How much do contractions really hurt? Ways to cope!

Updated: Apr 20

Let’s learn about contraction discomfort, you can do this! Watch the YouTube Video Here

  • How does a contraction feel?

  • What are braxton hicks and how do I know if my contractions are real or fake?

  • When and how to start timing contractions?

  • How can I support my partner during contractions?

  • I’m scared of the intensity of labor and contractions, what can I do to cope?

These are some of the questions I’m most commonly asked or that I hear. Have no fear, the doula is here!

This is me, mid contraction, about 8-9cm dilated.

Hi, I’m Charda, a mom, doula and lactation consultant in San Diego, California and I love teaching families how to have a more healthy and positive pregnancy, birth, parenting & breastfeeding experience! My focus is on empowering Black moms, babies and families to be resilient, informed and protected on their life journey!

We will learn:

Feel free to click on the titles to skip straight to what you need. To jump to the summary click here. Check throughout the blog for many freebies to add to your birth plan!

Contractions don’t have to be scary, think of these intense ‘period cramps’ as waves or surges that bring you closer to seeing your baby’s sweet face! Once you learn why contractions happen, the difference between real and false labor as well as how to cope with labor pains and discomforts, you will be well on your way to a more peaceful birthing experience through knowledge. You will feel more confident and empowered to surf the waves during birth! The average length of pregnancy is 40 weeks. But there is no way to know exactly when you will go into labor. Most people give birth between 38 and 41 weeks of pregnancy. The more you know about what to expect during labor, the better prepared you will be once it begins. No one knows exactly how labor begins, it's mostly speculated to begin with hormonal changes. As labor begins, the cervix will dilate (open) the uterus muscles will contract at regular intervals . When the uterus contracts the belly gets hard, between the contraction the uterus and cervix will soften and relax. Certain changes may signal that labor is beginning and these changes include one or all of the following:

  • Lightening - This is the sensation that the fetus has dropped lower and the head settles deep in your pelvis. Because the fetus isn’t pressing on your diaphragm, you may feel “lighter.” Lightening can happen anywhere from a few weeks to a few hours before labor begins.

  • Loss of the mucus plug - A thick mucus plug forms at the cervix during pregnancy. When the cervix begins to dilate several days before labor begins or at the start of labor, the plug is pushed into the vagina. You may notice an increase in vaginal discharge that is clear, pink, or slightly bloody. Some will expel the entire mucus plug.

  • Rupture of membranes - When the fluid-filled amniotic sac that surrounds the fetus during pregnancy breaks, it is called the rupture of membranes. This is also referred to as your “water breaking.” You may feel this as fluid that trickles or gushes from your vagina. If your water breaks, call your OB-GYN or midwife.

  • Contractions - Labor contractions happen in a regular pattern and get closer together over time.

You might or might not notice some of these changes before labor begins.

What are contractions & how do they feel?

One of the most commonly asked questions in my private childbirth education classes. As your uterus contracts, you may feel pain in your back or pelvis and this pain is similar to menstrual cramps. Contractions are your body’s way of helping your baby travel through the birth canal. Less than optimal positioning of the baby can lead to the body can lend to some pretty gnarly back labor, like I had with my first born. Contractions are an important part of the normal physiologic process of birth to unfold naturally. The body must continue contracting for the duration of the labor, and if at any point your body or baby takes a break or contractions slow down, there are ways to help stimulate them to start back up.

For many folks, building contractions are the most uncomfortable part of laboring, but once you understand them and why it’s happening, this makes you deal with it a bit more positively which helps promote a happy healthy birth. For a first time birth giver, 12 to 18 hours is an average labor time, after the first baby the subsequent labors are typically shorter around 8-10 hours, but every birthing person is different. Your labor may not be like your mother’s, your sister’s, or your friend’s labor. It may even be different with each child you have. Labor and delivery usually follow a pattern. An average first stage of labor lasts around 8 hours but during that time, only about 20% of that time will be uncomfortable and about 80% of the rest of the time you’re ok with little to no discomfort. The peak of the contraction is the hardest part, it’s only 10-20 seconds and out of that percentage it’s only about 7-8% of the total 8 hours. So for that 20 seconds that’s when you want to ride the wave. I like to use the analogy of waves in the ocean, you and your baby are the vessel that moves through that water and together you can ride that wave of the contraction. As the contraction rises to the top, when the wave is at it’s highest point, this is when we want to focus on our breath. I love this visual explanation from Bloomlife on what happens during a contraction.

How do I know if my contractions are real or fake?

Grab my free true vs false labor handout click here to download!

Braxton Hicks are false contractions that can happen for many weeks before real labor begins. These “practice” contractions can be painful for some and can make you think you are in labor when you are not. You might notice them more at the end of the day when you are winding down. First you want to know the 5-1-1 rule to decide where you might be in the process. 5-1-1 is an easy way to remember contractions being 5 mins apart or less AND contraction is lasting 1 min or longer AND this has been happening for 1 hour or longer, this would be signs of true labor.

You should call your doula or midwife to ask for more guidance. Sporadic uterine muscle activity is likely false labor while Synchronized or Rhythmic and somewhat predictable patterns of uterine muscle activity is likely true labor. False contractions will subside with position or activity change, may be uncomfortable, and can help tone the uterus. Real contractions usually start in the back and move to the front, they become more intense as time passes and will have their own rhythm and there will always be consistent waves with real labor. Not every pregnant person experiences these false labor pains, named after British gynecologist John Braxton Hicks. These practice mini contractions may not seem to be accomplishing anything, but they are actually believed to be helpful in preparing your body for labor.

When to start timing contractions?

