Preterm Birth: How to Self-monitor Labor Contractions

It’s often recommended that mothers at risk for preterm birth self-monitor contractions for at least one full hour each morning and again in the evening. Self-monitoring contractions means feeling your abdomen to see if you are having uterine contractions and then timing the contractions if you feel them. (For more about preventing preterm birth and preterm labor.)

Your doctor will tell you when and how often to monitor your contractions. Monitoring contractions includes measuring how long they last, how far apart they are, and how many you have in an hour. Do not trust your memory or guess. If you get upset or worried during the monitoring process, you may not be able to remember. Therefore, have pen and paper handy and a clock or watch with a second hand. To make things easier, you can download our contractions worksheet. Here’s how to monitor contractions.

Monitoring contractions
Place your fingertips wide apart.

Steps for Self-monitoring Contractions:
1) Empty your bladder to relieve any pressure on your uterus.
2) Drink one to two 8-ounce glasses of water; dehydration increases the level of the hormones that can lead to contractions.
3) Lie down on your left side with a pillow at your back. Don’t lay on your back. It can cause contractions to happen more often.
4) Place your fingertips wide apart on the top of your uterus, up near your breast bone. Press in lightly and feel for a tightening inside your abdomen.

What will I feel with my hands and fingers?

Contractions usually begin at the top of the uterus (above your belly button) and feel like a tightening or hardening of a muscle. Your uterus will get harder as the tightness increases to a peak. Then the uterus relaxes or softens as the contraction ends. If, with your fingertips, you feel your abdomen tighten (contract) and get hard and then relax and soften, you’re having a contraction. Also, you may be able to see your abdomen move as it tightens.

The uterus is a muscle. When the uterus contracts, it will feel hard to your fingertips — like your biceps feel when you “make a muscle” in your arm. With a contraction, your whole uterus should feel hard. So spread your fingers out so you can feel a large area. If you feel a hard “spot” it may be your baby’s buttocks or a foot — not a contraction in the uterus.

Timing Your Contractions
Click image to download our worksheet.

Timing Contractions

Each time you have a contraction, count how many seconds it lasts. When it’s over, write down the time and how many seconds the contraction lasted. If you have more than four contractions in one hour, empty your bladder again, drink at least two 8-ounce glasses of water, and monitor for a second hour. If the contractions start coming closer together or become painful, call your doctor.

How long do contractions last?

The length of a contraction is usually measured in seconds. Begin counting the seconds when the contraction begins (the uterus starts getting hard) and stop counting when the contraction stops (the uterus is soft and has completely relaxed). If you don’t have a watch with a second hand, count “one-thousand-one, one-thousand-two, one-thousand-three”. If you count to one-thousand-ten, and the contraction stops, the contraction lasted about ten seconds.

How far apart are my contractions?

The time between contractions is measured in minutes. The time between the beginning of one contraction to the beginning of the next is “how far apart” your contractions are. For example, if your first contraction begins at 9:00 and the next begins at 9:15, your contractions are 15 minutes apart. If contractions begin at 9:00, 9:15, 9:30, 9:45, and 10:00, you have had four contractions in one hour. The contractions are also “regular” because they happened every 15 minutes.

What to Do

It is common to have false labor—Braxton Hicks contractions—during the final weeks of pregnancy. These contractions are called false labor because they do not cause the cervix to expand (dilation) or thin out (effacement). These contractions may be regular and painful. They usually go away within an hour or so with rest. Count how many contractions you have in 20 minutes and how many you have in an hour. If you have regular contractions 4 times every 20 minutes or 8 times an hour that last for more than an hour, call your doctor’s office right away.

Labor and Contractions
Labor is the process that begins with repeated, forceful uterine contractions. Uterine contractions supply the power that makes birth possible. Contractions cause the cervix to dilate and help move the baby through the birth canal. Contractions are strongest in the upper part of the uterus, called the fundus, and push your baby downward toward the birth canal. Contractions last between 15 seconds at the beginning of labor to 90 seconds toward the end.

Labor is divided into 3 stages. In early labor, contractions are 15 to 30 minutes apart. Toward the very end of labor, contractions are only two to three minutes apart. The first contractions are usually mild and often painless. As labor progresses they get stronger and more painful. Between contractions there is no pain at all.

Uterine contractions press on the amniotic fluid and cause the bag of waters to break. As your baby’s head presses on the cervix, hormones are released that cause the contractions to become stronger and closer together. The cervix thins out and opens so your baby’s head can be pushed through the cervix and delivered from your vagina.