During a contraction, your main job is to stay as relaxed as possible, breathe deliberately, and let your body do the work. That sounds simple, but it takes practice and a few specific techniques to manage well. What you do between and during contractions changes as labor progresses, so knowing what to expect at each stage helps you feel prepared rather than overwhelmed.
First, Make Sure It’s Real Labor
Before you start timing anything, it helps to know whether you’re dealing with true contractions or Braxton Hicks, the “practice” contractions that can start weeks before labor. The key difference is coordination. Real contractions start at the top of the uterus and move in a wave through the middle and down to the lower segment. Braxton Hicks tend to feel like a tightening focused in one area and don’t travel through the whole uterus.
Signs that point to Braxton Hicks:
- Uncomfortable but not truly painful
- Irregular intervals that don’t get closer together
- They don’t get stronger over time
- They taper off and disappear, especially if you change position or go for a walk
Signs that point to real labor:
- Painful, not just uncomfortable
- Intervals between contractions get shorter
- Each contraction gets stronger and lasts longer
- They don’t stop regardless of what you do
Activity can actually trigger Braxton Hicks. If you’ve been lifting, cleaning, or on your feet for a long time, try sitting down or switching positions. If the contractions ease up, that’s your answer. If they keep coming and keep building, you’re likely in early labor.
Use Breathing as Your Primary Tool
Structured breathing during contractions does several things at once: it gives you a focal point, keeps oxygen flowing to your muscles and your baby, and creates a sense of control when the intensity feels like too much. You don’t need to master complicated patterns. The core idea is to breathe slowly and deliberately rather than holding your breath or breathing in shallow, panicky bursts.
In early labor, slow breathing works best. Aim for about half the number of breaths you’d normally take, inhaling through your nose and exhaling through your mouth. This conserves energy for the hours ahead. As contractions intensify during active labor, you can shift to a slightly faster rhythm, but try not to exceed double your normal breathing rate. Breathing too fast can make you lightheaded.
When it’s time to push, breathing changes again. One approach is to inhale deeply and exhale slowly through pursed lips while bearing down, keeping your abdominal muscles engaged around the baby. Another is to inhale deeply, hold your breath briefly (no more than six to ten seconds), and push while holding. Your birth team will guide you on which approach works best in the moment.
Move and Change Positions Often
Staying in one position, especially flat on your back, is one of the least helpful things you can do during contractions. Movement and gravity work in your favor. Different positions open your pelvis in different ways and can significantly change how a contraction feels.
Squatting opens the pelvis and gives the baby more room to rotate through the birth canal. It also helps you bear down more effectively when pushing begins. Kneeling while leaning forward, whether over a bed, a chair, or a birth ball, opens the pelvis in a similar way and can take pressure off your back. The hands-and-knees position is especially useful because it opens the pelvis and may improve your baby’s oxygen supply.
Between contractions, try walking, slow dancing with a partner, climbing stairs, rocking your pelvis on a birth ball, or simply standing and swaying. These movements encourage the baby to descend and can help labor progress. During a contraction, find whatever position lets you ride through it most comfortably, then shift again when it passes. There’s no single “right” position. The best one is whichever feels most manageable in that moment.
Try Water for Pain Relief
Warm water is one of the most effective non-drug options for contraction pain. Immersion in a tub during the first stage of labor (before pushing) is associated with shorter labor and less need for an epidural. A warm shower directed at your lower back can offer similar relief if a tub isn’t available.
Water immersion is generally considered appropriate for healthy pregnancies between 37 and 42 weeks. The American College of Obstetricians and Gynecologists recommends that actual delivery happen on land rather than in water, since there isn’t enough data on the safety of water birth. But for managing contractions in the hours before pushing, a tub or shower can make a real difference.
What Your Support Person Can Do
A labor partner isn’t just there for moral support. There are specific, physical things they can do that genuinely reduce pain and help labor move forward.
During active labor, a partner can help you shift between positions, walk with you, breathe alongside you through contractions, and count out loud if that helps you stay focused. Massage along the back, neck, or wherever feels good can ease tension between contractions. For nausea, a cold cloth on the forehead, ice chips, or warm liquids all help.
Back labor, where you feel intense pain in your lower back, calls for more targeted techniques. A double hip squeeze (pressing inward on both hips during a contraction) can relieve pelvic pressure. Counter pressure, where your partner pushes firmly against your lower back with the heel of their hand, directly counteracts the pain. Applying alternating hot and cold compresses to the lower back also helps. Positions that tilt you forward, like hands and knees or leaning over a birth ball, take the baby’s weight off your spine.
During pushing, a partner can hold a cool cloth to your forehead between pushes, help you into different pushing positions (squatting, side-lying, semi-sitting), and offer encouragement. Sometimes the most helpful thing is simply being a steady, calm presence.
Timing Contractions and Knowing When to Go
Timing contractions means tracking two things: how far apart they are (from the start of one to the start of the next) and how long each one lasts. A simple stopwatch or phone app works fine.
A widely used guideline is the 5-1-1 rule: contractions coming every 5 minutes, each lasting at least 1 minute, for at least 1 hour. This is a reasonable starting point, but your hospital or provider may give you slightly different thresholds. Kaiser Permanente, for example, advises first-time parents to come in when contractions are 3 to 5 minutes apart and lasting 45 to 60 seconds over an hour. If you’ve given birth before, the threshold is wider: every 5 to 7 minutes, lasting 45 to 60 seconds, because second and subsequent labors often progress faster.
Don’t get too fixated on the numbers. If something feels wrong, go in regardless of the timing pattern.
If Your Water Breaks
Your water may break as a gush or a slow trickle. Either is normal. When it happens, note four things: the color, the smell, the amount, and the time.
Normal amniotic fluid is clear, though it can be slightly yellowish or pinkish. It has a faintly sweet smell and won’t smell like urine. If the fluid is green or brown, that may mean the baby has passed meconium (their first stool), which can be a sign of distress. Go to the hospital immediately. Also go in right away if the fluid smells bad.
About 7 in 10 people give birth within 24 hours of their water breaking, and 9 in 10 within 48 hours. If labor doesn’t start on its own within 24 hours after your water breaks at 37 weeks or later, your care team will likely discuss induction because the risk of infection increases once the amniotic sac is no longer sealed.
Warning Signs That Need Immediate Attention
Most labor, even when painful and exhausting, follows a normal pattern. But certain symptoms during labor require immediate medical attention:
- Heavy vaginal bleeding (soaking a pad, not just spotting)
- Severe headache that won’t go away or comes with blurred vision
- Vision changes like seeing flashes of light, bright spots, or double vision
- Fever of 100.4°F (38°C) or higher
- Decreased fetal movement or a sense that the baby has stopped moving
- Severe belly pain that is sharp, sudden, or escalating (distinct from contraction pain, which comes in waves and eases)
- Trouble breathing or tightness in your chest or throat
- Extreme swelling of hands or face, especially if sudden
- Foul-smelling discharge or green/brown fluid
These can signal complications like preeclampsia, infection, or placental problems. If any of these happen at home, don’t wait for contractions to hit a certain pattern. Go to the hospital or call your provider right away.