Third trimester
Braxton Hicks vs real contractions: how to tell the difference
May 26, 2026 · 7 min read
In the third trimester your belly tightens, holds for a moment, and lets go, and the question lands every time: is this it? Most of these are Braxton Hicks, the body's practice contractions. Real labor contractions feel and behave differently, and once you know what to look for, the difference gets much easier to read.
What Braxton Hicks contractions are
Braxton Hicks contractions are sometimes called practice contractions or false labor. Your uterus is a muscle, and in the second half of pregnancy it rehearses by tightening and releasing. These practice contractions are common and usually harmless (ACOG). They tend to feel like a tightening or hardening across the front of your belly, more uncomfortable than painful, and they do not mean labor is starting.
Pattern: irregular versus a rhythm that builds
The clearest clue is the pattern. Braxton Hicks contractions are irregular: one now, another in twenty minutes, then nothing for an hour. They do not get closer together in a steady way. Real labor contractions settle into a rhythm. They come at regular intervals, those intervals shrink over time, and each contraction lasts about the same length or longer. If you time them and the gaps keep getting shorter, that is a sign of true labor.
Strength and location: where you feel it, and how hard
Braxton Hicks usually stay about the same strength and sit mostly in the front of the belly. Real labor contractions grow stronger as time passes, and many women feel them start in the lower back and wrap around to the front, or press downward into the pelvis. If each wave is clearly harder to talk or walk through than the last one, treat that as labor until your provider says otherwise.
The rest and water test
Braxton Hicks often calm down when you change what you are doing. Drink a large glass of water, empty your bladder, lie down on your left side, or take a slow walk if you have been sitting. Dehydration and a full bladder can both trigger practice contractions. Real labor does not care what you do: the contractions keep coming whether you rest, walk, shower, or drink water. If a change of position and fluids make the tightening fade, it was most likely practice.
The 5-1-1 rule in plain words
Many providers use the 5-1-1 rule as a simple signal for full-term pregnancies: contractions about 5 minutes apart, each lasting about 1 minute, continuing for at least 1 hour. When all three line up, call your provider or head in as they have instructed you. Your own provider may give you different numbers based on your history, how far you live from the hospital, or whether this is your first baby, so confirm the plan at a prenatal visit and follow their version.
Before 37 weeks: do not wait, call right away
Everything above applies to full-term pregnancies. Before 37 weeks the rules change: regular contractions, more than a few in an hour, a low dull backache that will not quit, pelvic pressure, cramping, leaking fluid, or any bleeding can be signs of preterm labor, and preterm labor caught early can sometimes be slowed (ACOG). Do not wait for a 5-1-1 pattern. Call your provider right away, and if you cannot reach anyone and symptoms are getting worse, go to labor and delivery or call 911 for an emergency.
Frequently asked questions
- How do I time contractions correctly?
- Note the time a contraction starts and the time it ends: that is the duration. Then note when the next one starts: the gap from start to start is the frequency. Time five or six in a row, since the trend matters more than any single contraction. You can use a notes app, a contraction timer, or the Mommy Passport to log them by voice in English or Spanish.
- Can Braxton Hicks be painful?
- They can be uncomfortable, and late in pregnancy some women find them strong. The difference is behavior: Braxton Hicks stay irregular, do not steadily intensify, and usually ease with rest, water, or a position change. When in doubt, call your provider. No one will fault you for checking.
- What if my contractions stop when I lie down?
- Contractions that fade with rest and fluids are most likely Braxton Hicks. Keep an eye on them, stay hydrated, and mention them at your next visit. If they return in a regular, strengthening pattern, or you are before 37 weeks and they keep coming, call your provider right away.