Your Guide to the Different Types of Contractions During Pregnancy

Whether you're currently pregnant or thinking about starting a family, you've likely given some thought to labor and delivery—and, more specifically, contractions. But how will you know when you are having contractions?

Contractions are essentially your body's way of helping nudge your baby out into the world. "The uterus surrounds the baby, and when the uterine muscles contract, that helps labor progress," explains Bart Putterman, MD, an OB-GYN at Texas Children's Pavilion for Women in Houston. These uterine contractions get your baby into position for birth and help them maneuver through the birth canal.

But having contractions doesn't necessarily mean you're going into labor. In fact, it could just be your body preparing and practicing for labor. Ahead, find out what you need to know about the different types of contractions, what they feel like, and what they mean so you'll know when you're having contractions—and it's the real thing.

Labor Contractions

True labor contractions might start out as an occasional, uncomfortable twinge of your abdomen. They'll slowly build to something more, like really bad menstrual cramps or gas pains. As labor progresses, these contractions will become stronger, more intense, and closer together.

The easiest way to know if you're having true labor contractions is by doing a simple self-test. Lie down and place a hand on your uterus. If your entire uterus is hard during the cramping, it's probably a contraction. If it's hard in one place and soft in others, those are likely not contractions—it may just be the baby moving around.

Also, if the contractions stop with a change in position or activity level or they subside and don't increase in frequency or intensity, they're likely Braxton Hicks. Consider your level of discomfort and pain, too. If the contractions hurt and are becoming increasingly stronger, they're likely labor contractions.

Back Labor Contractions

True labor contractions can cause back pain, ranging from a dull aching or cramping that radiates toward your uterus to more severe discomfort in the lower back. If the pain is intense and remains mostly in your back, you are likely experiencing back labor.

Back labor is typically a result of the baby's position as they move into the birth canal. Babies who present with their heads facing up (called occiput posterior or OP) often place more pressure on the nerves in the pregnant person's back, causing a heightened pain sensation.

However, some laboring people simply feel the pressure of contractions more acutely in their backs, which may or may not subside as the labor progresses. Talk to your birthing staff about pain relief options—there are medicated and drug-free ways to reduce the pain of back labor.

Other Types of Contractions

But not all abdominal cramping and uterine contractions during pregnancy are labor contractions. Here are a few other types of contractions you might experience during pregnancy.

Early contractions

You may start to feel a slight tightening and hardening of your bump throughout your pregnancy; this signals that your body is preparing for labor and delivery. "The uterus is exercising for the grand finale," says Paul du Treil, MD, director of maternal and child health at Touro Infirmary in New Orleans. These first disorganized twinges are a precursor to the real deal.

Causes of early contractions include stretching of the ligaments around the uterus, dehydration, constipation, and gas pains. In early pregnancy, these contractions can feel like mild menstrual cramps and are often nothing to worry about, but if they're accompanied by spotting, bleeding, or abdominal pain you should contact a health care provider.

Braxton Hicks contractions

Starting in the second trimester, some pregnant people experience sporadic "false" or "practice" contractions known as Braxton Hicks. They generally aren't painful, last anywhere from 30 seconds to two minutes, and happen randomly—although they can be triggered by things like exercise or sex.

Braxton Hicks contractions signal that your uterus is preparing for delivery. Try calming the cramps by drinking plenty of water, taking a warm (not hot!) bath, emptying your bladder, and breathing rhythmically. You should always contact a health care provider if you experience what you think are Braxton Hicks contractions that are accompanied by lower back pain and/or watery or bloody vaginal discharge, or if they are occurring at frequent, regular intervals.

Preterm contractions

Before 37 weeks of pregnancy, contractions that come regularly (every 10 minutes or less) may signal preterm labor. Other signs of preterm labor include:

• Cramps that resemble menstrual cramps
• Pressure in the lower abdomen
• Backache
• A noticeable change in vaginal discharge

While it's possible that the contractions you feel are triggered by overextension, dehydration, or even stress, it's still important to consult a health care professional anytime you experience contractions that are occurring in routine intervals, particularly if they are accompanied by other symptoms.

Contractions caused by sex and orgasm

If you have an uncomplicated pregnancy, orgasms—with or without penetration—don't increase the risk of premature labor. Likewise, sex during pregnancy isn't likely to trigger labor even as your due date approaches, but you may experience Braxton Hicks contractions or even light spotting afterward.

These contractions should subside in a couple of hours. If they're accompanied by any troubling symptoms (like bleeding, pain, vaginal discharge, or a decrease in fetal movements), however, contact a health care provider.

What To Do When Labor Contractions Begin

Once labor contractions begin, note how long they last and the length of time between them (measured from the beginning of one contraction to the beginning of the next). You'll also want to call your health care provider to check-in. You're considered to be in active labor if you have regular contractions that last for about one minute and come more often than every five minutes.

"You may be able to go about your life when labor starts, but there's a time where the energy shifts, and you can't do anything other than labor," says Siobhan Kubesh, a certified midwife with OB-GYN North in Austin, Texas. That's usually when it's time to go to the hospital or birthing center.

If this is your first pregnancy, it might take a while for your body to get into the groove of labor. Your entire labor from start to finish will likely last for several hours and up to a day or more, but there are exceptions. Subsequent pregnancies may involve much shorter labor. "Second and third babies typically come a lot quicker," Dr. du Triel says. "The [parent's] body has done this before and remembers the process, so they can quickly progress to active labor."