As the birth approaches it’s common to think ‘am I in labour?’ at every sign. You may have been experiencing Braxton Hicks, or ‘practice’ contractions for a while, but the contractions of labour should feel quite different. Here’s what you need to know.

What are contractions?

Contractions happen when the muscles of the uterus start to tighten and relax. The upper part of the uterus tightens and thickens, while the cervix softens, becoming thinner and flatter and gradually opening to allow the baby into the birth canal ready for delivery.

For many women contractions are one of the first recognisable signs of labour. They may begin as a pain or ache in the lower back or abdomen, and are sometimes described as similar to period pain.

How are they different from Braxton Hicks?

Unlike Braxton Hicks, labour contractions can be felt in other areas of your body, including your back, lower and upper abdomen and pelvis – and they won’t stop when your change position or relax.

Contractions come in ‘waves’, each one getting more intense until it peaks, and then slowly eases off, giving you and your baby a little rest before the next one. You should feel your abdomen become hard to the touch as the contraction reaches its peak, then become soft again as the uterus relaxes and the contraction subsides. To begin with they will be fairly spaced out – perhaps every 10 minutes or so, but will then become more regular, frequent and intense, lasting for longer each time.

Timing your contractions

Timing your contractions can be helpful to your midwife as it enables you to describe what’s happening in detail. Start counting from the beginning of one contraction to the start of the next. You can either write down the time each contraction starts and note how long it lasts, or count the number of seconds each contraction lasts.

In this early or latent phase of labour you should be able to distract yourself by taking a bath, going for a walk and carrying on as normal for as long as possible.

Active labour

Once the cervix has dilated to around 3 or 4cm you enter what is known as established labour. This is when contractions become much more regular and may occur 3 or 4 minutes apart.

After 6 or 7cm contractions become more intense and painful and it may feel as though there is no rest between contractions at all. Breathing and relaxation techniques can help you cope with contractions at this stage, but you may also now start to consider your options for pain relief.

When the cervix is fully dilated to 10cm you enter the transitional phase which is when you begin to feel the urge to push the baby out. The Contractions now become a little less frequent, but much stronger, and last for longer.

Second stage of labour

As you enter the second stage of labour, you will feel the need to push with each contraction. With each push, your baby will move a little further down the birth canal, each time slipping back again as the contraction subsides. This pattern will repeat until your baby’s head becomes visible and you begin to take shorter, panting breaths as they are born.

Once your baby is born the contractions will start again to allow you to push the placenta out. This is known as the third stage of labour.