Contractions in pregnancy: how to distinguish real from false

Each woman has her own physical structure which could generate, in the various stages of pregnancy and also as the date of delivery approaches, some symptoms that others do not have: in particular, some pregnant women could experience what are defined as false contractions or contractions by Braxton-Hicks.

Therefore it is important that in this period the woman knows how to distinguish between real labor pains and the painful manifestations that can occur before labor (false contractions) but which do not represent the warning of an imminent birth. Above all, all of this

  • to avoid false alarms,
  • to find out if the time has come or not to go to the hospital,
  • so as not to be anxious without a valid reason and to wait for the right moment in complete tranquility and relaxation.

The best way to distinguish them is to learn to listen to your body.

The signs that precede labor

As we have said, there are no specific signals or rules that can accurately indicate that you are going into labour. However, some signals sent by the woman’s body are unequivocal and can help her prepare for this event with awareness and serenity.

One of these signs is given by the detachment of the mucous plug, a detachment that is usually completely painless and often goes unnoticed. It essentially consists in the loss of mucus which, during pregnancy, closed the neck of the uterus thus protecting the internal cavity.

This detachment manifests itself with the release of a gelatinous substance, slightly denser than the typical vaginal discharge of pregnancy. It is not uncommon for slight streaks of blood to be noticed, due to the rupture of the capillaries.

Another indicative sign of the proximity of labor is the appearance of slight pains very similar to menstrual pains , pains that often also affect the lumbar area. Again, this is not the time to be alarmed: it is simply the uterus preparing for delivery.

How to distinguish false contractions from real ones

Before labor, false contractions, also called Braxton-Hicks contractions, occur in pregnant women (but not necessarily all):

  • These are abdominal spasms affecting the belly of the pregnant woman.
  • They appear at relatively short intervals, as well as they can stop suddenly.
  • Unlike labor contractions, they do not amplify over time and sometimes occur with long pauses.

It is not always easy to distinguish the moment of transition from false contractions to the real ones of childbirth. However, the two types of contractions are very different especially in terms of intensity and frequency.

The real ones,

  • they occur at fairly regular intervals, initially longer and then getting closer and closer, increasing in intensity at the same time: the main difference with false contractions is precisely the amplification of painful sensations.
  • Furthermore, once the actual contractions have begun, they never stop: the pain disappears between one contraction and another, but the succession is continuous.

When it’s time to go to the hospital

To get to know when it’s time to go to the hospital it is important to monitor the frequency and duration of the contractions. It is advisable to prepare to leave for the nearest hospital, when these come to have an average duration of about forty seconds and follow one another at intervals of less than ten minutes.

Even without this being a premature birth, the moment of birth can sometimes arrive much earlier than expected. In fact, the date of delivery that is communicated to the woman during check-ups is only presumed: it often happens even a couple of weeks in advance.

For this reason, women are advised to always keep everything needed for hospitalization close at hand: documents, linen, personal hygiene products, clothes for the baby and something to pass the time, such as a book or headphones for music.

The personal briefcase and the mini-kit for the little one should be prepared about three weeks before the presumed date of birth in order not to find yourself having to do everything at the last moment with the risk of forgetting something.

It’s also a good idea to write a detailed memo a month in advance. If it were the first child, the ideal would be to ask for some information from the maternity ward of the reference health facility which usually offers assistance to future mothers and who can also advise them on how to face the moment of hospitalization with efficiency and serenity.

When it’s time to move urgently

Sometimes there may be some events that require urgent hospitalization, sometimes even well in advance of the actually expected date.

Two of the conditions that impose the need to immediately consult a doctor or ask for the intervention of the emergency room are

  1. the sudden breaking of the waters even before the contractions,
  2. the appearance of bright red blood loss.

In the first case, in the absence of amniotic fluid, the baby is no longer adequately protected and remains exposed to the risk of infections from outside.

In the second case, the bleeding may be due to a detachment of the placenta, a detachment which requires suitable and immediate medical treatment.

Katherine Johnson, M.D., is a board-certified obstetrician-gynecologist with clinical expertise in general obstetrics and gynecology, family planning, women’s health, and gynecology.

She is affiliated with the Obstetrics and Gynecology division at an undisclosed healthcare institution and the online platform,

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