It's 2am. Your belly is tightening. Your heart rate picks up. Is this it? For many pregnant women — especially first-timers — distinguishing Braxton Hicks contractions from real labour contractions is one of the most anxious moments of the third trimester. The good news is that with the right information, you can tell the difference with confidence. Here's what you need to know.
What Are Braxton Hicks Contractions?
Braxton Hicks contractions — sometimes called "practice contractions" or "false labour" — are sporadic tightenings of the uterine muscle that can begin as early as the second trimester, though most women first notice them in the third. They are named after the English physician John Braxton Hicks, who described them in 1872.
These contractions are the uterus rehearsing for labour. They help tone the uterine muscle and may play a role in softening the cervix in preparation for delivery — but they do not cause the progressive cervical dilation that characterises true labour.
💡 Braxton Hicks contractions are experienced by the majority of pregnant women, but many don't notice them — particularly in a first pregnancy. They become more noticeable in the third trimester and are often triggered by dehydration, physical activity, a full bladder, or sexual activity.
What Do Braxton Hicks Feel Like?
Braxton Hicks contractions are typically described as a tightening or hardening of the abdomen — the uterus contracts and the belly becomes noticeably firm. They are irregular and unpredictable, don't follow a pattern, and may occur a few times an hour then stop entirely for hours. They usually last between 30 and 60 seconds, are uncomfortable but not intensely painful, and are generally felt in the front of the abdomen rather than radiating from the back.
They typically ease when you change position, walk around, rest, or drink water. This responsiveness to activity and hydration is one of the hallmarks that distinguishes them from real contractions.
What Do Real Labour Contractions Feel Like?
True labour contractions are fundamentally different in character — and once you experience them, most women say they knew.
A 2023 study in the American Journal of Obstetrics and Gynecology examining maternal perception of labour onset found that women who had experienced previous deliveries could distinguish true from false labour with significantly higher accuracy than first-time mothers — underscoring why clear education matters for nulliparous women in particular.
Real contractions are regular and progressively closer together, following a pattern that intensifies. Classic active labour follows the 5-1-1 rule: contractions every 5 minutes, lasting 1 minute, for at least 1 hour. Unlike Braxton Hicks, they grow stronger over time and don't ease with position change, hydration, or rest. They are felt throughout the abdomen and lower back — a wave of sensation that wraps from back to front rather than a localised tightening.
The Science of What's Happening
During true labour, contractions are driven by oxytocin — a hormone released by the posterior pituitary gland — acting on uterine oxytocin receptors that increase in number and sensitivity as term approaches. Each contraction causes the cervix to progressively efface (thin) and dilate (open).
A 2023 review in Frontiers in Physiology examined the molecular differences between Braxton Hicks and true labour contractions, finding distinct patterns of myometrial (uterine muscle) activation — confirming that these are physiologically different events, not simply a matter of intensity. Braxton Hicks contractions do not produce the coordinated, progressive cervical change that defines true labour — which is why they can occur for weeks without leading to delivery.
A Simple Way to Tell Them Apart
If you're unsure, use this guide. Braxton Hicks are irregular in pattern, stay the same or fade in intensity, are felt in the front of the abdomen, ease with rest or hydration, last 30–60 seconds, and produce no cervical change. Real labour contractions are regular and getting closer, build progressively stronger, wrap from back to front, continue regardless of what you do, last 45–90 seconds and increase, and produce progressive cervical dilation. When in doubt, time your contractions. If they are regular, intensifying, and lasting longer — call your provider.
Why This Matters If You're Banking Cord Blood
For families who have chosen to bank cord blood with AlphaCord, knowing when you're in real labour has a direct practical implication. Cord blood is collected by your delivery team in the minutes after birth — and that team needs to have your AlphaCord collection kit on hand and know the procedure in advance.
Arriving at the hospital at the right time — not too early on Braxton Hicks, not too late in active labour — gives your team the preparation time they need. If you're unsure whether what you're experiencing is real labour, the 5-1-1 rule is your most reliable guide. For the full picture of what cord blood banking involves and why it matters, read our complete guide: What Are Stem Cells? A Complete Guide for Parents.
Frequently Asked Questions
Can Braxton Hicks contractions turn into real labour? Braxton Hicks contractions don't cause cervical dilation and don't transition into real labour — but as you approach your due date, the boundary between prelabour and early labour can feel blurry. If contractions become regular and increasingly intense over time, treat them as real labour and contact your provider.
How early can Braxton Hicks start? As early as the second trimester — sometimes from around week 16 — though most women first notice them in the third trimester. Their frequency and intensity typically increase as the due date approaches.
Should I go to hospital if I'm having Braxton Hicks? If you're uncertain whether you're in true labour, contact your healthcare provider or go to labour and delivery to be checked. It is always better to be assessed and sent home than to wait too long.
Can dehydration cause Braxton Hicks? Yes. Dehydration is one of the most common triggers. Drinking a large glass of water and resting is often the first recommendation — if contractions ease, they were likely Braxton Hicks.
What is prodromal labour? Prodromal labour (sometimes called "false labour") sits between Braxton Hicks and active labour. Contractions can be regular, painful, and pattern-like — but stop before progressing to full cervical dilation. It's more common in women who have had previous deliveries. If this happens, rest, stay hydrated, and contact your provider for guidance.
Know the Signs — and Be Ready
Whether you're in Braxton Hicks or the real thing, the arrival of your baby is closer than ever. Make sure everything is in place: your hospital bag, your birth plan, and your AlphaCord cord blood collection kit. The window to collect cord blood is measured in minutes after delivery — and preparation is everything.
