As a pregnant woman approaches her due date, she may begin to feel tightening or contractions in her abdomen. This tight feeling across the stomach is a common sign of early labor. However, stomach tightening can also occur during pregnancy without signaling the start of labor. Distinguishing true labor contractions from other types of tightening requires knowing what to look for.
What causes tightening in the stomach during pregnancy?
There are a few different causes of abdominal tightening during pregnancy:
Braxton Hicks contractions
Braxton Hicks contractions, also known as false labor, are episodes of tightening in the abdomen that occur during pregnancy. They are essentially practice contractions that prepare the uterus for true labor. Braxton Hicks contractions often begin around 6 weeks of pregnancy, but are more commonly noticed in the second or third trimester.
Characteristics of Braxton Hicks contractions:
- They occur infrequently and irregularly.
- They do not increase in intensity or frequency.
- They are not typically painful.
- They may be more noticeable when dehydrated.
- They often go away with rest or hydration.
Braxton Hicks contractions may tighten the stomach temporarily but do not lead to labor or cause the cervix to dilate.
Round ligament pain
As the uterus grows during pregnancy, it stretches the large ligaments called round ligaments that support the uterus. This stretching can cause occasional brief, sharp pain on one or both sides of the lower abdomen.
Characteristics of round ligament pain:
- Occurs during sudden changes in position or movement.
- Feels like a short stabbing or shooting pain.
- Usually lasts only seconds to minutes.
- Most common during second trimester.
Round ligament pain may cause tightness or discomfort on the sides of the abdomen, but it is not related to the onset of labor.
Urinary tract infections
Urinary tract infections (UTIs) are common during pregnancy due to hormonal changes and increased pressure on the bladder from the growing uterus. UTIs can cause a constant tight, cramping feeling low in the abdomen.
Characteristics of UTI abdominal pain:
- Usually described as cramping or aching.
- Often focused in the area over the bladder.
- May be associated with stinging urination.
- Typically constant, not coming and going.
A UTI requires medical treatment but does not signal preterm labor.
Gas pains or constipation
Gas and constipation are very common discomforts during pregnancy. The pressure from gas buildup or stool in the colon can cause tightness or cramping low in the abdomen.
Characteristics of gas or constipation:
- Pain comes and goes and may change locations.
- Discomfort is often relieved by passing gas or having a bowel movement.
- No other signs of labor are present.
These digestive issues can cause abdominal discomfort but are not signs of labor beginning.
How are true labor contractions different?
True labor contractions feel significantly different from the various causes of abdominal tightness in pregnancy. Here are the key characteristics of true labor contractions:
Increase in strength and frequency
As labor begins, the contractions start out mildly painful and spaced widely apart. As labor progresses, the contractions become progressively stronger, longer, and closer together. False labor contractions do not increase and intensify in this manner.
Rhythmic pattern
True labor contractions occur in a regular, rhythmic pattern, rather than being random. They start softly, then peak in intensity, before fading again. Time how long each contraction lasts – they will follow a set pattern.
Location
Labor contractions tighten the top and sides of the uterus, spanning from the belly button down. This differs from digestive cramps or UTI pain that are normally focused low in the pelvic area.
Effect on cervix
Only true labor contractions dilate and efface (thin out) the cervix. If you are full term, you provider can check your cervix to see if changes are occurring during the contractions.
Can’t talk during contractions
True labor contractions are painful enough that most women cannot talk during the peak of contraction. For false labor, you may be able to converse normally.
Other labor signs present
Look for additional signs of labor such as bloody show (passing of mucus plug), rupture of membranes (water breaking), and pelvic pressure. If other signs of labor occur along with the tightening, it likely represents true labor.
When to call the provider
It can be hard to know if tightening and contractions truly signal the onset of labor. Call your obstetric provider if you experience any of the following:
- Painful contractions that become longer, stronger, and closer together
- Contractions every 5 minutes or less
- Contractions that do not go away with hydration and rest
- Additional signs of labor like pelvic pressure or bloody show
- Any concerns about the baby’s movements
Your provider can monitor your contractions and confirm if you are in true labor. Do not wait until the contractions are extremely painful before calling.
Coping techniques for contractions
If you start having regular contractions that may indicate early labor, try these coping techniques at home to ease discomfort:
- Take a warm bath or shower
- Do light walking
- Practice breathing exercises
- Have your partner provide a massage
- Use positions like rocking, swaying, or being on all fours
- Drink plenty of fluids
- Urinate frequently
Pain medications can often be avoided in early labor if you use these natural techniques. Change positions, stay hydrated, and try to relax muscles between contractions.
When to go to the hospital
Most providers recommend waiting to go to the hospital until:
- Contractions are under 5 minutes apart
- Contractions do not ease up with position changes
- Contractions prevent you from speaking during them
- You have bloody show or ruptured membranes
Arriving too early at the hospital may mean you are sent home if you are not sufficiently progressed in labor. Follow your provider’s guidance on when you should come in based on your contractions and other symptoms.
Conclusion
Tightening and contractions in the abdomen are common discomforts as labor approaches. However, not all abdominal tightness indicates true labor is starting – issues like Braxton Hicks, round ligament pain or digestion can also cause sensations of tightness.
True labor contractions become progressively stronger, longer, closer together and more rhythmic. Additional labor signs and cervical changes also occur with true contractions. While any abdominal tightening should be mentioned to your provider, regular painful contractions that fit a labor pattern are the most significant sign that delivery may be imminent. Stay in touch with your obstetrician, time your contractions, and utilize coping techniques to determine if your tightening sensations may be early labor beginning.
| Type of Tightening | Key Characteristics | Labor? |
|---|---|---|
| Braxton Hicks contractions | Irregular, infrequent, non-painful | No |
| Round ligament pain | Brief stabbing sensation, changes with movement | No |
| UTI | Constant cramping, stinging with urination | No |
| Gas or constipation | Intermittent, relieved with passing gas or stool | No |
| True labor contractions | Increase in strength, rhythm, despite position changes | Yes |
When to call the provider
Contact your healthcare provider right away if you have any of the following symptoms:
- Contractions that are increasing in strength and frequency
- Contractions that are less than 5 minutes apart
- Contractions that do not ease up with hydration and rest
- Additional signs of labor such as bloody show or ruptured membranes
- Decreased fetal movement
- Any other concerning symptoms
Your obstetric provider can help determine if your contractions and abdominal tightening are signs of true labor beginning. Do not wait until contractions are extremely painful before calling.
Coping techniques for labor
If you start having regular contractions that may be labor, try these coping techniques:
- Warm shower or bath
- Light walking
- Breathing exercises
- Massage from partner
- Positions like swaying, rocking, hands and knees
- Staying hydrated
- Frequent urination
These natural techniques can often help manage discomfort in early labor. Changing positions, relaxing between contractions, and sipping fluids are most helpful.
When to go to the hospital
Most providers suggest waiting to go to the hospital until:
- Contractions less than 5 minutes apart
- Contractions are extremely painful
- Unable to talk during contractions
- You have bloody show or broken water
Going to the hospital too early may mean being sent home if not progressed enough. Follow your provider’s guidance on when to come in based on your particular symptoms.