How to Tell the Difference Between Types of Contractions

Adriana Lozada:

I’m Adriana Lozada and you’re listening to Birthful. And today, just like every other week, we’re going to be talking about a topic that you need to know about. Today it’s the type of contractions. So many people ask me, how will I know if the contractions that I’m having are doing anything, if they’re real labor contractions? And so let’s talk about that. Roughly speaking, contractions can be grouped into about six types. The Braxton Hicks, prodromal contractions, positional contractions, camelbacks, regular labor contractions and expulsive contractions. Now, if you’re in your third trimester, then it’s very likely that you are going to be experiencing Braxton Hicks contractions at some point, although some people feel them in their second trimester and others don’t really feel them at all. Braxton Hicks contractions usually don’t hurt, but they can be quite annoying. When they happen, it feels like your whole belly is tightening suddenly and without any warning, it’s just really engaging your full abdominals.

And they go away as suddenly as they come. Braxton Hicks don’t really have a wave pattern to them. They don’t increase in intensity and they also have no frequency pattern. Some of the contractions may go on for a few seconds, others can last minutes, and then you might get several for a couple of hours and then they disappear. That feeling of all your belly muscles tightening along with the lack of pattern or the increase in frequency or intensity is what lets you know that they are not labor contractions. So why do Braxton Hicks happen? There can be many reasons. It can be your body’s way of saying that you’re overdoing it, causing your muscles to get crampy and irritated, or you may be dehydrated or your bladder may be really full. So things you can do are change positions, go to the bathroom or try putting your feet up while you drink a big glass of water.

These things can help. And if those don’t do the trick, then you may want to try a bath or a warm shower. Another reason why I feel Braxton Hicks happen is to give you a point of comparison for when you actually go into labor. So many of my clients have told me I’m having contractions and these feel different from what I’ve had before. And I myself have experienced this. So if you’ve ever asked yourself, how will I know if labor has started? Having had Braxton Hicks will help bring some clarity. Okay. So then moving on to prodromal contractions. And these happen as the uterus is preparing for labor. They can come and go for days or even weeks before actual labor starts, but fortunately not continuously. These contractions used to be called false contractions. And I’m happy that that’s no longer the case because there is nothing false or fake about how they feel.

Lozada: The thing about prodromal contractions is that they can psych you into thinking that you are in labor because they do have some regularity to them and may even increase in intensity, but they don’t tend to last very long and the pattern is not clockwork. I said that they could go on for days, but not continuously. So what’ll happen is they might start then stick around for a few hours, then go away, come back the next day or next week, taper off, build, go away again. You can see how annoying this is, especially if it happens during the night, several days in a row. So then you’re not getting any good sleep. And because they do feel like regular contractions, they can be painful. Sometimes they also tend to have a period cramping or wave like quality to them where they might start near your pubic bone and then wrap around to your back or move up to the top of the belly.

Prodromal contractions are irregular and they don’t stick around. So pay attention to whether they’re getting longer, stronger and closer together. And if that is not the case, then they’re likely prodromal. As frustrating and tiring as these contractions can be, they do have a purpose. The thing is, before the cervix can dilate, it needs to move forward and soften and start to thin out. And these prodromal contractions can help with that process. They also help the uterus find its rhythm and I’ve seen cases where they do bring on some dilation in this very random way that gives you the chance to get some rest here and there. So they’re not all to be hated. Since there’s no way of telling when prodromal contractions will organize into real contractions, the best thing you can do is ignore all early contractions as best as you can, until they require your full attention.

And in the meantime, prioritize your sleep, hydration and nutrition so that you are energized for when things really get going. Now, once labor starts, your contraction will become longer, stronger, closer together. That’s the mantra. Longer, stronger, closer together. And then they have a rhythmic pattern almost like clockwork. So then that’s what are called regular contractions. They may start to organize themselves around every 10 minutes, then eight, then five, and finally get to a pattern of every two to three minutes lasting a minute or longer. Although I have some cases where they don’t get any closer than five minutes and the baby is born anyway. Results may vary. Now, if you find that your contractions do have a rhythm, but the rhythm is kind of wonky, so for example, they are every nine minutes and then five and then six and then eight and a few of them are four minutes apart.

