# Difference Between Braxton Hicks and Contractions Author: Nex Virox Team (Editorial Team) Reviewed by: Varshal Nirbhavane Published: 2026-08-27 Last updated: 2026-08-27 Canonical: https://nexvirox.com/difference-between/difference-between-braxton-hicks-and-contractions/ **Quick answer:** The main difference between Braxton Hicks and Contractions is that Braxton Hicks are irregular, non-progressive practice tightenings that do not dilate the cervix, while Contractions are regular, increasingly intense uterine tightenings that do dilate the cervix and signal labor. Braxton Hicks is sporadic, short, and painless, while Contractions is rhythmic, longer, and intensifying.

Difference Between Braxton Hicks and Contractions: Comparison Table

Aspect	Braxton Hicks	Contractions
Definition	Irregular, painless uterine tightening episodes that occur intermittently throughout pregnancy.	Rhythmic, painful uterine muscle tightening that progressively dilates the cervix during labor.
Purpose	Condition uterine muscles and increase blood flow to the placenta without triggering labor.	Efface and dilate the cervix to push the baby through the birth canal for delivery.
Core Mechanism	Brief, uncoordinated muscle fiber tightening that does not generate synchronized cervical pressure.	Coordinated, wave-like muscle contractions that shorten the upper uterus and pull the cervix open.
Timing	Typically begin around week 20 of pregnancy and continue intermittently until delivery.	Start at term or preterm, signaling the onset of active labor and the birthing process.
Rhythm	Irregular intervals with no predictable pattern; frequency varies randomly from minutes to hours.	Regular intervals that steadily shorten, becoming closer together as labor progresses.
Duration	Each episode lasts 30 seconds to 2 minutes, then fades without a consistent length.	Each contraction lasts 45 to 90 seconds, with duration increasing as labor advances.
Intensity	Mild, often described as a squeezing sensation that remains weak and does not escalate.	Strong to severe, building in peak force and becoming more powerful with each successive wave.
Pain Level	Usually painless or mildly uncomfortable, felt as tightness rather than sharp or cramping pain.	Painful, radiating from the back to the abdomen, with severity increasing during active labor.
Frequency	Occur sporadically, sometimes 2 to 3 times per hour, often slowing with rest or hydration.	Occur every 5 to 10 minutes early, then every 2 to 3 minutes during active labor.
Cervical Effect	Do not cause cervical dilation, effacement, or any measurable change in the cervix.	Cause progressive cervical dilation from 0 to 10 centimeters and full effacement.
Progression	Do not intensify or increase in frequency over time; they remain stable or disappear.	Steadily intensify in strength, duration, and frequency until delivery is complete.
Response to Movement	Often stop or decrease when you walk, change position, or rest your body.	Continue or strengthen with movement, walking, and position changes during labor.
Response to Hydration	Frequently subside after drinking water, as dehydration is a common trigger for them.	Do not stop with hydration; they persist regardless of fluid intake during labor.
Location of Sensation	Felt mainly in the front of the abdomen, concentrated in the lower belly region.	Felt across the entire abdomen and often radiating into the lower back and thighs.
Onset	Begin gradually and fade away slowly, without a clear starting or ending point.	Start abruptly with a distinct wave, peak, and release that is clearly perceptible.
Regularity	Irregular and unpredictable, with no consistent interval between episodes.	Regular and predictable, with a consistent interval that shortens over time.
Duration of Pattern	Usually resolve within 1 to 2 hours, especially with rest or activity changes.	Persist continuously for 12 to 24 hours or longer until the baby is delivered.
Effect on Fetus	Do not affect fetal heart rate or cause any stress to the baby.	May temporarily dip fetal heart rate during peak, then recover after each wave.
Pain Relief	Relieved by rest, warm baths, gentle massage, or changing your body position.	Require breathing techniques, epidurals, or other medical pain management methods.
Medical Significance	Considered normal and harmless, requiring no medical intervention or treatment.	Indicate labor onset, requiring hospital admission and monitoring for safe delivery.
Detection Method	Detected by palpation of the abdomen, feeling a temporary hardening of the uterus.	Detected by tocometer monitoring, which measures pressure and frequency electronically.
Time of Day	Often more noticeable in the evening or at night when the body is at rest.	Can begin at any hour, with no preference for a specific time of day.
Trigger Factors	Triggered by dehydration, a full bladder, vigorous activity, or sexual intercourse.	Triggered by hormonal changes and fetal signals that initiate the labor cascade.
Hormonal Driver	Driven by low-level oxytocin fluctuations that do not reach labor-inducing thresholds.	Driven by high-level oxytocin and prostaglandins that stimulate strong uterine contractions.
Associated Symptoms	No accompanying symptoms like water breaking, bloody show, or cervical mucus changes.	Often accompanied by water breaking, bloody show, or a mucus plug discharge.
Typical Duration	Episodes last only a few minutes and do not form a continuous labor pattern.	Labor contractions last 12 to 19 hours for first-time mothers on average.
Common Misconception	Often mistaken for real labor, causing unnecessary trips to the hospital.	Sometimes dismissed as false labor, leading to delayed hospital arrival.
Intervention Needed	None required; they resolve spontaneously without medication or medical care.	Require active management, including fetal monitoring and delivery assistance.
Post-Delivery Presence	Cease entirely after delivery, as the uterus no longer needs practice contractions.	Continue briefly after birth to expel the placenta and reduce uterine bleeding.
Best-Fit Scenario	Best suited for mid-pregnancy practice sessions that prepare muscles without delivery.	Best suited for the final stage of pregnancy, culminating in the birth of the baby.