As soon as you have noticed they don’t stop coming! Or if you are unsure, try the 5-1-1 rule to see how far into it you get, have an app--I use this one, but here is a link to a reviews for a. few for both Android and iOS. If no partner is around, call your doula and ask if they can help you count them by phone or text. I have my clients send me a pregnant bump emoji every time they start and end a contraction, we do this for one hour, then we can decide what are next steps or options. From the beginning of one contraction to the end of the contraction is the duration of the contraction. The time in between from the end of one contraction to the start of another contraction is the interval length between your contractions, which will vary slightly. It may look something like this:

How to Time Contractions - Free Cheat Sheet Here & Contraction Log for Partners

  • Make a note of the time when your first contraction starts (time it is)

  • Write down how long the contraction lasts (duration)

  • Then mark the length of time from the start of the contraction to the start of the next one (frequency)

  • Keep noting these times for at least an hour to see if there is a pattern, and to see if the contractions are getting closer together.

If that time is 5 mins or less it’s time to head out or call the midwife. You want to start timing these as soon as you notice a pattern. Ask your birth partner, call or text your doula, or bust out an old fashioned pen and paper or an app if you prefer technology, then start timing for one whole hour, no matter where you are in the day/night or hour itself. If you notice after one hour you have had several contractions lasting 5 mins or less lasting for 1 minute or longer in length for the wave, then you are having a baby!

How can I support my partner during contractions?

Free Partner Support Handout Download Here

Ask them what they need, between the contractions. Use what you know, you are the closest person to them in the room. All else fails, if you have a doula ask them what to do, we love teaching partners!

Be silent but present during the contraction, tune in to their body language, follow their lead, provide positive distraction of laughter or gentle casual chatting–this is not the time to bring up negative or stressful things like bills or other life stressors.

If they respond well to it, provide lots of encouragement, be the hype man or woman!

Cheer them on and let them know how amazing, beautiful and powerful their body is during that time.

Water can help reduce the discomfort of contractions, so drawing them a warm bath or getting in the shower with them may promote relaxation to relieve crampy feelings. Turn on some light fun music like Afrobeats or Bob Marley, it can boost the mood and raise oxytocin levels to help ease pain. Ask them if the music is ok and if they’d like it lowered or if they have any requests.

Go Time Handout Download Here

When will it end?

Contractions have been going for hours and for some days, so once the baby is born you are thinking no more contractions, not just yet. You must also birth the placenta by pushing it out with those contractions that are lingering around for that very reason. It is important for the placenta to be delivered intact as retained placenta can lead to serious medical conditions. The amazingly stunning organ that your body grew to grow a human, can then be saved and kept if you’d like (you must arrange it yourself) or the birth location will discard it or donate it to research. If your contractions are not strong enough to deliver the placenta, they should ASK if you are ok with a shot of pitocin, usually in the thigh, and it will help start the process for a bit to help the placenta detach from the uterine wall. You will still have some mild cramping as you breastfeed too, which is good because it helps your uterus go back down to its previous size. Skin to skin is a great practice to incorporate into your early days and weeks routine to help regulate not just the baby but your body too!

Warning Signs

If you think you are in labor (or are not sure), call your ob-gyn or midwife. You should go to the hospital if you have any of these signs:

  • Your water has broken and you are not having contractions, no matter how far along

  • You are bleeding heavily from your vagina

  • You have constant, severe pain with no relief between contractions, non stop pain

  • You notice the fetus is moving less often or not at all

Interventions & Signs of Contraction Progress:

With all these contractions how do I know if I’m dilating?

It's normal for birthing folks to constantly ask how far dilated they are without realizing that isn't everything and the work that needs to happen for dilation to occur. Baby needs to be well positioned and touching the cervix with steady strong contractions. The most common way in the medical facilities is with a cervical check which requires fingers to be inserted into the vagina to assess for centimeters of cervical change and effacement or ripeness of the cervix. If you really can’t get with the idea of this, it’s a lot, or have been through trauma and would rather avoid or limit, that is all possible!

A few other ways medical professionals can check for dilation without entering are:

The booty line test - purple-ish on light skin and silver on darker skin, becomes more prominent as labor progresses like your contractions and everything else and that cute linea nigra on the belly.

Intuition - The birth giver knows their body best, you can just trust it and let it unfold to know when progress is happening

Diamond dilation - The Rhombus of Michaelis. As the sacrum moves outwards to make space, you may see this diamond shape, which means the baby is coming very soon! We know it’s happening when the woman’s hands reach upwards (to find something to hold onto, her head goes back and her back arches. It’s what Sheila Kitzinger (1993) was talking about when she recorded Jamaican midwives saying the baby will not be born ‘till the woman opens her back’. To avoid pelvic floor damage be in an upright position with your weight well forwards so that the rhombus or diamond is free to move.

According to Midwife Jean Sutton, Epidurals are great for pain relief but they interfere with spontaneous second stage and vaginal birth. In many cases, the reason birthing folks get an epidural is because the baby likely wasn’t in the best fetal positioning when labor started, a baby in a less optimal position needs all the space to turn around in. An OP (occiput posterior) baby needs the rhombus of Michaelis to move backwards so he has room to turn round so he can come out as an OA (occiput anterior) baby. Midwife Jean cites a number of examples of ways in which the rhombus can be effectively prevented from helping the pelvis to open:

  • If birth givers are on their back with their legs up, then their strong gluteal muscles prevent the rhombus from moving backwards.

  • If a birth giver has the hands behind their knees and is pulling legs up towards the tummy, the rhombus is also prevented from moving.

  • If an epidural is in place, the nerve supply is interfered with so that the impulse for it to happen is obstructed.

Noise - The louder you become with your humming or deep chants is also a good indicator of progress, listen and watch body language.