Braxton Hicks and “False Labor”

There is no such thing as “false” labor. The uterus contracts sporadically throughout the entire pregnancy as the uterine muscle cells stretch and prepare for the “real” labor contractions that will open and thin your cervix and push your baby out during childbirth. A better term for these sensations would be “warm-up” labor.

These sporadic contractions or tightening sensations are referred to as Braxton Hicks contractions. They are experienced as occasional lower abdominal menstrual-like cramping in early pregnancy. But, as your pregnancy progresses, you can actually feel your uterus ball up and harden, often from the top on downward before it softens again. 

While not painful, Braxton Hicks can feel like uncomfortable sensations in your abdomen and groin area. They are usually brief and irregular, occurring without any rhythm or pattern. However, they do happen with increasing frequency, length and intensity as your pregnancy advances. This can sometimes make it hard to distinguish them from actual early labor.

To Relieve Discomfort From Braxton Hicks Contractions

Make sure to keep well-hydrated with at least 64 ounces of  filtered, spring or well water daily, ideally between meals, at least 20-30 minutes before or 2 hours after. Lack of fluids can cause the uterus to become irritable and tighten more often.

Frequent Braxton Hicks contractions may also be your body’s message that you are doing too much and need to slow down, so take heed. Braxton Hicks contractions usually subside when you stop what you are doing and change your position, get up and walk around, sit or lie down.

During a contraction, stay mindful and fully aware of whatever is happening in the present moment. Get curious about, and lean into and even embrace your internal sensations without the story. Practice slow deep breathing, while consciously relaxing any tense muscles. Breathe into the most intense sensations you are feeling. This enables you to hone coping techniques for labor, and for life’s challenges!  When you shift your mindset in relation to discomfort and pain, especially when everything is normal (but also when not), miraculous transformation occurs. Start by welcoming it all, and look for the deeper message in your symptoms. Your body is brilliantly wise and has reasons for its behavior. This not only helps lead to relief, but also minimizes suffering, as well as point you in the direction of root causes that you need to address.

Master your breath and concentration by simply being aware of your breathing, doing three-tiered breathing and extended exhale breathing exercises on a regular daily basis. 

Deep abdominal or diaphragmatic breathing is the optimal form of breathing and an effective natural tranquilizer, especially if you do it often. To train yourself in this way of breathing, start getting comfortable in a reclined position or sit up straight. Place your hands on your belly and concentrate on breathing into them. Bring your attention slowly into your body from head to toe, observing and releasing any muscle tension. Be mindful of what you are currently seeing, hearing, smelling, feeling, tasting, and all the sensations of breathing.

Just watch without judgment or attachment. This takes you into the present moment, and is wonderfully relaxing.

Three-tiered, deep diaphragmatic breathing:

1. Exhale slowly through your mouth with an audible sigh.

2. Inhale deep into your belly for a count of 4 or 5.  Imagine a pump expanding your abdomen and lower back which causes you to inhale, then allows your ribs to expand with air, then your upper chest to rise towards your collarbone and shoulders.

3. For a count of 4 to 5, slowly release your breath through your mouth in the same order as the inhale - from abdomen to ribs then upper chest. Let go and relax more each time you exhale.

4. Repeat this cycle for a total of 8 times or at least a few minutes.

For more guidance and deeper transformation, schedule an online or in-person breathwork session with me.

Visualize what the tightening sensations are doing to “ripen” your cervix as it helps it to soften, come forward, shorten, become thinner, and possibly dilate or open a little in preparation for labor at term. Be reassured that a ripe cervix often responds more readily to actual labor contractions, meaning a shorter and thus easier time getting to the point when you can push your baby out.

If you are bothered by these contractions and nothing seems to help, consider homeopathy specific to your individual symptoms. Homeopathic remedies are safe and amazingly effective in alleviating this sort of cramping during pregnancy. I have had great success with Cimicifuga or Caulophyllum 30 c particular to each person’s unique presentation. You can consult with a classical homeopath, or refer to books like Homeopathy For Pregnancy, Birth and Your Baby’s First Year by Miranda Castro. 

