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Braxton Hicks contractions, also known as practice contractions or false labor, are sporadic
uterine contractions Uterine contractions are muscle contractions of the uterine smooth muscle that occur during the menstrual cycle and labour. Uterine contractions occur throughout the menstrual cycle in the non-pregnant state and throughout gestation. Throughout ...
that may start around six weeks into a pregnancy. However, they are usually felt in the
second The second (symbol: s) is the unit of time in the International System of Units (SI), historically defined as of a day – this factor derived from the division of the day first into 24 hours, then to 60 minutes and finally to 60 seconds ...
or
third trimester Pregnancy is the time during which one or more offspring develops ( gestates) inside a woman's uterus (womb). A multiple pregnancy involves more than one offspring, such as with twins. Pregnancy usually occurs by sexual intercourse, but can ...
of
pregnancy Pregnancy is the time during which one or more offspring develops ( gestates) inside a woman's uterus (womb). A multiple pregnancy involves more than one offspring, such as with twins. Pregnancy usually occurs by sexual intercourse, but ca ...
.


Associated conditions

Braxton Hicks contractions are often confused for labor. Braxton Hicks contractions allow the pregnant woman's body to prepare for labor. However, the presence of Braxton Hicks contractions does not mean a woman is in labor or even that labor is about to commence. Another common cause of pain in pregnancy is
round ligament pain Round ligament pain (RLP) is pain associated with the round ligament of the uterus, usually during pregnancy. RLP is one of the most common discomforts of pregnancy and usually starts at the second trimester of gestation and continues until deliver ...
. Table 1. Braxton Hicks contractions vs. True Labor


Pathophysiology

Although the exact causes of Braxton Hicks contractions are not fully understood, there are known triggers that cause Braxton Hicks contractions, such as when a pregnant woman: * is dehydrated * has a full bladder * has just had sexual intercourse * has been exercising (running, lifting heavy objects) * is under excessive stress * has had her stomach touched There are two thoughts for why these intermittent uterine muscle contractions may be occurring. The first is that these early “practice contractions” could be helping to prepare the body for true labor by strengthening the uterine muscle. The second is that these contractions may occur when the fetus is in a state of physiological stress, in order to help provide more oxygenated blood to the fetal circulation.


Signs and symptoms

The determination of Braxton Hicks contractions is dependent on the history and physical assessment of the pregnant woman's abdomen, as there are no specific imaging tests for diagnosis. The key is to differentiate Braxton Hicks contractions from true labor contractions (see Table 1 above). Most commonly, Braxton Hicks contractions are weak and feel like mild cramping that occurs in a localized area in the front abdomen at an infrequent and irregular rhythm (usually every 10-20 minutes), with each contraction lasting up to 2 minutes. They may be associated with certain triggers and can disappear and reappear; they do not get more frequent, longer, or stronger over the course of the contractions. However, as the end of a pregnancy approaches, Braxton Hicks contractions tend to become more frequent and more intense. On a physical exam, some uterine muscle tightening may be palpable, but there should be no palpable contraction in the uterine fundus and no cervical changes or cervical dilation. Braxton Hicks contractions do not lead to birth. More concerning symptoms that may require assessment by a healthcare professional include: * Any bleeding or fluid leakage from the vagina * Contractions that are strong, frequent (every 5 minutes), and persisting for an hour * Changes or significant decreases in fetal movement


Management

Although there is no specific medical treatment for Braxton Hicks contractions, some alleviating factors include: * Adequate hydration * Drinking warm milk, herbal tea, or having a small meal * Urination to empty a full bladder * Rhythmic breathing * Lying down on the left side * A mild change in movement or activity level * Relaxing and de-stressing (e.g., a massage, nap, or warm bath) * Trying other pain management techniques (e.g., practices from childbirth preparation class)


History

Braxton Hicks contractions are named after
John Braxton Hicks John Braxton Hicks (23 February 1823 – 28 August 1897) was a 19th-century English doctor who specialised in obstetrics. He was born to Edward Hicks in Rye, Sussex. He was educated privately and in 1841 entered Guy's Hospital Medical S ...
, the
English English usually refers to: * English language * English people English may also refer to: Peoples, culture, and language * ''English'', an adjective for something of, from, or related to England ** English national ide ...
physician A physician (American English), medical practitioner (Commonwealth English), medical doctor, or simply doctor, is a health professional who practices medicine, which is concerned with promoting, maintaining or restoring health through th ...
who first wrote about them in Western medicine. In 1872, he investigated the later stages of pregnancy and noted that many pregnant women felt contractions without being near birth. He examined the prevalence of uterine contractions throughout pregnancy and determined that contractions that do not lead to labor are a normal part of pregnancy.


References

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