What Is Braxton Hicks?

Braxton Hicks are sporadic, painless uterine tightening that begins around the second trimester. They prepare the uterus for labor by exercising the muscles, yet they do not cause cervical dilation or signal that childbirth is imminent.

Definition of Braxton Hicks

Braxton Hicks are intermittent, non-rhythmic contractions of the uterine myometrium that occur before true labor onset. These contractions lack the intensity, frequency, and cervical change required to classify them as active labor, serving instead as physiological practice contractions.

Key Characteristics of Braxton Hicks

Characteristic	What It Means in Practice
Irregular timing	Intervals between tightening vary widely and never form a consistent, shortening pattern.
Non-progressive intensity	Strength stays mild or fluctuates randomly instead of steadily increasing over time.
Short duration	Each episode typically lasts 15 to 30 seconds, rarely extending beyond one minute.
Localized sensation	Discomfort concentrates in the lower abdomen or groin rather than radiating from the back.
Painless or mild	Most women describe pressure or tightness, not the severe cramping of true labor.
Activity responsive	Walking, resting, or changing position often makes the tightening fade or stop entirely.
Hydration sensitive	Drinking water frequently relieves episodes because dehydration can trigger uterine irritability.
No cervical change	These contractions do not dilate or efface the cervix, confirming they are not labor.
Evening prominence	Episodes often increase in frequency during late afternoon or nighttime hours.
Third trimester peak	They become more noticeable and frequent as pregnancy progresses toward term.

Common Examples of Braxton Hicks

Post-exercise tightening – a brief, firm uterine squeeze after a short walk or light stretching session.
Dehydration episode – a hard, painless tightening that resolves within minutes of drinking a full glass of water.
Position-change response – a quick contraction that appears when rolling over in bed or standing up quickly.
Bladder pressure trigger – a mild tightening that occurs when the full bladder presses against the uterine wall.
Evening resting pattern – a series of gentle tightenings that arrive while sitting still on the couch after dinner.
Fetal movement reaction – a brief firmness that follows a strong kick or stretch from the baby inside.
Stress-induced episode – a temporary tightening that arises during a tense or anxious conversation and then fades.
Sexual activity response – a short contraction that follows orgasm due to natural oxytocin release.
Hand-on-belly observation – a visible hardening of the uterus that a partner feels when placing a palm on the abdomen.
Third-trimester practice wave – a rhythmic but non-painful tightening that lasts under a minute and stops on its own.