Herbs can also help you relax, sleep, lessen the pain, and either discourage your contractions, or encourage them if you are term.  If you are interested in herbs, there are several options to try alone or in combination. Go for high-quality sources like Gaia, Wish Garden or Eclectic Institute, or other professional grade brands I use and recommend like those in my online holistic apothecary.  Most of the supplements and herbal remedies I recommend are available on my customized online holistic apothecary. Find the best supplements that have gone through my thorough screening process there. Look in the category for uterine irritability/false labor or search them individually. My online dispensary is a convenient way for you to purchase my hand-picked, professional-grade, whole food supplements and other natural health products. Ordering is simple, and the products will be shipped directly to your home or work within a few days. See some samples from the apothecary at bottom of this blog.

For persistent irregular uterine cramping that is not associated with labor, make sure you are getting plenty of calcium and magnesium in your diet. Start by eating lots of green leafy and seaweed veggies, ground sesame seeds (tahini), wild caught fish like salmon, almonds, whole grains, and organic yogurt and cheese. Avoid excessive cow dairy intake, coffee and soda, and even spinach, which decreases calcium absorption. You may need additional supplementation. Take at least 400 mg magnesium and 1200 mg calcium daily in 2-3 divided doses, or make your own infusion of nettles and red raspberry leaf tea, using the recipe here.

Also, helpful herbs to reduce cramping are cramp bark, black haw, and wild yam. You can experiment with one of them at a time, or use all together in combination. Take 1 - 5 cc of each tincture every 30 minutes to few hours, depending on how often and intense the cramping is (particularly if it is interfering with your sleep each night in the last several weeks of pregnancy).

Prior to 37 weeks, you need to drink 2 large glasses of water, lie down and contact your midwife or doctor immediately if you experience any of these potential warning signs of premature labor:

• A feeling of your uterus tightening or cramping in a pattern of every 15 minutes 

• Cramping becomes closer, longer and stronger

• Dull lower backache that feels different than usual (not related to position or strain)

• Pressure or fullness in your pelvic area like something is going to fall out

• An increased amount of discharge, fluid or bleeding from your vagina

• Persistent diarrhea or intestinal cramping 

• A sense that something isn’t right

As Things Progress 

Toward the last several days to weeks of pregnancy, Braxton Hicks contractions can be frequent enough to feel like early labor, and can thus lead to frustration and exhaustion, especially if they are keeping you from sleeping. In this case, it is important that you encourage them to go away at night so you can sleep well. Unplug from the computer or smartphone after dark, dim the lights and go to bed early. For more support winding down, take a warm bath with your favorite essential oils, ask your partner to give you a soothing massage with a few drops of lavender in almond oil, read a boring book or watch light drama or a comedy, and drink a glass of warm milk. But if you need something stronger and do not have a history of alcohol addiction, drink a glass of wine or beer, or take 2 shots of whiskey in juice or before going to bed. Or try alcohol free Hops. Sufficient rest is essential to give you the needed strength for the hard work of labor to come.

Common herbs taken alone or in combination, to ease discomfort once you are in early labor are: 

• Motherwort tincture ¼ to ½ dropperful up to every few hours

• Skullcap tincture ¼ to ½ dropperful up to every hour

• St. John’s Wort tincture a dropperful up to every hour 

For sleep, you can try a great mineral combination of  magnesium and calcium in approximately equal amounts like 400 mg each, or doubling the magnesium available in tasty powder form to make a warm drink.

If you are interested in herbs, take 2 capsules of herbal Valerian standardized extract (400-900 mg) or Hops (300-600 mg). Using these herbs together in lower dose combination can be more effective. 

