When it happens · 4 min read
Preterm labor, or just Braxton Hicks?
Your uterus has been practicing for weeks and you've learned to ignore it. Then something feels more insistent than usual, and you're doing arithmetic on your phone at 1am. Here's how the distinction actually works — and why, this side of 37 weeks, the threshold for calling is deliberately low.
Last updated August 9, 2026
What Braxton Hicks feel like
Irregular — no rhythm you could set a clock by. Infrequent, and they don't build. Usually painless, more a tightening or hardening than a pain. Often concentrated at the front. And crucially, they respond to what you do: they typically ease if you change position, lie down, empty your bladder, or drink a couple of glasses of water. Dehydration and a full bladder both provoke them, which is why that combination is worth trying first for irregular tightenings.
What preterm labor looks like instead
Regular contractions — coming at intervals you can time — that keep coming and get closer together, stronger, or longer. They persist through rest, hydration, and position changes rather than fading. Pain often starts in the back and wraps to the front.
And they usually bring company: a dull low backache that comes and goes in waves, a feeling of pelvic pressure or the baby pushing down, period-like cramping, a noticeable change in vaginal discharge (more, watery, mucus-like, or bloody), or any leaking of fluid. More than four to six contractions in an hour before 37 weeks is a widely used threshold for calling, but the pattern matters more than the exact count.
Why hours matter
This is the reason not to spend the night monitoring yourself. If preterm labor is genuinely underway, two time-sensitive things can help significantly: corticosteroids given to you, which accelerate the baby's lung maturity and measurably improve outcomes, and — if needed — transfer to a hospital with a neonatal unit before rather than after delivery. Both take time to organize. Arriving early preserves options that arriving late removes.
The likeliest outcome of calling is still that you are monitored, everything settles, and you go home. That is a good result, not a wasted trip.
Call immediately, regardless of contractions
Any gush or steady trickle of fluid. Any vaginal bleeding. A clear, sudden increase in pelvic pressure. Reduced fetal movement. Each of these before 37 weeks earns its own call, whether or not anything is tightening.
Common questions
- They stopped after I drank water and lay down. Still call?
- If they genuinely settled and you're otherwise well, that's the classic Braxton Hicks picture — mention it at your next appointment. If they return, or came with any fluid, bleeding, or pressure, call now.
- How do I time them properly?
- From the start of one to the start of the next, noting how long each lasts. Regular intervals that shorten over an hour is the pattern that matters — and it's the exact information the triage midwife will ask for.
- I've had these since 24 weeks and everything's been fine.
- Frequent practice contractions are common and often normal. What warrants the call is a change in your own pattern — more regular, stronger, or newly accompanied by pressure, discharge changes, or backache.
If it's this, not that
Still not sure
This page is the general answer. Yours is a specific child.
The advisor can be. It has read everything here, and it knows how old your children actually are — which is the whole difference wherever guidance changes with age. Ask it anything.
- She's got a temperature of 100. Is that something to worry about?
- He's obsessed with space and galaxies — what toys are worth getting him?
Free. It comes with the note.
It answers from the same cited pages you are reading, and when the question is where to go, from the real clinician, hospital and childcare records behind this site — not a link to go search them yourself. It says so when we have not written about something, and it is not a doctor; for anything urgent it gives you the threshold and tells you to call.
Where this comes from
Every claim on this page traces to one of these. See every source we use →
Written from the sources named above, and it is not a substitute for your own doctor. If something feels wrong to you, that instinct is a good enough reason to call — you know yourself and this family better than any page does.