Your guide to contractions: What to expect in labor

An OB/GYN advises how to tell the difference among false, true and premature labor

Your guide to contractions: What to expect in labor

During your labor, you may experience contractions in a variety of ways. Labor by definition is the tightening of the uterus that causes cervical change. Signs of labor include vaginal bleeding or a gush of fluid which may be water breaking. Women who have been more active or dehydrated may contract uncomfortably, a situation that should resolve with rest and hydration. You should contact your health care provider if you are concerned about fetal movement. You should also do so if you are unsure about your contractions overall.

In this guide to contractions, you can learn more about what to expect.

False labor

Braxton-Hicks contractions, also known as false labor, are like practice contractions. These contractions do not cause thinning or stretching of the cervix and are usually felt as tightening or mild discomfort. The pain tends to be felt in the upper stomach rather than in the back or lower stomach.

True labor

True labor contractions are painful and regular, getting more strong and frequent over time. They should get closer together — five to 10 minutes or closer — rather than farther apart.

Contractions start in the lower back and wrap around to the lower stomach during which time the cervix thins and stretches. Activity during true labor can cause contractions to strengthen. A cervical exam during these contractions helps determine if the cervix is dilating.

Premature ventricular contractions

PVCs are a type of abnormal heartbeat. The heart has four chambers — two upper atria and two lower ventricles. Normally, a special group of cells in the sinoatrial node (SA) of the right atrium start the signal to start your heartbeat. The signal rapidly moves through your heart’s conducting system. As it travels to the left and right ventricles, the signal triggers nearby parts of your heart to contract, allowing the heart to squeeze in a coordinated process.

In a PVC, the signal to start your heartbeat instead comes from one of the ventricles. This signal is premature, happening before the SA node has been able to fire. The signal spreads through the rest of your heart, causing a heartbeat. If this happens very soon after the previous heartbeat, your heart will push out very little blood, causing a feeling of a pause between beats. If it happens a little later, your heart pushes out an almost-normal amount of blood, leading to the feeling of an extra heartbeat. So the heart has a random ‘premature’ heartbeat between many other normal heartbeats.

Causes of PVC include:

  • Reduced blood flow to the heart
  • Scarring after heart attack
  • Electrolyte abnormalities like low sodium or potassium levels
  • Increased adrenaline, for example during periods of anxiety
  • Certain drugs, including digoxin
  • Pregnancy

Symptoms of PVCs and who is at risk

Most people with occasional PVCs do not have symptoms and when they do happen, they are usually minor. Occasionally, PVCs cause the unpleasant awareness of the heartbeat known as palpitations. Some people experience feeling a ‘skipped’ or ‘extra’ heartbeat. Other possible symptoms include dizziness, near-fainting and a pounding sensation in the neck.

PVCs generally cause dangerous symptoms only in people with other heart problems. For example, they might happen in someone whose ventricle already squeezes poorly. A person with heart failure may notice increased symptoms, like shortness of breath. Some of the heart conditions increasing the risk for PVCs are:

  • Congenital heart disease
  • Coronary heart disease
  • Dilated cardiomyopathy
  • Heart attack
  • Heart failure
  • High blood pressure
  • Hypertrophic cardiomyopathy
  • Mitral valve prolapse

Occasional PVCs are common in people of all ages, but the risk increases with age. Only rarely do PVCs cause problems on their own without accompanying heart issues.

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Posted In Health Information, Pregnancy, Women's