Contractions in pregnancy

These contractions are an important indicator of how far along you might be in your labour: in the earliest stage of labour, the contractions tend to be irregular and mild (they may feel like menstrual cramps or stomach gas). As labour progresses, they tend to become very regular and very strong. The time gap between the contractions also reduces.

Some key features to recognise labour contractions by are:

• The contractions are rhythmic; meaning you can time them and see patterns in the intervals between contractions and the length of contractions.
• The intensity and duration of contractions increase with time.
• The pain usually starts in the back and radiates towards the front of the body.

Here’s a look at the three stages of labour, and how contractions feature in each one:

Stage 1

Oxytocin hormone and prostaglandins (made up of lipids) are the two main chemicals responsible for producing labour contractions. While they are produced naturally in the body, doctors may also use these chemicals to induce labour where necessary.

Here's how the chemicals are produced in the body naturally: When the baby comes lower down the mom-to-be’s pelvis, it causes the cervix to open up and become thinner. This, in turn, sends signals to the brain to release oxytocin, to trigger contractions.

At this time, the placenta releases prostaglandins which also help to produce contractions and thin out the cervix further.

The longest of the three stages, stage 1 can last from 12-20 hours. By the time stage 1 ends, the cervix dilates to about 10 centimetres (or about four times its normal size).

Some important signs of this stage include lower back pain and cramping. Just before this stage begins, the fetal membranes (a sort of sac that protects the baby during pregnancy) break and amniotic fluid comes out - this is colloquially known as water breaking. Whenever this happens, you may notice a brownish discharge before the amniotic fluid starts to flow. Rest assured, this is absolutely normal.

Intensity and frequency of contractions

• In the latent phase of stage 1 of labour, the frequency of contractions can be anywhere between one in every 20 minutes to one every five minutes. Each contraction can be 30-90 seconds long.
• The contractions come in faster and last longer as the labour progresses to the active phase of stage one. At this time, the contractions tend to be 45-60 seconds long, and they recur every three to five minutes.
• In the final phase of stage 1, called the transition phase, the contractions are much closer together: they can be 60-90 seconds long and 30-120 seconds apart.

Stage 2

In this stage, the baby slides further down. Once the baby’s head pushes out into the birth canal, the mom-to-be can start pushing the baby out in time with the contractions (sometimes this is instinctive, at other times, a doctor or midwife needs to encourage expecting mothers to push and relax at the proper intervals). The duration of this stage can vary between a few minutes and three hours.

Intensity and frequency of contractions

• The contractions tend to be regular, longer and stronger now, to ease the baby’s passage through the birth canal.
• In this stage, while a portion of the uterus actively helps to push the baby out, the lower half of the uterus remains relaxed and stretches to let the baby come out through the birth canal.

Stage 3

Over the next few minutes to a half-hour, mild contractions push the placenta out of the new mom's body after delivery.

As the contractions become stronger, the important thing to remember is to breathe through them, call your doctor and make arrangements to get to a hospital where you can deliver your baby safely. Remember also that you’ve prepared for this is over several months

Getting contractions before the 37th week of pregnancy can be scary. However, mild and irregular contractions can be perfectly innocent and nothing to worry about.

In fact, pregnant women can experience mild uterine contractions as early as six weeks into the gestation period. These contractions, known as Braxton-Hicks contractions, are more commonly felt in the second and third trimester of pregnancy, though.

While doctors don’t know the exact cause for these contractions, some factors that can trigger them are dehydration and having sex during pregnancy. Braxton-Hicks are also considered to be the body’s way of getting ready for labour.

Some key features to recognise Braxton-Hicks contractions by are:

• They are non-rhythmic, sporadic, unpredictable contractions that do not become regular with time.
• They are usually triggered when the mom-to-be has been very active or is dehydrated.
• Braxton-Hicks contractions can last up to 2 minutes, whereas real labour contractions are typically under 90 seconds.
• Braxton-Hicks contractions become weaker with time, whereas real labour contractions get stronger.
• Braxton-Hicks contractions often affect the abdomen or one particular area rather than radiating from the back to the front of the body.

Also known as false labour, Braxton-Hicks contractions tend to be irregular and do not increase in intensity over time. Shifting positions and doing breathing and relaxation exercises can help some women overcome these. That said, you should visit your doctor if the pain does not go away even after shifting positions, drinking water and doing breathing exercises.

Going into labour anytime between the 20th week of pregnancy and the 37th week of pregnancy is known as premature labour. Contractions between week 20 and week 37 of pregnancy that are regular in frequency, and which result in the opening of the cervix for birth are known as preterm labour contractions. (These are different from Braxton-Hicks contractions, as Braxton-Hicks do not result in birth.)

There are many risk factors for going into premature labour, including carrying twins, smoking and a previous premature delivery. Talk to your doctor about preventive steps and care measures, if you are at risk of going into labour prematurely.

If you get contractions before the 37th week of pregnancy, time them and monitor them for intensity. Head to the hospital if your contractions are getting stronger or if have more than six contractions in one hour: there’s no need to panic but if the contractions do cause your cervix to open, it would be a good idea to be in the hospital in case they send you into premature labour.