Advantages and Limitations of Braxton Hicks

Advantages	Limitations
Strengthens uterine muscles for the physical demands of active labor and delivery.	Cannot reliably predict when true labor will begin, offering no useful timeline to expectant mothers.
Improves blood flow to the placenta, supporting oxygen and nutrient delivery to the fetus.	Frequent episodes can cause significant anxiety, leading many women to make unnecessary emergency room visits.
Provides practice for breathing and relaxation techniques used during real contractions.	Discomfort can disrupt sleep quality, especially when episodes cluster during nighttime hours.
Helps women recognise the sensation of uterine tightening before labor actually starts.	They cannot be distinguished from preterm labor without a medical examination, creating diagnostic uncertainty.
Stimulates cervical ripening in late pregnancy, potentially easing the early stages of labor.	No evidence shows they shorten overall labor duration or reduce delivery complications in any measurable way.
Offers reassurance that the uterus is functioning normally and actively preparing for childbirth.	Intense episodes can be mistaken for real labor, causing false alarms and unnecessary hospital admissions.
Encourages increased water intake, which benefits overall maternal health and amniotic fluid levels.	They do not produce cervical dilation, so they provide zero progress toward actual delivery.
Creates natural opportunities for partners to practice comfort measures and supportive touch.	Persistent or painful variants may signal an underlying issue like placental abruption or infection.
Typically harmless and self-limiting, requiring no medical intervention or pain medication.	Cannot be used as a training metric because their frequency and intensity vary unpredictably between pregnancies.
Helps the uterus maintain tone, reducing the risk of postpartum hemorrhage after delivery.	They offer no reliable warning system for preterm labor, giving women a false sense of security.

What Is Contractions?

Contractions are rhythmic tightenings of the uterine muscle that occur during labor. They work to efface and dilate the cervix, pushing the baby downward through the birth canal. Each contraction peaks, holds, and releases, creating the force needed for childbirth.

Definition of Contractions

Contractions are periodic, involuntary muscular spasms of the uterus characterized by a wave-like tightening that begins in the fundus and spreads downward. They increase in frequency, duration, and intensity as labor progresses, serving to expel the fetus and placenta from the uterine cavity.

Key Characteristics of Contractions

Characteristic	What It Means in Practice
Rhythmic pattern	They arrive at predictable, regular intervals that steadily shorten as labor advances.
Increasing intensity	Each wave grows stronger than the last, peaking before gradually easing off.
Cervical change	They cause measurable effacement and dilation, which midwives verify via examination.
Duration of wave	Each contraction typically lasts 30 to 70 seconds from start to full release.
Frequency interval	They occur every 2 to 5 minutes during active labor, leaving brief rest gaps.
Location of pain	Discomfort starts in the lower back and wraps around to the lower abdomen.
Unstoppable onset	They continue regardless of rest, position change, or hydration, unlike false labor.
Peak plateau	Intensity builds to a sustained high point before the muscle relaxes completely.
Progressive nature	They do not fade; they escalate until delivery is complete.
Associated urge	Late-stage contractions trigger an involuntary pushing reflex in the mother.

Common Examples of Contractions

Early labor contractions – mild, irregular waves every 5-20 minutes that last 30-45 seconds, causing gradual cervical dilation to 3 cm.
Active labor contractions – strong, regular waves every 3-4 minutes lasting 45-60 seconds, dilating the cervix from 4 to 7 cm.
Transition contractions – intense, overlapping waves every 2-3 minutes lasting 60-90 seconds, completing dilation from 8 to 10 cm.
Pushing contractions – powerful surges that accompany the maternal urge to bear down, guiding the baby through the pelvis.
Placental contractions – milder waves that occur after birth to detach and expel the placenta from the uterine wall.
Postpartum contractions – cramping waves in the days after delivery that shrink the uterus back to pre-pregnancy size.
Induced labor contractions – waves triggered by synthetic oxytocin (Pitocin) when natural labor fails to start or progress.
Augmented contractions – strengthened waves achieved by increasing Pitocin dosage when existing contractions are too weak.
Back labor contractions – waves felt predominantly in the lower spine, often linked to the baby facing the mother's front.
Prodromal contractions – real, painful waves that dilate the cervix slightly but then stall, lasting for days without true progress.

