Practice contractions can start as early as week 20 and get more frequent into the third trimester. The five specific features that distinguish them from real labor — plus the 60-second test that resolves the question.
Braxton Hicks contractions feel like a tightening across the entire belly, usually painless but sometimes mildly uncomfortable. They were first described in 1872 by Dr. John Braxton Hicks (English physician) and remain the medical term for practice contractions.
Almost every pregnancy has them. They start as early as week 20 and become more noticeable through the second and third trimester. The job is to tell them apart from real labor without making a panicked trip to L&D every time the belly tightens.
The uterus is a smooth muscle that does not sit still for 40 weeks. It contracts periodically throughout pregnancy — sometimes called "practice contractions" or "warm-up contractions." The contractions are real (you can see the belly visibly tighten and harden) but they are not productive labor: they do not progressively dilate or efface the cervix.
Functions, as best we understand them: tone the uterine muscle for delivery, increase blood flow to the placenta, and potentially help reposition the baby in late pregnancy. Whether they meaningfully shorten labor is unclear; the research is mixed.
| Feature | Braxton Hicks | Real labor |
|---|---|---|
| Pattern | Irregular, unpredictable | Regular intervals, getting closer over time |
| Intensity | Stays the same or eases up | Progressively stronger |
| Duration of each | 30 seconds to 2 minutes, often varies | 30 to 70 seconds, gradually lengthening |
| Location | Front of the belly only | Wraps around — front of belly AND lower back |
| What stops them | Hydration, rest, position change, food | Nothing — they continue regardless |
If 4 or 5 of these point to Braxton Hicks, you are almost certainly not in labor. If 4 or 5 point to real labor, time them and call your OB or midwife.
The fastest at-home test for any contractions that feel suspicious:
If contractions stop, become further apart, or weaken — Braxton Hicks. If they continue at regular intervals and get closer or stronger — call your OB or midwife.
If you can match the contraction onset to a specific trigger above, that is another data point for Braxton Hicks.
Real labor pain is qualitatively different from Braxton Hicks in a way that is hard to explain in advance and obvious in the moment. The features that come up consistently in patient accounts:
The 5-1-1 rule (US standard for first-time pregnancies at term):
If contractions meet 5-1-1, go to the hospital. Adjust to 4-1-1 or even 3-1-1 if you have had a previous fast labor, or if your OB has given you a different threshold.
Call before 5-1-1 if any of these are also happening:
The third trimester checklist includes the contraction-timing apps that work, what to prepare in advance, and exactly what to tell the L&D triage nurse when you call.
See the third trimester checklist →Before 37 weeks, the threshold for calling is lower. Any pattern of regular contractions — even 10 minutes apart — for an hour warrants a call. Preterm labor signs:
If you suspect preterm labor, call immediately. Preterm labor can sometimes be stopped if caught early; the window for intervention is narrow.
Almost every pregnancy has at least one "is this it?" moment that turns out to be Braxton Hicks. Going to L&D for "false labor" and being sent home is one of the most common outcomes of a triage visit. Nobody at the hospital judges you for it. Your OB has had countless calls from people who were not in labor. They would rather you call about Braxton Hicks 5 times than miss real labor once.
When in doubt, time them, drink water, lie down for 30 minutes, and call your OB if they continue.
General guidance only. If contractions feel different from any pregnancy guidance suggests, call your OB or midwife — they answer "is this it?" calls every day and would much rather you ask.
