Experts Say - Braxton Hicks and Real Contractions

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Experts Say - Braxton Hicks and Real Contractions

Dr Kelly Loi, Fertility Specialist from Mount Elizabeth Hospital Limited answers your pregnancy related questions.


I’m just about 30 weeks along in my pregnancy and am starting to worry about how labour will be. I’ve heard about Braxton Hicks contractions but how do I differentiate the real contractions from those?


Braxton Hicks refer to tightenings of the uterine muscles which tend to occur sporadically, usually from mid-pregnancy onwards, especially after 28 weeks. As the pregnancy progresses, Braxton Hicks tend to become somewhat more often, but are characteristically painless and irregular, occurring several times throughout the entire day.


One can usually recognise the onset of true labor when the contractions are painful and regular, occurring approximately every 15 minutes. “Real” contractions are also associated with dilation of the cervix. Unlike the earlier painless and sporadic Braxton Hicks, which caused no obvious cervical changes, these contractions may help the cervix thin out (efface) and open up (dilate).


With early labour, there may also be accompanying signs including the release of the mucus plug, also called the ‘show’. This refers to the plug of mucus which blocks the opening of the cervix during pregnancy. It is released as the cervix softens and dilates. The release of the mucus plug usually appears as a blood stained mucus discharge.


Sometimes, the water bag may break first resulting in a gush of water running down your legs. If the water breaks, then start making your way to the hospital for monitoring of the baby’s heartbeat. There are also potential increased risks of infection and you may need antibiotics.


Every woman’s labour is different. So pinpointing when yours begins isn’t really possible. Braxton Hicks can indeed be difficult to distinguish from early signs of preterm labour. If the pregnancy has not reached 37 weeks yet and contractions are starting to occur at regular intervals with more than 4 contractions an hour, — or if there are any other signs of preterm labour such as the show or watery discharge — let the doctor know immediately so that he/ she can examine you for cervical dilation.

Thanks for sharing!