Advantages and Limitations of Contractions

Advantages	Limitations
They drive cervical dilation, the essential mechanical step for vaginal delivery to occur.	They cause severe, often overwhelming pain that many women cannot tolerate without analgesia.
They compress placental blood vessels briefly, which protects the baby from sudden blood loss during birth.	They can reduce oxygen supply to the fetus during each peak, risking fetal distress in compromised pregnancies.
They signal clear, unmistakable labor onset, giving women a reliable cue to head to the hospital.	They can exhaust the mother physically, leading to maternal fatigue that slows further progress.
They help position the baby's head into the optimal occiput-anterior alignment for descent.	They may become dysfunctional or uncoordinated, failing to dilate the cervix despite hours of effort.
They trigger the Ferguson reflex, releasing oxytocin that strengthens subsequent contractions naturally.	They can cause uterine hyperstimulation when induced, raising the risk of uterine rupture.
They shorten the cervix through effacement, a prerequisite for complete dilation.	They cause referred pain in the back and thighs, which persists even between contraction peaks.
They compress the baby's chest during delivery, helping clear amniotic fluid from the newborn's lungs.	They can be artificially prolonged by Pitocin, creating contractions that are stronger but less effective than natural ones.
They provide measurable progress markers that clinicians use to assess labor stage and timing.	They do not guarantee successful vaginal birth; many women still require cesarean delivery despite strong contractions.
They promote the release of catecholamines in the baby, aiding postnatal adaptation and alertness.	They can cause maternal blood pressure spikes, particularly dangerous for women with preeclampsia.
They naturally separate the placenta from the uterine wall, reducing the risk of retained placenta.	They offer no benefit in preterm labor, where they represent a dangerous complication requiring urgent suppression.

Similarities Between Braxton Hicks and Contractions

Shared Aspect	How Braxton Hicks and Contractions Are Alike
Uterine muscle activity	Braxton Hicks and contractions both involve the uterus tightening and relaxing its muscle fibers.
Primary body system	Both Braxton Hicks and contractions originate from the reproductive system during pregnancy.
Physical sensation	Braxton Hicks and contractions both produce a noticeable tightening or hardening feeling in the abdomen.
Natural bodily process	Braxton Hicks and contractions are both natural physiological events that occur without external intervention.
Hormonal influence	Both Braxton Hicks and contractions are triggered and regulated by pregnancy-related hormones like oxytocin.
Duration measurement	Braxton Hicks and contractions are both measured in seconds to track how long each episode lasts.
Frequency tracking	Both Braxton Hicks and contractions are monitored by counting how many occur within a specific time frame.
Intensity assessment	Braxton Hicks and contractions both vary in strength and are evaluated on a scale of mild to strong.
Location of sensation	Braxton Hicks and contractions both create feelings that radiate across the front of the lower abdomen.
Pregnancy stage	Both Braxton Hicks and contractions can occur during the second and third trimesters of pregnancy.
Non-invasive monitoring	Braxton Hicks and contractions are both observed externally without needing internal medical devices.
Maternal awareness	Braxton Hicks and contractions both require the pregnant person to consciously notice and report the sensations.
Healthcare communication	Both Braxton Hicks and contractions are discussed with midwives or doctors during prenatal checkups.
Pain scale variability	Braxton Hicks and contractions both range from completely painless to noticeably uncomfortable for different individuals.
Time-based patterns	Braxton Hicks and contractions both follow a temporal pattern that can be charted over hours.
Abdominal hardening	Both Braxton Hicks and contractions cause the uterine wall to become firm and tense to the touch.
Relaxation phase	Braxton Hicks and contractions both include a distinct period where the uterus softens after the peak.
Activity influence	Braxton Hicks and contractions are both affected by the mother's physical activity level and position.
Hydration sensitivity	Both Braxton Hicks and contractions can be influenced by the mother's overall hydration status.
Breathing techniques	Braxton Hicks and contractions both respond well to controlled breathing and relaxation methods.
Comfort measures	Braxton Hicks and contractions are both eased by changing position, walking, or resting.
Normal pregnancy sign	Both Braxton Hicks and contractions are considered standard, expected events in a healthy pregnancy.
No fetal harm	Braxton Hicks and contractions both do not directly harm the baby when they occur normally.
Self-limiting episodes	Braxton Hicks and contractions both eventually stop on their own after a finite period of time.
Documentation practice	Both Braxton Hicks and contractions are commonly recorded in a journal or app by expectant mothers.
Partner involvement	Braxton Hicks and contractions both often involve a partner helping with timing and comfort support.
Medical triage trigger	Braxton Hicks and contractions both prompt a call to a healthcare provider when patterns change significantly.
Uterine blood flow	Both Braxton Hicks and contractions temporarily affect blood flow through the uterine muscles.
Post-episode recovery	Braxton Hicks and contractions both leave the mother feeling tired or relieved after the episode passes.
Pre-labor preparation	Braxton Hicks and contractions both help the uterine muscles practice for the eventual birth process.

