Pregnancy involves a series of physical changes as the body adapts to nurturing a developing baby. Uterine contractions are a common experience during this period, representing the tightening and relaxing of uterine muscles. Understanding the different types of contractions and their significance is important for monitoring pregnancy progression.
What Are Braxton Hicks Contractions?
Braxton Hicks contractions are sensations of uterine tightening that occur sporadically throughout pregnancy. Often called “practice contractions,” they tone the uterine muscle in preparation for labor. These contractions are typically irregular in rhythm and intensity, feeling more like a mild cramping or a firming of the abdomen rather than true pain. They do not increase in strength, frequency, or duration over time, nor do they cause cervical dilation, distinguishing them from true labor. Braxton Hicks may subside with changes in activity, rest, or hydration.
When Braxton Hicks Begin with Twins
Braxton Hicks contractions can occur at different times in pregnancy. In singleton pregnancies, they are often noticed during the second or third trimester, though they may begin as early as six weeks gestation. With twins, individuals may experience these practice contractions earlier, often starting in the first or second trimester, sometimes around 22 to 23 weeks, due to increased demands on the uterus.
The presence of two babies significantly increases the size and stretching of the uterus compared to a singleton pregnancy. This greater uterine distension can lead to earlier and potentially more frequent or intense Braxton Hicks contractions. The uterus accommodates the growth of two fetuses, making these tightening sensations more noticeable. This physiological response prepares the uterine muscles for labor.
Telling the Difference: Braxton Hicks vs. True Labor
Distinguishing between Braxton Hicks and true labor contractions is important, especially in a twin pregnancy where preterm labor can be a concern. Braxton Hicks are unpredictable; they do not follow a regular pattern, and their intensity does not steadily increase. These practice contractions are felt as a tightening across the front of the abdomen and often ease or disappear with changes in position, activity, or by drinking water.
True labor contractions, by contrast, exhibit a clear pattern and become progressively stronger, longer, and closer together. The discomfort often starts in the back and wraps around to the front of the abdomen, persisting or intensifying regardless of movement or rest. True labor contractions cause cervical changes like effacement and dilation. While Braxton Hicks may feel uncomfortable, true labor contractions are painful.
When to Contact Your Healthcare Provider
Contact a healthcare provider if there is any uncertainty regarding contractions, especially during a twin pregnancy. Seek immediate medical advice if contractions become regular, strong, and frequent, such as more than four to six contractions in an hour, particularly before 37 weeks of gestation. Other concerning signs include a sudden gush or trickle of fluid from the vagina, which may indicate the water has broken.
Vaginal bleeding, persistent lower back pain, or menstrual-like cramping that does not subside are also reasons to contact a healthcare provider. A decrease in fetal movement for either baby, or any sensation of increased pressure in the pelvis or vagina, should also prompt a call. Prompt communication ensures potential complications, such as preterm labor, can be assessed and managed quickly.