At the end of pregnancy, most women experience an increase in Braxton-Hicks contractions. These are mild contractions that feel like your belly is tightening and then releasing. Most women don’t experience pain with these contractions and their pattern tends to be irregular. In fact, both of those are indicators that the contractions you are having are BH and not the real thing: more or less painless and irregular (and therefore difficult to time). Most practitioners will state a specific number of BH contractions that they consider normal late in pregnancy. Until you have more than that many in an hour, you don’t need to call in. For example, my office says if you have six or more in an hour, call in just to make sure they don’t want to see you. I’ve heard a range of about four to eight, so it’s a good idea to check in with your doctor about when they want to see you.
I tend to have a lot of BH contractions, so I make sure to mention them at every appointment this late in pregnancy; the answer every time: It’s totally normal.
However, as the end of pregnancy approaches, you might also have some real contractions. How will you know the difference? Real contractions hurt; they often begin at the top of the uterus, radiate downward and reach their apex feeling like a menstrual cramp (women with back labor will have different sensations). But a couple real contractions alone are not a reason to go running to the hospital. If you think you are having real contractions, there are a couple things you should do before calling your provider. First, stop what you’re doing. If you’re up and walking around, sit down and rest. If you’re already sitting and resting, get up and move around. Second, drink a big glass of water. If your contractions continue after that, start timing them.
Next, ask yourself if the contractions are regular and timeable. Meaning, do they come every 5, 10, 15, 20 minutes? Usually, real contractions have a pattern to them, which makes them easier to time. Once you establish a pattern, you should call your provider and say, “I’m having contractions every X minutes, what should I do?” Chances are they will tell you stay home and continue to time them, calling back if the contractions get stronger, longer and closer together.
From reading my birth board on a popular baby-themed website, I’ve learned that being told to stay home annoys the crap out of a lot of women. I find that interesting because if I had been able to labor and deliver the way I originally planned, I would have wanted to stay home as long as possible.
So what are some reasons to stay home?
As a side note, if your water breaks first, call in and see if they want you to come in right away. Some practices will want to see you right away (especially if you tested positive for Group B Strep); some will say, call back when you’re having contractions (if you aren’t already having them).
As a second side note, all of this information pertains to healthy, low-risk pregnancies. If you are high-risk or have pre-existing conditions, everything changes, and of course, do everything and anything you need to make sure that you and your baby are attended to promptly.