Braxton Hicks or Contractions: Which Should You Choose?

You do not choose either; your body decides. The single variable that separates them is cervical change. Real contractions dilate the cervix; Braxton Hicks do not. Time them for one hour to identify the pattern before deciding next steps.

When to Use Braxton Hicks

Choose Braxton Hicks when contractions are irregular, short, and fade with movement or rest. They occur before 37 weeks, stop when you change position, and never grow stronger. Use them as practice signals to hydrate, empty your bladder, and monitor without rushing to the hospital.

When to Use Contractions

Choose Contractions when pain follows a regular rhythm of five-minute intervals lasting 60 seconds for one hour. They intensify with walking, persist despite rest, and feel like waves radiating from the lower back. This pattern signals active labor, so contact your provider and prepare for delivery.

Common Misconceptions About Braxton Hicks and Contractions

Common Myth	The Reality
Braxton Hicks are just weak contractions that do nothing at all.	Braxton Hicks do real work by increasing blood flow to the placenta and toning uterine muscles, but they never dilate the cervix.
Real contractions always start in the lower back and radiate forward.	Contractions typically begin in the upper uterus and move downward, while back pain is only one possible location for true labor pain.
Drinking water will stop true labor contractions every single time.	Hydration stops Braxton Hicks because dehydration triggers them, but true contractions continue regardless of fluid intake and cervical change.
Braxton Hicks are always painless and barely noticeable to pregnant women.	Braxton Hicks range from mild tightness to genuinely uncomfortable pressure, and some women find them quite painful in the third trimester.
If contractions are irregular, they cannot possibly be real labor.	Early true contractions are often irregular for hours before becoming consistent, so irregularity alone does not rule out active labor.
Braxton Hicks only happen during the third trimester of pregnancy.	Braxton Hicks can begin as early as the second trimester around week 20, though most women only notice them after week 28.
Real contractions always feel like intense menstrual cramps in the lower abdomen.	Contractions feel differently for each woman, including tight bands across the belly, deep pelvic pressure, or a dull ache in the thighs.
Walking always makes Braxton Hicks go away and makes real contractions stronger.	Walking often stops Braxton Hicks but does not reliably strengthen true contractions; some women find walking actually eases early labor discomfort.
Braxton Hicks can cause the cervix to dilate if they happen frequently.	Braxton Hicks do not efface or dilate the cervix, whereas true contractions produce measurable cervical change over time.
A contraction that lasts longer than one minute is always a true labor contraction.	Braxton Hicks can occasionally last over a minute, but true contractions lasting 60 to 90 seconds are a stronger labor signal.
You cannot feel Braxton Hicks if you are lying down or resting quietly.	Braxton Hicks often become more noticeable when you rest, because movement and position changes can temporarily suppress them.
True contractions always hurt enough to stop you from talking or walking.	Early true contractions are often mild and manageable, and many women talk and walk normally until active labor intensifies.
Braxton Hicks are completely harmless and never require any medical attention.	Frequent, regular Braxton Hicks before 37 weeks may signal preterm labor and require evaluation by a healthcare provider.
Real contractions follow a perfect pattern like clockwork from the very first one.	True contractions often start irregular and gradually become more rhythmic, so a messy pattern early on is completely normal.
Braxton Hicks feel exactly the same at 20 weeks as they do at 39 weeks.	Braxton Hicks intensity and frequency increase as pregnancy progresses, with later ones feeling stronger and more frequent.
If you have had Braxton Hicks, you will definitely know when real labor starts.	Many women struggle to distinguish Braxton Hicks from early true contractions, especially during a first pregnancy without prior reference.
Contractions only happen in the abdomen and never cause pain in other body areas.	True contractions can radiate pain to the lower back, hips, thighs, and groin because uterine nerves connect to those spinal regions.
Braxton Hicks stop completely if you change your position or activity level.	Changing position often relieves Braxton Hicks, but some continue regardless of movement, especially in late pregnancy.
Real contractions always get closer together and never spread back out again.	True contractions can temporarily space out during early labor, though overall they trend closer, longer, and stronger over hours.
Braxton Hicks are caused by the baby moving or kicking inside the womb.	Braxton Hicks are uterine muscle contractions, not fetal movements, though baby activity can sometimes trigger a tightening episode.
Contractions feel like a constant, unrelenting pain without any breaks.	True contractions have a distinct peak and release, with pain building, climaxing, and fading rather than remaining constant.
Braxton Hicks only occur at night and never during the daytime hours.	Braxton Hicks happen any time, though they feel more noticeable at night when you are still and less distracted by daily activity.
Having many Braxton Hicks means you will have an easier or faster labor.	Frequent Braxton Hicks do not predict labor duration or intensity, as uterine practice contractions are unrelated to delivery speed.
True contractions always cause the cervix to dilate at a steady, predictable rate.	Cervical dilation with true contractions varies widely, including stalled progress for hours, before suddenly advancing several centimeters.
Braxton Hicks are a sign that something is wrong with the pregnancy.	Braxton Hicks are a normal physiological function, and experiencing them does not indicate fetal distress or pregnancy complications.
You can time contractions accurately using only your own internal sense of time.	Manual timing is unreliable because pain distorts time perception, so use a stopwatch or contraction app for accurate interval measurement.
Braxton Hicks never happen in women who have had a previous pregnancy.	Braxton Hicks often feel stronger and start earlier in subsequent pregnancies because uterine muscles retain memory from prior births.
Real contractions always require immediate hospitalization the moment they begin.	Early true contractions often last hours at home, and hospitalization is only needed when contractions meet the 5-1-1 rule or water breaks.
Braxton Hicks are the same thing as preterm labor contractions.	Braxton Hicks do not change the cervix, while preterm labor contractions cause dilation and effacement before 37 weeks gestation.
Contractions are always felt in the front of the belly and never in the back.	Back labor contractions cause intense lower back pain, often from the baby facing posterior, and feel distinctly different from frontal cramps.