Also, try CBD from hemp oil, several drops under the tongue and repeat every few hours as needed. This is the new rage, as it helps promote sleep without the potential risks of the THC component of cannabis on the developing fetus. Results from anecdotal evidence and preliminary research, although sparse (as is common with most natural remedies in pregnancy), are promising. Make sure it is absolutely pure, and from a reputable source who can recommend proper dosing or from pharmacies licensed to dispense it, as it is largely unregulated. 

During the day, you have the choice of carrying on as usual and letting nature take its course, or encouraging the contractions to develop into a progressive early labor pattern by:

• Taking a long brisk walk alternating with climbing stairs

• Engaging in another sort of upright but gentle exercise activity like dancing - do both slow sensual with your partner, and more upbeat, funky hip hop, belly or African styles. Turn on the music that speaks to you, get lost in it and move like no one is watching.

• Getting romantic and sensual, and having sexual intercourse

• Rolling and pulling on your nipples as a baby would do during breastfeeding 

• Using a breast pump 

Continue these activities until you get regular contractions every 5 minutes lasting at least 45 seconds. In any case, make sure to drink lots of fluids and eat small frequent meals of nourishing food (especially whole grains, nuts, seeds, beans, fresh fruit and vegetables, and healthy protein) as an athlete does who is running a marathon. Do something that you enjoy and/or organize a pleasant change of scenery, express your fears and emotions with your partner, a close friend or family member, and try to surrender to the process.

If you need more personal support and guidance, schedule a consultation with me. Check out my number one international best selling book Natural Birth Secrets and my online course, an online version of how I have helped thousands in my local practice. Both resources are unique, but each provide an in depth, one-of-a-kind holistic approach created by me, a seasoned holistic nurse midwife of over two decades, who helped thousands and has seen everything! 

Photo by Megan Hancock Photography

For extra support in pregnancy and relief of common aches and pains, wear an abdominal binder. Bellefit makes a fine one as pictured above. They also make postpartum support girdles . I have a holistic approach to life, including healing after pregnancy and birthing. Nothing replaces abdominal toning and exercise for restoring muscle strength and tone - which I encourage for all mamas as soon as they feel up to it postpartum. Nothing replaces touch, slow deep abdominal breathing, and a 'love your postpartum body' perspective that I promote.  But I have found many mamas simply feel comforted by this support garment, especially early postpartum and temporarily as needed....to be used without forfeiting abdominal toning and strengthening exercise, breathing well and touch. 

I have found Bellefit supportive garments to help like they use belly binding around the world such as in Indonesia. They do aid in early postpartum healing and provide support many mamas feel comforted by. I deal with human beings and the reality is many postpartum mom's struggle with body image, feel frustrated that getting back to themselves takes longer than expected. Being into holistic health and healing includes being sensitive to real human struggles - the mind, body, heart and soul of each person and their unique situation. Having helped countless women with these issues after having a baby as a midwife, I have found many still love that binding and feel better with this support, and ability to fit into their pre-pregnancy clothes comfortably and sooner than they would if they went through a C-section or natural childbirth recovery without it - especially when they have to dress up and fit into a certain favorite outfit for a special occasion or wedding not long after having a baby.

Have a Great Pregnancy and Postpartum Recovery (with a little help from Bellefit)! You can check them out and purchase here.

Anatomy and Physiology of Childbirth

Childbearing Classic the Series' - with Illustrations by Jan Ruby Baird.

Anatomy and Physiology of Childbirth

Women, miraculously made, are a perfectly designed vessel to bring a baby into the world.

Each body part is created for a purpose and specifically placed where and when it is so babies can be born.

It’s a dance between feminine bodies and their babies… each knowing exactly what they are supposed to do. I empower women to get their minds out of the way, and learn to work the brilliant natural process.

When given the opportunity to flourish… and to rise up to the moment…. A woman’s body has the capacity deliver almost every time.

Watch this video where CNM Anne Margolis talks about the anatomy and physiology of childbirth and what to expect physically and emotionally in all its stages. Charts used are from 'Childbearing Classic the Series' - with Illustrations by Jan Ruby Baird.

