Contractions During Pregnancy: How to Tell If They’re Real (A Doula Explains)

If you’re pregnant, chances are you’ve already asked yourself at least once:

“Are these contractions… or am I overthinking this?”

You’re not alone. One of the biggest sources of confusion in pregnancy is understanding what contractions mean and whether labor is actually starting. The truth is, your body practices long before baby day, and not all contractions are meant to send you into labor.

Let’s break it down in a way that actually makes sense.

There are several types of contractions during pregnancy, and knowing the difference can take a lot of stress out of the waiting.

How Contractions Work (The Big Picture)

Your uterus is a powerful muscle. For most of pregnancy, it stays relaxed so your baby can grow safely. As you get closer to birth, your body slowly begins to prepare:

• Your uterus becomes more responsive to labor hormones

• Muscle fibers start working together more efficiently

• Your cervix begins to soften and prepare

Contractions are your body’s way of practicing, positioning baby, and eventually birthing your baby.

Not all contractions mean labor and that’s a good thing.

Braxton Hicks Contractions (Practice Contractions Vs Labor)

Braxton Hicks contractions are incredibly common and completely normal.

What they usually feel like:

• Tightening or hardening of your belly

• Mild pressure or discomfort

• Kind of annoying

• Short and irregular

What they do:

• Help your uterus “practice”

• Improve blood flow to the uterus and placenta

• Prepare your muscles for labor

What they don’t do:

• They don’t get stronger

• They don’t get closer together

• They don’t change your cervix

These contractions often ease up with rest, hydration, or a change in position.

Braxton Hicks are not a sign that labor has started! They’re just your body warming up.

Prodromal Labor (The “Almost, But Not Yet” Stage)

Prodromal labor can be frustrating, exhausting, and emotionally confusing but it’s still purposeful.

What it can feel like:

• Contractions that seem regular

• Sometimes painful

• Often worse at night

• May last hours, days, even weeks

What makes it different from true labor:

• Contractions may stop and start

• Cervical change is slow or minimal

• Labor doesn’t fully progress yet

Why your body does this:

• Helps baby settle into a good position

• Begins early cervical softening

• Prepares your nervous system for labor

Prodromal labor doesn’t mean your body is failing. It means your body is preparing.

True Labor Contractions (The Real Deal)

True labor contractions are the ones that bring your baby into your arms.

What they feel like:

• They become strong, rhythmic waves

• Regular timing

• Get longer, stronger, and closer together

• Often start in the back and wrap around the belly

• Don’t stop with rest or hydration

What they do:

• Thin (efface) and open (dilate) your cervix

• Move baby down and out

• Create steady, progressive labor

The key difference: true labor contractions cause ongoing cervical change.

Preterm Labor Contractions (Before 37 Weeks)

If contractions begin causing labor before 37 weeks, they need medical attention.

Warning signs include:

• Regular contractions early in pregnancy

• Pelvic pressure

• Persistent low back pain

• Cramping that doesn’t go away

• Changes in vaginal discharge

📞 If you notice these signs, call your provider right away.

When Contractions Need Extra Monitoring

Sometimes contractions can come too frequently, especially during inductions.

Why this matters:

• Baby needs breaks between contractions for oxygen

• Your uterus needs time to rest between waves

Your care team monitors this closely to keep both you and baby safe.

Quick Cheat Sheet

A Gentle Reminder

Every labor looks different. Slow progress doesn’t mean something is wrong. Your body isn’t on a clock.

As your doula, my role is to help you understand what your body is doing, know when to rest and when to lean in, and feel confident instead of second-guessing yourself.

If you’re ever unsure reach out. That’s what support is for.