Contractions refer to when the muscles in your uterus (womb) tighten and then relax. Contractions can occur at any time during your pregnancy, but you are unlikely to feel them early in your pregnancy. Contractions become stronger, more regular and more painful once you are in labour. Speak to your doctor or midwife during a pre-natal visit about what you should do when you start to feel contractions.

What is a contraction? What are the signs?

During a contraction your uterus tightens in order to dilate (open) your cervix (the neck of your womb) and move your baby downwards during the first stage of labour.

Contractions can feel like a wave that starts at the top of your uterus and moves downwards. If you put your hand on your abdomen during a contraction you will feel your abdomen become hard, and then soften as the contraction ends.

Contractions become more frequent and intense as labour progresses. You will feel the pain ease between contractions. Contractions continue until your cervix dilates to be about 10cm wide, and is wide enough for your baby to be born.

What do contractions feel like?

Women can experience contractions in different ways. Your contractions may feel like cramps in your lower stomach and can start off feeling like period pain. You may have dull lower back pain or pain in your inner thigh that you feel down your legs.

At first, your contractions will be short and around 30 minutes apart. As your labour advances, your contractions will get stronger and closer together. Your contractions will eventually last for up to a minute and come every 2 to 3 minutes.

What are Braxton Hicks contractions?

Braxton Hicks contractions occur throughout your pregnancy but often you won’t feel them until your second trimester. These are contractions that tone the uterus, but don’t open the cervix. Braxton Hicks contractions are sometimes known as ‘false labour’, since they can be strong and may feel uncomfortable.

You can tell the difference between Braxton Hicks contractions and ’real labour’ since Braxton Hicks contractions will stop if you change your position or have a warm shower. Labour won’t stop if you do these things.

What should I do when contractions start?

When your contractions begin, you don’t always need to go straight to the hospital. If you are comfortable and have had a normal pregnancy, you can stay at home and rest while you are in the early stages of labour.

However, you should go straight to the hospital in any of the following situations:

• your waters break (note the time, colour and amount of fluid)
• your contractions become painful and regular
• labour has begun and a doctor or midwife has advised you to go to hospital early
• you are in labour and have planned a caesarean birth
• you have a known medical condition that means you will need close monitoring during labour
• there has been a change in your baby’s movements

Call triple zero (000) and ask for an ambulance in any of the following situations:

• if your labour is progressing quickly and you think you may not make it to hospital in time
• if you have heavy bleeding from your vagina
• if you have a severe headache or blurred vision

How are contractions timed?

Time your contractions from the beginning of one contraction to the beginning of the next contraction. You should also measure the length of your contractions.

In true labour, your contractions will become regular over time and come closer together. In false labour, your contractions will remain irregular.

True contractions last for about 30 seconds at the beginning of labour and will eventually become longer — up to 75 seconds. False-labour contractions vary in length and strength.

How can I ease the pain from contractions?

There are a few ways to ease pain during contractions.

Non-medication-based strategies include:

• spending time in a bath or pool
• heat packs
• warm showers
• acupuncture
• massage, hypnosis and other relaxation techniques

There are also medicines that your midwife or doctor can give you to help ease your pain during contractions. Examples include:

• nitrous oxide gas (inhaled pain reliever)
• morphine or pethidine (medicine injected under the skin)
• epidural analgesia (medicine injected into the epidural space in the spine)

What happens if I start having contractions too early?

Babies who are born before week 37 of pregnancy are premature. If you are having contractions or other signs of labour earlier than week 37 of your pregnancy, go straight to the hospital.

Many women who have early contractions do not give birth prematurely. Urgent medical care will help ensure a healthy continuation of your pregnancy.