Giving birth - contractions

Braxton Hicks contractions (sometimes called 'practice contractions') can happen earlier in pregnancy but they do not usually open the cervix. They are:

• often irregular (but may become regular)
• more common at night
• usually painless

They may feel uncomfortable during the third trimester.

Contractions refer to the muscles in your uterus (womb) tightening and then relaxing. These tightenings can happen anytime during pregnancy. Not all contractions are a sign of active labour. It is very important to call the birth unit at your hospital or your midwife immediately if you are having contractions before 37 weeks.

During active labour the contractions dilate (open) your cervix (the neck of your womb) and help move your baby downward during the first stage of labour.

Contractions become more frequent and more intense as labour progresses. You will feel the pain ease between contractions. Contractions continue until your cervix is fully dilated to 10 cm which allows space for your baby to be born.

Braxton Hicks contractions can happen throughout your pregnancy but you may not notice them until your second trimester. They are more common at night, irregular and painless but they may become uncomfortable during the third trimester. These are contractions that help the uterus prepare for labour but don't open the cervix. Braxton Hicks contractions are sometimes called 'false pains' or 'practice contractions'. This is because they can be strong and may feel uncomfortable, but don't lead to labour and birth.

There are ways to tell the difference between Braxton Hicks contractions and active labour.

Braxton Hicks contractions	Contractions (real labour)
irregular and short (usually lasting for 30 seconds)	may start as irregular, but will become regular and last longer as they continue
usually uncomfortable but not painful	usually more painful as they progress
walking does not make them stronger	walking may make them stronger
lying down may make them go away	lying down does not make them go away
do not get stronger	get stronger as they progress
do not get closer together	get closer together as they progress

If you are comfortable and have had a normal pregnancy, you don't need to go straight to hospital or your chosen birthing place. You can usually stay at home and rest while you are in the early stages of labour. This applies whether you are planning to give birth in a hospital, a home birth, with a private midwife or in a birth centre.

In early labour, you can use simple comfort measures such as resting between contractions, changing positions, warm showers or baths, using heat, a transcutaneous electrical nerve stimulation (TENS) machine, slow breathing and gentle movement.

You can contact your midwife or doctor at any time if you are unsure, need support, or want advice about when to travel to your chosen place of birth. If you are having a home birth, call your midwife to let them know you have started having contractions.

Contact the birth unit in your hospital, the place you plan to give birth or your midwife if:

• your waters break (note the time, colour and amount of fluid)
• your contractions become painful and regular (2 or more contractions in 10 minutes)
• you have pain or discomfort that needs extra support
• you are in labour and have planned a caesarean birth
• you have any concerns
• there has been a change in your baby's movements

If you live in a rural or remote location, be sure to discuss what to do when contractions start with your pregnancy care provider ahead of time.

It can be helpful for you (or someone supporting you) to time your contractions. Your midwife or doctor may ask about how long they last, how strong they feel and how often they are coming, to understand how your labour is progressing.

Tip for timing your contractions:

• Start timing from the beginning of one contraction to the beginning of the next.
• Measure how long each contraction lasts.
• You can use a watch, clock or a contraction timer app to help you.
• Start timing contractions when they feel more regular, when they start to get stronger or when you notice a pattern.

In active labour, contractions usually become regular, stronger, longer and closer together.

There are a few ways to ease pain during contractions.

Non-medicine strategies include:

• spending time in a warm bath, shower or pool (not if the waters have broken)
• heat such as hot packs (be careful not to burn yourself as a stretched belly is less sensitive to heat)
• transcutaneous electrical nerve stimulation (TENS therapy)
• acupuncture
• using a birth ball
• squatting position
• 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. Some examples include:

• paracetamol
• nitrous oxide with oxygen gas for inhalation
• morphine
• epidural analgesia (medicine injected into the epidural space in the spine)

Read the glossary of pregnancy and labour — A list of common terms and abbreviations used by health professionals in pregnancy and labour.

The Australian Government has a range of pregnancy information resources.

The Queensland Government has fact sheets about early labour, what contractions feel like and how to time contractions.

You can also call the healthdirect helpline on 1800 022 222 (known as NURSE-ON-CALL in Victoria). A registered nurse is available to speak with you 24 hours a day, 7 days a week.

• Birthing on Country supports culturally safe, community-led maternity care for First Nations families.
• Find an Aboriginal Community Controlled Health Organisation (ACCHO) near you.

Languages other than English

• The Multicultural Centre for Women's Health offers a library of pregnancy, birth and postpartum resources in many languages.
• Monash Health has health information translated into many languages, including pregnancy-care topics.

Information for sexually and gender-diverse families

• Rainbow Health Australia has a library of practical resources on services for LGBTIQ+ and gender-diverse families.
• QLife is a free, national phone and webchat service that provides anonymous peer support and referrals for LGBTIQ+ people and their families.