Braxton Hicks phenomenon and real labor are two terms very commonly heard in the obstetrics ward. Both these conditions present the same. The pain felt by the mother is the same. The baby is the most precious thing for a couple. So in late pregnancy, couples panic with even a little twinge of pain. Therefore, it is very important to understand the differences between Braxton Hicks contraction and real labor and know how to recognize these conditions.
Braxton Hicks Contraction
Braxton Hicks contractions are non-sustained, short lasting bouts of pain in the lower abdomen which is very similar in character to real labor. Mothers who have delivered normally previously know how labor pain feels and they panic with these pains confusing them for labor pain. The character of the pain, in other words, is that the actual feeling of pain is very similar to real labor. However, Braxton Hicks contractions are spontaneous, sudden inset and fleeting. They do not last long. The actual power of contractions is very less than those that occur in real labor.
Braxton Hick contractions are irregular; not rhythmic like in real labor. These contractions are due to asynchronous contractions of isolated areas of muscle in the gravid uterus. These may be triggered due to movements of the baby, external pressures and idiopathic. The cervix does not dilate with Braxton Hicks contractions.
Real Labor
Real labor is defined as the process of expulsion of products of conception at term. Real labor pains start due to hormonal changes, which occur towards the term leading to increase of prostaglandin receptors in the uterus. Prostaglandin leads to sustained uterine contractions which last for more than 30 seconds. These contractions start irregularly and become rhythmic as labor progresses. In advanced labor, uterus contracts about 3 times every ten minutes. The characteristic features of real labor pain that set it apart from Braxton Hicks are sustained, rhythmic, and forceful nature. The induction of labor can be done by artificial rupture of membrane, prostaglandin vaginal inserts, and artificial separation of membranes.
Real labor has three stages. First stage of labor is defined as the time from the onset of forceful uterine to full dilatation of the cervix up to 10 cm. First stage has two parts. The first part is called the latent period. Usually the baby lies head down in the uterus. When the uterus starts contracting the baby gets pushed down. The head of the baby presses against the lower segment of the uterus and this stimulation leads to the dilatation of the cervix. The latent period is 4-6 hours long and ends when the cervix is at 3 cm. From 3-10 cm the cervix dilates at a rate of 1cm per hour; thus the active phase of the first stage lasts around 6-7 hours. The first stage of labor is augmented with synthetic oxytocin infusion.
The second stage of labor is from full dilatation of the cervix to the delivery of the baby. The mother feels the urge to bear down and this power, in addition to uterine contractions, pushes the baby down the birth canal. The third stage of labor is from the delivery of the baby to the delivery of the placenta. Management of labor is a complicated process. Maternal, fetal well-being, as well as the progression of labor, should be closely monitored with a partogram.
What is the difference between Braxton Hicks and Real Labor?
• Braxton Hicks contractions occur before the term while real labor usually starts at term.
• There is also a phenomenon called pre-term labor.
• Braxton Hicks contractions are sudden onset, very short lasting, fleeting and irregular contractions while real labor is characterized by prolonged, sustained, rhythmic uterine contractions.
• Braxton Hicks contractions do not culminate in child birth while labor pain does.