Conclusion

Difference Between Braxton Hicks and Contractions comes down to rhythm and progression. Braxton Hicks are irregular, painless, and fade with movement. True contractions grow longer, stronger, and closer together. Pick Braxton Hicks when timing stays erratic; pick contractions when intervals shorten steadily and pain intensifies.

## FAQ ### What is the main difference between Braxton Hicks and contractions? The main difference is that Braxton Hicks are irregular, painless practice tightenings that do not change the cervix, while true contractions are regular, increasingly painful waves that dilate the cervix and signal labor. ### Are Braxton Hicks contractions real contractions? No, Braxton Hicks are not real contractions because they only tighten the uterine muscle temporarily without causing cervical dilation, effacement, or the progressive labor pattern that true contractions produce. ### Which is more painful, Braxton Hicks or real contractions? Real contractions are significantly more painful because they involve stronger, coordinated uterine waves that intensify over time, whereas Braxton Hicks are typically mild, painless, or just uncomfortable and never escalate in severity. ### Do Braxton Hicks cost anything to treat or manage? No, Braxton Hicks cost nothing to treat because they resolve on their own with simple home measures like changing position, drinking water, or resting, unlike true labor which requires hospital delivery and medical care. ### Are Braxton Hicks safe for the baby? Yes, Braxton Hicks are safe for the baby because they are normal, harmless practice contractions that do not reduce oxygen supply or trigger early delivery, though you should contact your doctor if they become regular or painful. ### What is the biggest mistake women make with Braxton Hicks? The biggest mistake is mistaking Braxton Hicks for real labor and rushing to the hospital too early, which leads to a false alarm, whereas ignoring true contractions can cause a dangerously late arrival for delivery. ### Can Braxton Hicks and contractions be used interchangeably? No, Braxton Hicks and contractions cannot be used interchangeably because they describe different physiological events, with Braxton Hicks being non-labor practice tightenings and contractions being the active force that delivers the baby. ### How can I tell Braxton Hicks from real contractions in real life? In real life, time your tightenings and change your activity, because Braxton Hicks stop or fade with movement or rest, while true contractions continue regardless of position and grow longer, stronger, and closer together. ### Can I switch from having Braxton Hicks to real contractions suddenly? Yes, you can switch from Braxton Hicks to real contractions suddenly because the practice tightenings can transition directly into active labor at any time, so you must monitor for a regular pattern of increasing intensity and frequency. ### When should I worry that Braxton Hicks have become real contractions? You should worry when your tightenings become regular, arrive every five minutes for an hour, grow more painful, or come with fluid leakage or bleeding, because those signs indicate true labor has begun and you need medical evaluation.