What do contractions feel like? From early labor to pushing

Your belly goes tight and there’s a dull ache low in your back. Many people wonder what labor feels like near the end of pregnancy, especially with a first baby. Contractions feel different for everyone, but they follow patterns you can learn to read.

What do early contractions feel like?

Early contractions often feel like period cramps. Some people mainly notice a dull backache, pressure low in the pelvis, or discomfort in the thighs, hips or belly (HealthLinkBC). Cleveland Clinic describes early labor contractions as feeling more like an ache or pressure.

During each one your uterus tightens. If you put a hand on your belly, you’ll feel it getting harder. When the muscle relaxes, the pain fades and the hardness eases (NHS). You may also feel an urge to use the bathroom, because your baby’s head is pressing on your bowel.

Early contractions are usually short and irregular, and mild enough that you can still talk through them. Cleveland Clinic puts them at about 20 to 30 seconds. HealthLinkBC says they last 15 to 30 seconds at first and later up to 45 seconds. The gaps shrink from every 10 to 20 minutes to every 5 to 7 minutes. This early, or latent, phase can take hours or sometimes days (NHS). For typical timings at every stage, see how long contractions last.

Period-like cramps turn into labor gradually. Cleveland Clinic explains that true labor contractions may begin as a cramp or a feeling of pressure. Within a few hours they tend to get stronger and come closer together. Cramps that stay mild, stay irregular or fade when you rest are more likely to be practice contractions. Other early hints, such as a bloody show or loose stools, are covered in signs of labor.

What do active labor contractions feel like?

As labor becomes established, contractions change. Cleveland Clinic lists the ways people describe them:

• very strong and intense menstrual cramps
• a wave of tightness that starts at the top of the uterus and moves down
• a squeezing or pushing sensation across the whole abdomen

The pain can spread to the lower back and legs. Others feel it in the back first, wrapping around to the front and down the thighs (healthdirect).

Each contraction usually begins gently, builds to a peak and then tails off. Between contractions you may not feel much pain at all (NHS inform). In active labor they typically last 40 to 70 seconds and come every three to five minutes (Cleveland Clinic). They’re intense enough that you can’t walk or talk during one.

You may turn inward at this point. HealthLinkBC lists quiet focus on yourself and doubts about whether you can cope among the things you might feel in active labor.

How much it hurts is very individual. NHS inform says contractions may remind you of period pains or feel much more painful. The intensity varies a lot from one woman to the next. ACOG adds that your labor may not be like your mother’s, sister’s or friend’s. It may even be different with each child you have.

For a labor that’s going normally, Cleveland Clinic has a general rule. Go in once contractions last about 60 seconds and come every 3 to 5 minutes. Ask your provider for their rule well before your due date. When to go to the hospital compares the rules hospitals use.

Transition and pushing: what the end of labor feels like

Transition is the last stretch of the first stage. The cervix opens from about 7 or 8 cm to 10 cm. Contractions now come every 2 to 3 minutes and last 60 to 90 seconds (HealthLinkBC). HealthLinkBC also lists what you might feel:

• pressure in your bottom
• shaky arms and legs, and leg cramps
• hot or cold flashes and sweating
• nausea or vomiting
• moments of panic or irritability

Once your cervix is fully open, you may feel a strong urge to push that can feel like needing to poop. As the vagina stretches, you may feel splitting or burning. Pushing contractions are powerful and also come every 2 to 3 minutes, lasting 60 to 90 seconds (HealthLinkBC). For an overview of what happens in each phase, see the stages of labor.

What does back labor feel like?

Back labor is intense pain low in your back that starts during labor. It may be worst during contractions, but it can stay painful in between. About 1 in 4 people report intense low back pain during labor (Cleveland Clinic).

It usually starts in active labor, at around 6 cm, though it can begin earlier. The pain can feel constant and get worse with each contraction, and it may not ease in between. It can come with muscle spasms that spread to the hips. Providers believe the main cause is the baby’s position. In the occiput posterior position, the baby faces your belly and the back of its head presses on your lower spine and tailbone. Back labor can be extremely uncomfortable for you, but it doesn’t harm your baby (Cleveland Clinic).

Things that may help, according to Cleveland Clinic:

• Leaning forward over a couch or a sturdy chair, or kneeling in front of a birth ball and leaning on it
• Bouncing on a birth ball or rolling your hips around it
• Counterpressure on your lower back from a water bottle or tennis balls, rolled by you or your partner
• A warm bath or a shower aimed at your lower back, or a warm or cool compress that never touches your skin directly
• Asking your provider about TENS, sterile water injections, pain medicine or an epidural

Real contractions or Braxton Hicks?

Practice contractions can feel similar, and ACOG notes that Braxton Hicks contractions can sometimes be very painful. What tells them apart is how they behave over time, as this comparison from ACOG and Cleveland Clinic shows:

	Braxton Hicks	Labor contractions
Pattern	Irregular, no pattern	Regular, getting closer together
Length	Often 20 to 40 seconds	Often 30 to 70 seconds, getting longer
Strength	Weak, or start strong and then fade	Get steadily stronger
Rest, walking or lying down	May ease off or stop	Keep going
Where you feel them	Usually only at the front	Often start in the back and move to the front

If you’re unsure, time your contractions and see whether they keep going while you rest and drink water. A contraction chart on paper works for this. ACOG says that if rest and fluids make them go away, they aren’t true labor contractions. Sometimes only a vaginal exam can show whether your cervix is changing (ACOG). There’s more on practice contractions in Braxton Hicks, and on contractions that stop and start for days in prodromal labor.

What helps you cope

NHS inform suggests a few things for when you feel a contraction coming. Relax your shoulders, face and hands. Keep your breathing slow and relaxed and focus on breathing out. Sway or rock your pelvis and make any noises that help, and don’t resist the contraction: it will build, peak and fade. A birth partner can rub your back, hold your hand to keep your rhythm, or breathe with you.

At the start of labor, the NHS also suggests:

• walking or moving about
• drinking fluids such as isotonic sports drinks
• having a snack
• taking a warm bath

Australia’s healthdirect adds resting between contractions, changing positions, warm showers and heat packs.

The Contraction Timer app has a guided breathing exercise: in through your nose, then a long breath out, with optional vibration. Its timer, also free online, keeps the length and spacing of each contraction for you. You can try both before labor starts.

When that’s not enough, hospitals and birth centers can offer medical pain relief such as nitrous oxide, morphine or an epidural (healthdirect).