Let's Talk About | Contractions: How Do They Work?
Contraction. The word itself can stir up a mix of emotions and feelings for many people, especially pregnant parents, and even more so if it’s your first baby. The way a contraction is depicted in films and TV shows only can lead to a sense of fear and worry. We know they’re an important part of the labor and birth process, but many of us have also heard cautionary tales from our family or friends. Things you likely haven’t heard: Why contractions are an important part of labor, or how contractions actually work to bring a baby down through the birth canal. The most common question we’re asked: “When will I know I’m actually having contractions and in labor, and how do I set those apart from the Braxton Hicks I’ve been having through pregnancy?”
At Gather Birth, we’re experts in all things birth, including “contraction interpretation.” As birth doulas and childbirth educators, we’ve supported hundreds of birthing and pregnant parents in Minneapolis, St. Paul, and the surrounding areas here in Minnesota. We’ve also had the gift of supporting folks virtually across the nation! We’re going to break down some of the common mysteries surrounding contractions, hoping it fills you with more confidence and less confusion as you prepare for your own labor and birth.
What causes contractions to occur?
One of the most misunderstood things about labor, in general, is how it works. We can’t tell you how many times we’ve received the same excited text from a first-time parent. They think today is the day, they’re in labor! It’s followed up by, “What do I need to do to keep this moving?” The overall assumption from most pregnant people is that, unless you’re actively doing something, your labor will stop; you are the one who is responsible for doing things to make your labor move forward. This can’t be further from the truth.
In reality, labor is a hormonal process, one that benefits from rest rather than continued activity, as well as a sense of confidence and relaxation instead of intense focus and productivity. Your uterus is encouraged to contract by the production of numerous hormones, but most prominently oxytocin and endorphins. Oxytocin is called the “love” hormone, while endorphins are the hormone of “happiness” (and the body’s natural pain relief!). It should go without saying, but if you’re stressed out and exhausted, it will be really challenging for your body to continue to produce these hormones. Instead, your body will emit adrenaline, which competes with the latter two hormones, causing your contractions to slow down, space out, and your labor to stall. Not great.
Ideally, you’ll choose activities and movements that support your ability to rest and relax during labor and in between contractions. You’ll surround yourself with people and tools to keep you confident in your body and maintain a feeling of safety and support. You’ll use comfort tools that will boost your body’s production of the hormones mentioned above.
What is happening during a contraction?
Hormones signal your uterus to contract, tightening the muscles around your baby. Your uterus isn’t just a muscle, it’s actually a group of multiple muscles working together. Most people don’t know there are several ways your uterus can contract during labor. Your uterus has muscles that stretch horizontally across the bottom, near the cervix. There are also muscles that run vertically, starting at the base of your uterus, moving up toward your fundus, which is what the top of the uterus is called.
During the first stage of labor, as your cervix dilates from zero to ten centimeters, your uterus is using a specific set of muscles to strengthen and soften in all the right places. If you are relaxed during a contraction, taking long deep breaths with as little tension as possible throughout your body, your uterus will contract the long, vertical muscles toward the top of your abdomen. These are the muscles we can often see and feel as the belly tightens around baby, pushing them further down onto the cervix, which in turn aids in process of dilation. As your baby’s head makes contact with your cervix, it helps soften and open the area, as well as signals your body to create more oxytocin and endorphins. This is the rhythm of labor, folks: a feedback loop of bodily responses to these ever-important hormones in labor, birth, and postpartum.
Now, if you’re having a hard time resting in between contractions, your uterus will use a different set of muscles toward the bottom of the uterus. These lower uterine muscles tighten horizontally, in turn limiting the pressure of baby’s head on the cervix and slowing the dilation process. This is certainly not ideal, but it doesn’t mean you have to be in a constant state of fear, tension, and pain. Using comfort tools during contractions and prioritizing rest in between can benefit your body’s ability to be the most effective in getting back on track.
Lastly, once your cervix is completely dilated and you move into the second stage of labor, which is pushing, your contractions will change. Hormones spike and communicate with the uterine muscles to adjust. When a contraction begins during this pushing phase, the thick layer of fundus will press down on your baby, guiding them further into the birth canal, and eventually under the pubic bone with a little back and forth movement. This is why many people feel an unstoppable urge to push during contractions!
Ok, so what’s the difference between Braxton Hicks and labor contractions?
This is a common question for first-time parents and can even creep up on the most experienced parent in the final weeks of waiting for baby. If you’ve never felt a contraction before, how do you know you’re actually having one? Because our uterus is working in a different way, there is often a clear difference in how a Braxton Hicks, or pre-labor contraction feels, compared to one in labor.
Braxton Hicks often present with the sensation of your belly tightening. Though some people may feel some cramping or sharpness as they get closer to their estimated due date, the main sensation is usually a tight belly. Braxton Hicks contractions have several other defining characteristics. Of note, they have no pattern or rhythm in how they come and go. Typically, these contractions won’t have a consistent frequency and don’t change in intensity over time. If your contractions taper off when you change positions, use the restroom, or drink some water, they’re likely Braxton Hicks.
Labor contractions usually have a sensation often compared to menstrual cramps. Most people will feel a labor contraction as cramping sensations lower down in their abdomen. This sensation can often stretch across to cramping in the lower back, as well your thighs and bottom. These contractions will slowly start to develop a pattern, coming and going consistently over time. As you move toward active labor, they’ll come more frequently, last longer in duration, and build in intensity.
