What Causes My Belly to Feel Hard and Tight?

If you're in your second or third trimester of pregnancy and you notice that sometimes your pregnant belly gets very hard, feels tight, and even causes mild discomfort, you're probably experiencing Braxton-Hicks contractions. These kinds of contractions, which are also called "practice contractions" or "false contractions" (because they can falsely cause a parent to think they are in labor), do not follow a pattern or cause pain like labor contractions, but may help prepare the uterus leading up to labor. 

Braxton-Hicks contractions are named after Dr. John Braxton Hicks, an obstetrician from England who practiced in the mid- to late 1800s. Braxton Hicks observed that, "after many years’ constant observation, I have ascertained it to be a fact that the uterus possesses the power and habit of spontaneously contracting and relaxing from a very early period of pregnancy."

Braxton-Hicks Contractions: What You Need to Know

What: Practice/warm up contractions that do not cause or signal labor, or dilate the cervix

When: Second or third trimester; usually felt/noticed earlier in the second trimester for subsequent pregnancies

Where: Usually in the upper to mid abdomen, in the front of your mid-section

Why: While we don't know for certain the cause or purpose of Braxton-Hicks, it is believed to be a way to help prepare the uterus for eventual labor and birth. In basic terms, the uterus is a muscle and muscles can contract when irritated. 

Who: People who are pregnant, though not everyone will experience Braxton-Hicks contractions during pregnancy

How: Braxton-Hicks contractions are usually felt as a tightening and a hardening of the abdomen (the uterus). They usually last only 20-30 seconds and may happen throughout the day without a regular pattern. They may cause discomfort or feel difficult to move or bend over during. 

What Triggers Braxton-Hicks Contractions?

When you pay attention to Braxton-Hicks contractions long enough, you will likely begin to notice that they are routinely triggered by certain activities, including:

• Movement after being still, or exercise
• A full bladder, or after emptying your full bladder when you pee
• Orgasm or various sexual acts
• When your baby is moving around a lot 
• If you are dehydrated
• If your belly has been touched, bumped, or manipulated in some way
• "Overdoing it" -- too much activity throughout the day

What Can You Do About Braxton-Hicks Contractions?

The short answer is: nothing. Even if it was possible to remove all of the triggers listed above, you would likely still have them. The good news is that BH contractions are generally short -- they're over before you know it and you're not out too much time or energy. If you have a Braxton-Hicks contraction that feels particularly uncomfortable or are having them frequently, you can try a few remedies to alleviate them, including:

• Drink water to rehydrate
• Take a warm bath
• Rest -- lay down, sit down 
• De-stress in a way that works best for you

When Should You Be Concerned About Braxton-Hicks Contractions?

The headline above is misleading -- Braxton-Hicks contractions are not concerning. It's when a Braxton-Hicks contraction is not a Braxton-Hicks contraction that causes concern or a change in what is happening. If you have contractions that come with any of the following signs, contact your OB, midwife, or doctor, as these signs may signal the beginning of labor:

• Regularity and longer lasting - forming a noticeable pattern
• Regularity/pattern before 38 weeks - preterm labor
• Growing stronger in intensity
• Pain
• Bleeding
• Fluid leakage
• Blood tinged mucous
• Cramping or lower back ache that is constant or comes in regular waves

Braxton-Hicks contractions can be annoying and inconvenient, but generally do not cause problems or pain. It is important to know the signs and symptoms of true labor, and how to distinguish BH contractions from labor contractions. One of the best ways to get educated about that is to take a childbirth class during pregnancy. Childbirth classes teach everything from the basics of recognizing labor to the details of coping with labor pain and the many choices you will have to make surrounding your birth, postpartum, and early parenting. Childbirth classes are worth your time, money, and effort! 

References

BMJ: ADC Fetal & Neonatal Edition; "John Braxton Hicks (1823–97) and painless uterine contractions";  https://fn.bmj.com/content/81/2/F157 

American Pregnancy; "Braxton Hicks Contractions"; http://americanpregnancy.org/labor-and-birth/braxton-hicks/

The Bump; "What Are Braxton Hicks Contractions?"; https://www.thebump.com/a/braxton-hicks-contractions

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