Overview

Braxton Hicks contractions

During the second and third trimesters of your pregnancy, you may notice times when your belly tightens and becomes firm to the touch and then relaxes. These are called Braxton Hicks contractions. Think of them as "warm-up" exercises for your uterus.

These contractions may be so mild that you rarely notice them. Or they may be strong enough to make you stop what you are doing.

You may begin to feel Braxton Hicks contractions between the 28th and 30th weeks of your pregnancy. But sometimes they start as early as the 20th week. You most likely will have more of these contractions during your ninth month.

It is often hard to tell the difference between true labor pains and Braxton Hicks contractions, especially in your first pregnancy. Braxton Hicks contractions:

• Tend to be irregular and vary in strength. They do not become more regular or stronger.
• Go away when you're active. (True labor pains may continue or increase during activity.)
• Are more noticeable when you rest.
• Occur less than 4 times an hour.

True labor pains tend to last longer, become stronger, and occur closer together than Braxton Hicks contractions.

If you are not sure what type of contractions you're having, talk to your doctor or midwife.

Preterm labor

Preterm labor is labor that comes too early—between 20 and 37 weeks of pregnancy. In labor, the uterus contracts to open the cervix. This is the first stage of childbirth. In most pregnancies, this happens at 37 to 42 weeks. Preterm labor is also called premature labor.

It can be hard to tell if preterm labor starts. You may have regular contractions. This means about 6 or more contractions in 1 hour, even after you've had a glass of water and are resting. You may have other symptoms, such as menstrual-like cramps or leaking or gushing of fluid from your vagina.

Call your doctor or midwife if you have any of these signs of preterm labor.

First stage of labor and delivery

The first stage of labor is divided into three phases: early labor, active labor, and transition.

Early labor

Early labor is often the longest part of the birthing process, sometimes lasting 2 to 3 days. Contractions:

• Are mild to moderate (you can talk while they are happening) and last about 30 to 45 seconds.
• May be irregular (5 to 20 minutes apart) and may even stop for a while.
• Open (dilate) the cervix to about 4 cm (1.6 in.) to 6 cm (2.4 in.). Those who are delivering for the first time can have many hours of early labor without the cervix dilating.

It's common for those in early labor to go to the hospital and be sent home until they are in active labor or until their "water" (amniotic sac) breaks.

Active labor

Active labor starts when the cervix is about 5 cm (2 in.) to 6 cm (2.4 in.) dilated. This stage is complete when the cervix is fully effaced and dilated and the baby is ready to be pushed out.

During this phase, contractions get stronger, are more frequent (every 2 to 3 minutes), and last longer (50 to 70 seconds). Now is the time to be at or go to the hospital or birthing center. If your amniotic sac hasn't broken before this, it may now.

You may be restless and excited, and you may feel the need to shift positions often. This is good because it improves your circulation.

As your contractions get stronger:

Transition

Transition is the end of active labor. As the baby moves down, contractions become more intense and longer and come even closer together. Delivery isn't far off.

During transition, you may be self-absorbed, focused on what your body is doing. You may want others nearby for support but be annoyed or distracted by their attempts to help. You may feel more and more anxious, nauseated, exhausted, or fearful.

If you're delivering for the first time, transition may take up to 3 hours. If you've had a vaginal birth before, it will usually take no more than an hour. Some people have a very short and intense transition.