Waves. Surges. Contractions. These are all words to describe the work your uterus does during the childbirth process. For those who have never given birth before, there is often a lot of curiosity about the sensations of labor. These sensations are subjective and can be hard to describe, but by understanding the structure and mechanisms of the uterus and by asking people who have experience unmedicated childbirth what they felt, we can start to arrive at a consensus.

“There is no other organ quite like the uterus. If men had such an organ they would brag about it. So should we”
―Ina May Gaskin

What is happening in the body during labor?

The uterus is a muscular organ. When you are not pregnant, it is about the size of your fist. By the time your due date arrives, that same fist-size organ has grown to be about the size of a watermelon. When it contracts during labor, the muscles shorten and harden.

You can feel this same sort of action when any of your muscles are contracted. Try feeling your bicep while your arm is resting. The muscle will feel long and soft. Then if you touch the muscle while you tense it, creating a fist and curing your arm like a strong man, you will notice the muscle bunches up and feels firm under your fingers.

The purpose of uterine contractions in labor is to open the cervix, which is the lower segment of the uterus. The muscular outer layer of the uterus is arranged vertically, and when it contracts, it shortens and pulls in an upward motion, gradually coaxing the cervix open over the baby’s head. At the same time, the fundus, which is the top portion of the uterus the farthest point away from the cervix, builds in strength with each contraction, adding a downward pressure that pushes the baby’s head against the cervix (and eventually down and out the birth canal). You can think of this as a synchronized push and pull action, with the vertical muscles pulling the cervix up around the baby’s head, and the fundus pressing the baby firmly down against the cervix.

What does it feel like subjectively?

Since labor contractions are a muscular action, you can relate them to other muscle sensations you may have felt. The tightness and involuntary nature of contractions is similar to the feeling of getting a charley horse in your calf, but on a larger scale (remember the uterus is the size of watermelon at this point - much larger than your calf muscle).

Unlike a sudden charley horse, labor contractions have a wave-like pattern. You will start to feel the contraction building as you uterine muscles begin to tense and tighten. It will reach a peak of intensity about half way through, when the fundus is engaged. The downward pressure of the fundus pressing the baby’s head onto cervix may also be felt as a sharp sensation, particularly noticeable at the peak of the contraction. The cervix is sensitive to touch. You might have noticed a similar sharp sensation during a pap smear or cervical exam. After the contractions has peaked and the muscles begin to relax, you will start to experience relief from the uncomfortable sensations until they are gone completely.

Some people report that this muscular, cramping sensation feels like internal twisting, similar to a washcloth being tightly wrung, or like an internal band being gradually tightened and squeezed.

Others note that, similar to the way a charley horse might make you jump up and want to move and stretch your leg to relieve the cramp, labor contractions encouraged them to get up and move, to stand and sway rhythmically, to walk, or to rock their hips until the sensation ended.

Some people also notice labor contractions as starting in a specific spot in the body, and then wrapping around to envelop the entire uterus. Some feel them starting in the back and wrapping around to the front. Others feel them starting low in the pelvis, similar to the place you might feel period cramps, and wrapping upward.

Are they like menstrual cramps?

Speaking of period cramps, how similar are they to labor contractions? Menstrual cramps are also caused by the uterine muscles contracting and relaxing, so they aren’t dissimilar. Again, the difference is in the scale—remember the fist size uterus vs. the watermelon sized uterus—and in the additional pressure caused by the baby’s head against the cervix.

How can you tell when you’re experiencing a labor contraction?

For most people, labor starts of slowly and gradually, so it can be tricky to tell exactly what is going on, and to differentiate early labor contractions from Braxton Hicks contractions.

Early labor contractions are often described as being more similar to period cramps, or even back spasms that come and go.

Here are ways to help you determine if you are feeling labor contractions:

Try touching your belly to check for firmness
During a labor contraction, your belly will feel evenly firm all over. If you touch your belly in late pregnancy, it will feel similar to touching the tip of your nose (it will be a little bit squishy with firmness underneath). If you touch your belly during a labor contraction, it will feel like touching your forehead, firm with no squishiness.
Look for the wave pattern
Labor contractions will start off indistinctly, build in intensity until they reach a peak, and then gradually fade away.
Look for a progressing pattern
As your labor gets going, you will start to notice your wave-like contractions coming in a pattern, and that pattern will eventually grow in intensity. Contractions will last longer, feel stronger, and occur closer together. Longer, stronger, closer together = labor progress!

What is in a name ?

Labor is a great mental challenge. Some people find that referring to the sensations of labor as “contractions” brings up negative connotations of pain and discomfort.

They prefer to use words that have positive connotation, like “surge” (which makes you think of strength, of activity, of upward motion), or words with a neutral connotation, like “wave” (which makes you think of water, of natural ebb and flow, of peace).

Focus on the positive

To meet the mental challenge of labor, it is important to keep a positive mindset. Your body will be experiencing very intense sensations, maybe even the most intense sensations you have ever experienced, but it is how you translate those sensations that matters most.

Remember that when you are feeling labor contractions you are feeling the strength of your own body. You are feeling your power, your healthy body functioning perfectly to bring your baby into your arms.

What do contractions feel like?

Tips From a Midwife: 10 Ways to Mentally Prepare for Labor

Ariane’s Birth Story