What is my body doing during childbirth?

During pregnancy, you’re looking at what your appearance is on the outside.  You see your skin stretching, meeting the physical space of encasing a growing being.

Most of the conversation is external, comments of size, possible stretch marks.

Just behind this wall of protection, lives a breathing, vibrant and meticulous ecosystem.

Swimming in a double wrapped membranous bag of amniotic fluid, lives your baby. Baby is encased in the womb, which is surrounded by the uterus. The placenta connects to the baby through the umbilical cord. All of baby’s nutrients are delivered to him or her through this cord, which also removes waste.

5 Things That Change With Pregnancy and Labor:

·         Through pregnancy, your uterus grows as your baby grows.

·         Moving into labor, your cervix changes. It is firm, thick, long, and closed during pregnancy, and during labor, it softens, thins, shortens and opens.

·         As your cervix dilates, you may release a mucus plug. This could, but not always, allow for some blood to show.

·         Your vaginal canal of muscles is stretched, holding space for your baby’s head to come through.

·         Your pelvis, which is 3 bones connected by ligaments, can stretch. It can get smaller or larger depending on your position. When we talk about station, it’s in reference to whether the baby’s head is engaged in the mid pelvis, or how many centimeters it is above or below it.

Movement and position during labor is important.

Lying down gives the pelvis less room to allow for the baby’s head. Squatting, kneeling, hands and knees, lunging, standing, walking, or dancing open up the pelvis and helps baby to navigate his or her way down.

Photo by @seasonaldoc

What does it mean if my water breaks?

Since your baby is double wrapped, in two bags of amniotic fluid, the first bag can break, sometimes in early labor, which releases no more than a few tablespoons of fluid that can make up to a pancake sized stain on your underwear. This could prompt thoughts and concerns about ‘ruptured membranes’ - your main bag of fluid breaking - and may lead to unnecessary interventions to prevent infection of risk, especially when there is a prolonged period of time between this and birth – when in actuality your water did not break.

On the contrary, this tiny gush of fluid ONCE, is usually a sign that labor is beginning, and only the first bag has broken. As long as there are no signs on evaluation, and no continual flow of fluid, the main bag is often still intact and will break during later stages of labor. It’s imperative to check with your health care provider if you have concerns over any flow of fluid to confirm what is going on.

How is my baby’s head able to make it through such a small area?

The miraculous design of a baby’s body, includes their skull, which is not fused yet… the soft spots (fontanels- between certain suture lines) on it are there because these bones are not yet closed together, so your baby’s head can mold to accommodate the pelvis. And women’s birth canals can stretch and expand to accommodate baby.

What is happening to my body before I go into labor?

Every body is different but there are some general signs.

Pre-labor could last a few weeks. Here are some signs labor could be approaching:

·         A dropping sensation as baby descends lower in the pelvis

·         More pelvic pressure

·         Trips to the bathroom more frequently

·         Easier to breathe

·         Less heartburn

·         More sensation of Braxton Hicks – as the uterine muscles warm up and ripen the cervix

·         Bowel movements become more frequent and loose

·         Excited surge of energy

·          “Nesting” – feeling the urge to clean, organize and prepare

I am humbled by the many various and unique ways women start labor!

Just as women come in so many different shapes, sizes and forms, labor is just the same.

Physical and Emotional Sensations

In general, when you start to feel a regular pattern of sensations of uterine tightening, we would consider that the onset of labor. These regular sensations, are commonly referred to as contractions, but that is a limited term, and that can create a sense of tension.

The top of the uterus does contract, so the bottom shortens, thins and expands. The sensations come and go, build to a peak and then gradually lessen as waves, with no such sensation in between, like the calm waters between the waves.  SO, let’s use the word wave instead – some mamas prefer surges, or make up their own affirmative positive term, like hugs to the baby.

They are different than Braxton Hicks.  