Then they go back to nine minutes apart and maybe they started really strong and intense from the get go, but they’re short and aren’t getting any longer. Or maybe they spread out while you lie down, but get really close together when you stand. Or you feel a concentrated, intense or sharp pain in one part of your body, say in your hip or lower back, or maybe you start feeling like you need to give little pushes or grunts during contractions, even though you are not fully dilated. All those sort of irregular patterns usually indicate that you’re having positional contractions, meaning that the baby is probably not in the most aligned position and would benefit from you changing your position. So to do that, keep moving to give baby space to move around themselves and get better aligned. Now there’s a type of positional contractions that is so unique, it gets its own name.

Lozada: And these are known as camelbacks. Camelbacks feel like they sound. You get one contraction and then as that one is coming down, right before it ends, boom, then another contraction comes in. They’re back to back. Often the first contraction is going to be bigger than the second one. And if you’re having camelbacks more than once in awhile, if that becomes your regular pattern, then you definitely want to focus on changing positions to see if those get more rhythmic. Okay. So then the last type of contractions are expulsive contractions. How and when you feel these is going to depend on how your birth is going, the baby’s positioning, whether you have an epidural or not, or whether a care providers are coaching your pushing or not. Usually with directed pushing or with epidurals, you do not feel these explosive contractions as much. But basically what happens is that the uterus actually changes direction from pulling up to open and absorb that cervix and give baby space to come out and down and out and is now pushing down to help expel your baby.

These contractions have a lot of involuntary force in them, a lot of strength. And some people describe them similarly to the involuntary forces of throwing up. That kind of big movement that you can’t control and has a lot of force behind it. Or they may say that they feel that the uterus was doing all the pushing and that it was not something they could stop. Basically they couldn’t not push. If you want to fully experience these expulsive contractions, then it’s important that you support your hormones and your fetal ejection reflex by trying to get out of the way. Get out of your thinking brain, which is hard to do. But when you’re in the depths of labor and in labor land, keep supporting that going internal, your body will flow into these contractions, those hormones will build. As you can imagine though, coach pushing where you’re thinking about pulling your legs and curling around your baby and holding your breath and tucking your chin and so on, that really engages your thinking brain.

So it’s not very supportive of these expulsive contractions. I’ve had clients that have explored both options during their pushing stage. So one really doing the pushing themselves and coach pushing, following the directions. And then the other one of just going deep into their contractions and letting those build and then experiencing the expulsion part of it. And they definitely report, oh, those were different and I could feel the uterus was doing so much pushing. It was easier. To support these expulsive contractions, the best thing to do is to do nothing. Just let things build, continue to do your regular contractions and let your body kick in. A good rule of thumb on whether it’s time to push is that if you have to think about it, then it probably isn’t. If you are able to support this type of contractions, you’re going to find that you have a lot less work to do during the pushing stage because the contractions are going to be doing the heavy pushing for you. You can connect with Birthful on Instagram at Birthful podcast. And to learn more about Birthful and my birth and postpartum preparation classes, go to birthful.com.

Birthful was created by me, Adriana Lozada, and is a production of Lantigua, Williams and Co. The show’s Senior Producer is Paulina Velasco. Jen Chien is Executive Editor. Cedric Wilson is our Lead Producer. Kojin Tashiro is our Associate Sound Designer and mixed this episode. Thank you for listening to and sharing Birthful. Come back for more ways to inform your intuition.

CITATION: 

Lozada, Adriana, host. “How to Tell the Difference Between Types of Contractions.” Birthful, LWC Studios, Dec 15, 2021. Birthful.com.