Just testing - or real thing?

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How to tell the difference between 'practice' contractions and the early onset of the real thing?

You've probably heard that as you near your due date, your uterus tightens occasionally as it grows, stretches, and "practices" for giving birth. These practice tightenings are called Braxton-Hicks contractions and they are perfectly normal. 

However, about 10 percent of pregnant women experience preterm labour contractions. Unlike Braxton-Hicks, preterm labour contractions are the real thing. They indicate your labour is starting before your baby is ready to be born. 

How can you tell whether you're experiencing Braxton-Hicks or preterm labour contractions? The differences are mostly in the frequency, intensity, and duration. Here's what to look for:

Braxton-Hicks Contractions

Preterm Labour Contractions

Stopping Preterm Labor

Preventing Preterm Labor

Braxton-Hicks Contractions

You'll start to notice Braxton-Hicks contractions in your third trimester. They may feel like a generalized tightening of your uterus, almost as though it were balling up; or they may feel like the baby is doing a somersault. The contractions usually aren't painful and almost always stop after an hour or so. Although all women have Braxton-Hicks, not all women feel them, particularly with their first baby. So don't be alarmed if you never experience them.

Preterm Labour Contractions

Preterm labour contractions can occur anytime between the 20th and 37th week of pregnancy. They do not stop, and they may become more frequent, regular, and uncomfortable over time.
Other signs of preterm labour include:

 Menstrual-like cramps above the pubic bone
 Pressure or achy feeling in the pelvis, thighs, or groin
 Dull, low backache or back pressure
 Intestinal cramping or diarrhea
 Increased vaginal discharge
 Watery fluid, pinkish or brownish discharge, or blood coming from the vagina

If you experience any of these symptoms or more than four contractions in an hour, call your midwife immediately. You may be asked to come in to be checked, or she may ask you to time your contractions. You can feel the contractions (your uterus tightening and relaxing) by placing your fingertips lightly on your abdomen.

Stopping Preterm Labor

If your midwife thinks you might be in preterm labour, she will arrange for you to be admitted to hospital. There are three reasons for this. Firstly, to do a vaginal examination to check whether the cervix is opening up, and to do tests on the vaginal fluid, which may predict preterm labour. Secondly, to try and stop labour with drugs. These don't always work, and are not suitable for everyone, but your doctor will advise. If you really are in preterm labour they will give you a steroid injection to help the baby's lungs develop. 

If the contractions continue, you may be admitted to the hospital so your provider can monitor you more closely. 

Finally, if all this fails and the baby is born preterm, it is better for him to be in hospital. He might be very small and have problems breathing, eating, keeping his body temperature at a normal level, and developing body organs. A preterm baby is cared for in a special Neonatal Intensive Care Unit (NICU), where special assistance helps the baby develop properly. Some hospitals call this a Special Care Baby Unit (SCBU).

Preventing Preterm Labor

You can also take precautions that may help prevent preterm labour from starting in the first place: 

 Drink eight ounces of juice or water every couple of hours to prevent dehydration, which could make your uterus more "irritable."
 Eat a healthy diet and gain 12 to 16 kilos (25 to 35 pounds) during your pregnancy.
 Keep your bladder empty to decrease the chance of a urinary tract infection (UTI), which can increase the risk of preterm labour contractions.
 Always wipe from front to back after urinating or having a bowel movement, to prevent a UTI.
 Wear cotton undergarments. Cotton "breathes" better than other fabrics, and the more air flow, the less risk of bacterial growth.
 Stop smoking, and don't use drugs or alcohol.
 Use condoms when having vaginal intercourse.
 Avoid having sex with multiple partners.
 Sit down with your legs elevated every hour or so, and don't lift heavy objects.
 Stop physical activity and rest if you experience contractions that don't stop within a short time.
 Try to decrease the stress in your life.

The possibility of preterm labour is scary, but most women experience only Braxton-Hicks contractions. The best thing you can do right now is pay close attention to your uterine activity, and take good care of yourself. Call your midwife should anything unusual develop.

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Complications

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contractions

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bleeding

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cramps