Labor waves tend to be felt low in the pelvis, and go around the back of the body.  They come in a pattern. This means they keep coming. Maybe one comes in 5 minutes, another in 10, then another in 7, and then another in 20… it becomes a pattern when they persist. Just like they can range in interval, they range in duration – lasting in the early stages from 20-60 seconds on average. And they feel different.

How will I feel at the onset of labor?

Early waves can feel like menstrual cramping. As they progress, the sensations become more intense, last longer and come more frequently.  They can feel like a tightening with pressure down low in your belly and sometimes low back. You’ll be able to have a conversation and go about your day. You’ll be coping well, sociable and excited.

How do I know when I am progressing in labor by how I am feeling?

Waves of the cramping will come more frequently, lasting a little bit longer. They tend to come more consistently, like every 4-6 minutes and last anywhere from 45-75 seconds.

These feel more intense, and you’ll generally not be able to speak through them. Some women will begin to moan, breathe and need to become inwardly focused. When not disturbed, laboring women make natural opiates that lessen sensation of pain and enable them to enter a trance-like state.

Midwife Pam England calls this “labor land.” This trance-like state is important because it takes us out of our thinking brain and more into an instinctual, primal and sensual experience that allows our bodies to do their job of birthing.

Photo by@amoremfocofotografia.

As labor progresses, the main bag of amniotic fluid may break. This could result in a large gush of fluid releasing at once, or periodically – either making a large puddle on the floor, soaking through your clothes and surface beneath you, or making a large maxi pad heavy like a babies full diaper after a night’s sleep. There can also be a small amount of normal bleeding, from a few streaks or spotting, to no more than a light period. Some women in transition will belch, vomit, get sweats, feel shaky and restless.

Moving into active labor, a woman needs more support.

Emotions to Consider

When the first stage of labor reaches the final stages, ‘transition’ labor feels most intense – but means progression to pushing out and meeting your baby is coming soon. Labor sensations are coming every few minutes, lasting an average of 60-90 seconds. They are still coming in waves, which rise and fall, with a delicious rest in between.

I encourage women to stay present and know what is common, so you can embrace, rather than fear it.

I like everyone at the birth to know that our birthing mom will experience intense emotions towards the end of labor and that’s normal. So no one will be scared, I reinforce to everyone that she is working hard and she is internally focused.  

It’s important for everyone at the birth to know and understand the items below, and it’s also ok for you to know the signs during this period, as it may help relieve doubt that arises.

A woman in transition may:

·         Lose her ability to cope and feel overwhelmed

·         Doubt her decision to birth in the way she wanted to

·         Want to give up

·         Ask for drugs

·         Curse

·         Panic

·         Think she is dying or that something is really wrong

These are all signs that more support is required.

At this point we bring her back to the present, let her know she is not alone, we reassure her all is well, and remind her we are moving closer to meeting her baby!

This intensity is normal and it’s healthy. It is just part of the process, necessary for the huge transformation that is about to occur.  And in the scheme of things, it does not last that long. To the mama experiencing it, it feels long, but the earlier part of labor, although easier, is usually much longer – up to several days. And in transition we are talking no more than several hours, in the course of a lifespan – around one minute plus, at a time. You can take normal healthy labor sensations for 60-90 seconds with rests in between.

So I actually should NOT push at this point?

This is something I feel very strongly about.

The medical model of care defines active labor when a woman is at least 6 centimeters dilated, and the pushing or second stage when a woman is full dilated. Fully dilated means there is no longer any cervix in front of and encircling the baby’s head.

Photo by Mary Elliot O'Haire.

This time is not to be spent trying to push before the natural urge is felt, but honored as a resting phase. Often the waves naturally slow down, and there is a sense of calm. Some women sleep to recharge, and wake up to a surge of increased energy needed for pushing. I believe we are to honor this time, and allow our body and baby to do the work they were perfectly designed to do – the vast majority of times. When the natural physiologic process of birth is allowed to progress on its own, the baby will soon lower into the pelvis on its own, and then you may feel a strong instinctual urge to push; that is the actual start of pushing, the second stage of labor, not when your cervix is examined to be fully dilated.

