was 18 weeks along when I experienced Braxton Hicks for the first time. I was attempting to tuck in my oldest daughter who had fallen asleep on top of her blanket. As I rolled her to pull out the blanket, she kicked her leg out and got me in the tummy. It startled me and the next thing I knew I was having mild contractions.

This was the first Braxton Hicks of many to come. As my pregnancy progressed they came on thick and fast, to the point where they took my breath away.

WHERE DID BRAXTON HICKS GET ITS NAME?

An English physician by the name of John Braxton Hicks coined the term after he found women to experience labour type contractions without actually going into labour (without the cervix dilating). 

WHEN YOU WILL EXPERIENCE THEM

Women usually experience Braxton Hicks any time from the second trimester, and even earlier in subsequent pregnancies.

Obstetrician, Dr David Addenbrooke, says Braxton Hicks are a healthy part of pregnancy and can be experienced from the get-go.

“They can happen anytime during pregnancy but become more frequent and stronger in the last month or two of pregnancy,” he says.

“This is thought to be because of the baby putting pressure on the cervix and lower part of the uterus.”

During early pregnancy, they can be triggered by irritation of nearby organs, such as an upset stomach or a urinary tract infection.

“Sometimes stretch on the ligaments can trigger them, such as during the ‘round ligament’ stretch that occurs in the early second trimester,” he adds.

Everyone experiences pregnancy in their own unique way and Braxton Hicks are one of the many symptoms that vary between women. Some women feel them during the early stages of second trimester, like me, while others report never feeling them until right before labour. The intensity and duration also vary.

Generally speaking, Braxton Hicks become more frequent after the baby engages, says Dr Addenbrooke. Most women find the baby starts to engage at around 36 weeks in first pregnancies, though it can be earlier. If it is not their first baby, the baby often engages much later or not until labour begins.

“Engaging is when the widest part of the baby’s head is under the bony part of your pubic bone,” says Dr Addenbrooke.

“The cervix can be higher in some women, so even if the baby is not engaged it may still be putting pressure on the cervix to trigger Braxton Hicks.”

WHAT HAPPENS TO YOUR UTERUS WHEN YOU GET THEM

Dr Addenbrooke says the uterus is a giant bag of muscle that is thickest at the top and becomes thinner towards the bottom, like a funnel.

“The muscle fibres are arranged like a spiral, so that when the muscle contracts it pushes down towards the opening of the funnel,” explains Dr Addenbrooke.

“In the lower third of the uterus the muscle is gradually replaced by elastic collagen, and the cervix (neck of the womb) is essentially all elastic collagen lined by the mucous secreting glands. 

“There are nerves in the cervix that respond to stretch and send reinforcing signals to the muscle of the uterus to contract.”

During labour, this is believed to create a “positive feedback loop”, where further pressure of the baby’s head on the cervix increases muscle contraction in the uterus.

“Braxton Hicks are your body practising this loop until the signals become strong enough to build into the snowball effect of labour when the cervix starts opening up,” says Dr Addenbrooke.

YOUR BODY’S INFLUENCE ON CONTRACTIONS

Uterine contractions can be triggered by physiological changes going on in your body.

Dr Addenbrooke says hormonal factors are a huge part of this, and oxytocin production from your brain ramps up as you near full term.

“The uterus has receptors to this hormone that are also increasing during the pregnancy, making the muscle more sensitive to this effect.

“Hydration is also important for excitation of the uterine muscle, as are electrolyte imbalances.”

Contractions can trigger subtle changes in your heart rate and blood pressure.

“These are much more appreciable during labour contractions, but you may notice them during a painless Braxton Hicks contraction if you are lying on your back and need to reposition because you feel dizzy or nauseous.”

THE DIFFERENCE BETWEEN BRAXTON HICKS AND A LABOUR CONTRACTION

Are you nearing the end of the third trimester and not sure if you’re in early labour or just experiencing Braxton Hicks?

Dr Addenbrooke says pain or discomfort is not typical with Braxton Hicks contractions, but sometimes they can be.

“The medical definition of labour is ‘painful contractions of the uterus accompanied by a dilatation of the cervix,” says Dr Addenbrooke.

“So, in strict medical terms we “diagnose” labour contractions when the cervix is beginning to open up.

“The first few centimetres of dilatation can happen quite gradually in the last weeks of pregnancy though, and many women have very strong labour pains without having any dilatation of the cervix, so this definition is problematic from a practical point of view.”

Instead, Dr Addenbrooke tells his patients the most obvious difference between an early labour contraction and a true labour contraction is your ability to hold a conversation while it is happening.

When women repetitively experience significant discomfort from Braxton Hicks contractions, doctors often refer to them as having an “irritable uterus”.

“If you have to mentally go to another place for 30-40 seconds during the peak of a uterine contraction, it is a very strong sign this is a labour contraction.”

WHAT YOU CAN DO TO REDUCE THE FREQUENCY AND DISCOMFORT OF BRAXTON HICKS:

  • Stay hydrated
  • Have regular bowel movements
  • Keep muscles and pelvic/ spine joints limber by doing gentle exercises or stretches
  • Avoid standing for long periods
  • Avoid expressing from the breast if you’re getting Braxton Hicks that concern you, as this promotes oxytocin, and is a reason doctors say not to start deliberately stimulating breast ducts for colostrum until after 36 weeks.
  • Medical pain relief, such as paracetamol, if required.

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Pregnancy forces you to surrender control of your body, making it an often anxious time with so many unknowns coming into play. 

Contractions are certainly up there on the list as one of the top pregnancy variables that can leave you stumped as you try to decipher what they mean. And judging from my experience, Braxton Hicks can be painful towards the end of the third trimester, and even mimic early labour.

One night at 36 weeks pregnant I arrived home after taking my daughter to dance class and couldn’t move from the car. I was having painful back to back contractions for 45  minutes. As they became less frequent I was able to move into the loungroom and slumped on the sofa, convinced I was I early labour. 

Another hour passed and they petered off completely. This illustrates how unpredictable Braxton Hicks are, and if I wasn’t married to an obstetrician I certainly would’ve rocked up at the maternity ward, STAT! 

If in doubt seek advice from your midwife or doctor. There is no such thing as a stupid question and peace of mind is paramount to staying calm for yourself and bub.

Cheers for now. I’m off to reheat my cup of tea and watch Friends reruns before baby August wakes for a snuggle and feed 😌

Your friend and parenting peer,

Cherie x