Medical disclaimer. This article is general information about late pregnancy and labour, and it is not medical advice. Your midwife or obstetrician may give you different instructions based on your history, and their guidance always wins. If you have bleeding, leaking fluid, reduced fetal movements, or you are under 37 weeks with regular tightenings, call them now rather than reading on.
Braxton Hicks vs real contractions comes down to one word: pattern. Braxton Hicks squeeze your belly, hold for anywhere from a few seconds to a couple of minutes, and let go — and no matter how many you get, they never settle into a rhythm. Real labour contractions do the opposite. They get longer, stronger and closer together, and they carry on whether you walk, lie down, drink a litre of water or hold perfectly still.
That is the whole test. Everything below is how to run it properly, because in the moment, at 38 weeks, at two in the morning, the difference is genuinely hard to feel.
The side-by-side
| Braxton Hicks | Real labour contractions | |
|---|---|---|
| Rhythm | Irregular — two close together, then a long, quiet gap | Regular, and the gap between them shrinks |
| Over an hour | Come and go; no build | Longer, stronger, more frequent — the NHS's three words |
| Length | Unpredictable — often under 30 seconds, occasionally up to 2 minutes | Settle around 30–70 seconds and keep lengthening |
| Intensity | Usually weak; they stay the same or get weaker, then disappear | Climbs steadily; the last hour is worse than the first |
| Where you feel it | Usually a tightening in one area of the abdomen, like mild period cramps | Radiate into the lower back and upper belly |
| Response to movement | Often stop when you change what you are doing | Ignore walking, resting, position changes and water |
| How it feels | Uncomfortable, but usually painless | Can feel like extreme period pains, and the pain builds through each contraction |
| Talking | You can talk, laugh, even sleep through them | MedlinePlus: they make you "unable to talk to other people or laugh at a joke" |
| Effect on the cervix | Do not dilate the cervix, though they may play a part in softening it | Efface and dilate the cervix; this is what a vaginal exam checks |
The last row is the only definitive one, and it is the one you cannot check yourself. Everything else is a strong signal, not a diagnosis. That is not a hedge — it is why "come in and we'll have a look" is such a common answer when you phone.
What Braxton Hicks actually are
Your uterus is a muscle, and it contracts throughout pregnancy — believed to start around six weeks, long before you could possibly notice. Most people do not become aware of these tightenings until the second or third trimester.
They are thought to tone the uterine muscle in preparation for birth and to briefly increase blood flow to the placenta. They are named after John Braxton Hicks (1823–97), the nineteenth-century doctor credited with describing them, and they are normal. Frequent ones are not a sign that something is wrong, and they do not mean labour is starting soon.
What they are not is a countdown. You can have weeks of them and still go past your due date. You can have almost none and go into labour on a Tuesday.
The walk, hydrate, rest test
Braxton Hicks have known triggers: dehydration, a full bladder, and a burst of activity. Real labour has none — nothing you do at home makes it stop. So change every trigger at once and see what happens.
- Empty your bladder.
- Drink a large glass of water and keep drinking over the next hour.
- Switch your state. If you have been very active, lie down. If you have been sitting for a long stretch, get up and walk.
- Time everything for a full hour. Not ten minutes. An hour.
If the tightenings space out, weaken or stop, you have your answer — that was practice. If they carry on and the gaps keep closing, that is labour behaving like labour.
One honest caveat about step 2: hydration is a diagnostic nudge, not a treatment. A Cochrane review pooled two small trials — 228 women in preterm labour with intact membranes — and concluded that the data are too few to support hydration as a specific treatment for preterm labour, while noting that women with evidence of dehydration may benefit. Water can quiet an irritable uterus. It cannot stop labour, and it is not a reason to delay a phone call.
Why timing beats feel
Pain is a terrible clock. Contractions feel much closer together than they are when they hurt, and much further apart when you are distracted. Written-down numbers settle arguments that your nervous system cannot.
Three rules for timing that people get wrong:
Measure start-to-start. The interval is from the beginning of one contraction to the beginning of the next — not from the end of one to the start of the next. If each contraction lasts a minute, measuring end-to-start under-reports every gap by that whole minute: contractions genuinely five minutes apart get written down as four, and you hand triage numbers that describe someone further along than you are.
Log the duration too. Frequency alone is half the picture. Contractions that come every five minutes but only last 25 seconds are not the same event as contractions every five minutes lasting a minute.
Look at the trend, not the row. One contraction proves nothing; three in a row can be coincidence. What you want to see across an hour is the average interval falling and the average duration rising. That combination is what makes a pattern.
Once a pattern is there, most hospitals give you a threshold to act on. A widely used one in the US is the 5-1-1 rule — five minutes apart, one minute long, sustained for one hour — but plenty of providers use 4-1-1 or 3-1-1 instead, especially for second babies or if you live far away. Ask which one they want at your 36-week appointment, and write the answer down. You can run the count on our contraction timer or with pen and paper; what matters is that the numbers exist.
When to call, whatever the timer says
The pattern rules are for uncomplicated, full-term labour. Several situations override them entirely. Contact your midwife, maternity unit or obstetrician straight away if:
- You are under 37 weeks and having regular contractions or tightenings, period-type pains, backache that is not usual for you, or a gush or trickle of fluid. The NHS lists all four under urgent advice, and separately makes "you're less than 37 weeks pregnant and think you might be in labour" an urgent call in its own right. Whether an episode is settling is a judgement for a clinician, not for a timer.
- Your waters break, whether or not contractions have started.
- There is any vaginal bleeding.
- Your baby's movements have changed or reduced. This is never something to time and watch.
- A contraction lasts longer than two minutes, or you have six or more in ten minutes.
- You think the baby is coming now and you have a strong urge to push. The NHS says to call 999 for an ambulance — that is an emergency call, not a maternity-unit call.
And the quiet one nobody writes down: if something feels wrong and you cannot say why, phone. Maternity triage lines exist for exactly that call, and they would far rather have it than not.
How ProbaBaby helps
ProbaBaby's contraction timer does the counting so you can concentrate on the contraction. You pick the hospital rule your provider actually gave you — 5-1-1, 4-1-1 or 3-1-1 — and a progress card tracks all three criteria live (minutes apart, the one-minute duration, the one-hour pattern) with a Ready or Tracking badge; it will not call a rule met until you have logged enough completed contractions for that rule, which is six, eight or twelve respectively. Each contraction can carry an intensity from 1 to 10, a note, and a pain location: lower back, lower abdomen, whole abdomen, hips or thighs. From your average interval and duration, the app classifies the session as early, active or transition, and the session runs as a Live Activity on the Lock Screen and Dynamic Island so you are not unlocking your phone at 3am. The hospital alert is dismissible and re-arms after 30 minutes, or sooner if your average intensity climbs by two levels — so dismissing it once does not silence it for the night. When you phone, you can export the session as a text summary with the rule, stage, pain location, averages and which criteria were met. If you are carrying twins, the app says plainly that the timing rules are not twin-specific and to ask your care team when to head in.
If you have not thought about the logistics yet, what to pack and when is a better use of a Braxton Hicks evening than refreshing a timer.