When a woman is told to push as soon as she is fully dilated, especially her first vaginal birth, she will exhaust herself, as the baby is not low enough in the pelvis to create the urge to push. She will have to work longer and harder, as baby is higher, she is working against her body, not with it.  It’s like pushing out a bowel movement when you don’t feel the urge to. Once baby naturally lowers and the laboring mom will have rested, her body creates a natural strong urge to push; it is much easier to wait and use that internal force to do much of the work for you.

I like to honor the resting phase when all is well. It typically lasts several minutes to an hour or more.

Baby will lower him/herself down, and a woman will feel pressure and a powerful urge to push.

Like having a bowel movement, you will know when you have to push your baby out.

Although contractions are not as frequent as they were in the latest part of labor, many women feel a renewed excitement, a renewed determination, become hyper-focused on what is happening and getting the job done.

Baby starts the descent and glimpses of her head may be seen that come and go, as it makes a few steps forward and a little back, before it begins to actually come out. The birth canal opens to accommodate. In a healthy childbirth, the baby’s head emerges and the shoulders and the rest of the body follow more easily.

Baby's head is emerging. Mama is pushing naturally, working hard, but not suffering. Mama loved her birth. Photo by @birth_unscripted

When does the placenta come out?

The third stage of labor is between the birth of the baby and the birth of the placenta.

When left undisturbed, this stage can last anywhere from 5 minutes to an hour.

This is a sacred time between parents and baby. Everyone is meeting for the first time.

Physically, you’ll know when the placenta needs to come out. Cramping will occur. It’s not like in labor but cramping increases and is accompanied by a gush of blood. It’s common to lose up to 500 ccs of blood or a bit more at birth.

The uterus clamps down and pushes out the placenta. It contains no bones, like a slab of raw meat, so it doesn’t hurt to push out.

The baby takes time to adjust to life outside the womb. She becomes very alert and an unfolding is happening… She is looking around, moving her arms and legs, and eventually starts rooting, sucking and other breastfeeding reflexes.

Women know how to birth their babies and babies know how to be born.

Let me help you not only cope with birth but love your experience no matter where you plan to give birth and despite any challenges you may face! For more info on my online LOVE YOUR BIRTH course click here. I’ve taken everything I’ve learned, trained and supported women with locally for over 20 years in my private practice and I’ve poured all of my love, passion, knowledge and experience into creating something truly special for you - it is an ultimate guide to pregnancy, childbirth, postpartum and beyond!

Learn how to LOVE YOUR BIRTH wherever it is and however it unfolds. I’ve taken everything I’ve learned, trained and supported women with locally for over 20 years in my private practice and I’ve poured all of my love, passion, knowledge and experience into creating something truly special for you and created the LOVE YOUR BIRTH online course. 

Photo by Megan Hancock Photography

 

Please let me know if you found this information useful! Also, please let me know you have any questions that you’d like to submit for our Ask the Midwife series. And I’d love if you shared this information with anyone you think may benefit!

You are supplying your baby's complete nutrition and hydration requirements, as well as your own. It is difficult to get everything you need even from the best of whole food varied organic diet. Do you need supplements? Here are some of my favorite I recommend to mamas in my practice.

Make your Red Raspberry Leaf and Nettle herbal infusion.....rich in needed nutrients and specifically nourishing for pregnancy, birth and postpartum. Place 1 oz of dried red raspberry leaf, 1 oz of dried nettle leaf in a quart-sized glass canning jar with strainer, fill it with boiling water, cover and steep for at least 2 -4 hours at room temperature. Strain and place in a covered pitcher. You can make it in larger quantities and store in the fridge. For taste, dilute with water or steep for less time (but no less than half an hour), add lemon or lime juice, mint leaves or a teaspoon of honey. Drink 1-4 cups daily hot or cold.