Ever wonder what your uterus gets up to during pregnancy?
Apart from stretching with your growing baby, what else is it doing in there?
You might have heard of Braxton Hicks contractions, also known as ‘practice contractions’, as the uterus gets ready for labour.
You might notice them in the middle trimester.
The contractions are usually irregular and quite mild. They stop after a while, particularly if you rest or hydrate.
Some women, however, experience what is known as an irritable uterus. This is when the uterus contracts in a disorganised fashion during pregnancy.
What Is Irritable Uterus?
The uterus is a powerhouse of muscle layers. During pregnancy, the inner horizontal layer of muscles keeps the cervix closed.
The outer vertical muscle layer begins to contract when labour begins, opening the cervix and pushing the baby out.
You can read more about this in What Your Uterus Does In Labour.
Labour contractions are regular and strong. In comparison, the contractions associated wth irritable uterus can feel more like twitching.
Unlike labour contractions, irritable uterus contractions don’t affect the cervix and don’t lead to labour.
Very few studies have been done to investigate irritable uterus in pregnancy, and the ultimate cause of it is still unknown.
However, from anecdotal evidence we are aware of some common triggers for the contractions: exercise; lifting heavy objects; having an orgasm; dehydration; stress; constipation; and a full bladder.
It is generally believed irritable uterus causes preterm labour. In 1995 researchers published a research paper that examined the link between irritable uterus and preterm labour.
They found preterm labour was more likely to be linked to other high risk factors. However, 18.7% of women who had uterine irritability experienced preterm labour; among women who did not, the incidence of pre-term labour was 11%.
Unfortunately there have been no further studies into this link and so the reason for this increased risk remains unknown.
What Are The Symptoms Of Irritable Uterus?
Irritable uterus can feel similar to Braxton Hicks contractions but the contractions occur more frequently, are more painful, and tend to be more regular in length and frequency.
Due to the intensity of the contractions many women mistake them for real labour. The contractions can also be accompanied by a feeling of pressure and/or pain in the back.
Unlike Braxton Hicks, irritable uterus contractions worsen with increased activity. Irritable uterus can also feel like a constant tight belly, which can become worse when standing or walking. The tight belly can last for over an hour at a time.
How To Diagnose Irritable Uterus?
If you’re experiencing contractions before 37 weeks your care provider will run some tests to see what is happening.
A pressure sensitive belt will monitor the strength, length and duration of the contractions.
Other tests will help to assess whether or not you are at risk of preterm labour:
- Analysis of vaginal secretions, to check for fetal fibronecin, which can indicate preterm labour; this test isn’t 100% accurate.
- Ultrasound, to check the length of your cervix, which will begin to shorten before you go into labour.
Treatment For Irritable Uterus
Dealing with uterine irritability can be very challenging. The ongoing contractions can interrupt your sleep and your increased watchfulness might add to your exhaustion.
Because we don’t know what causes irritable uterus it is hard to know how to treat it.
This advice might be useful:
- Keep your bladder empty; a full bladder can create further irritation
- Stay hydrated
- Reduce your stress levels
- Get plenty of sleep
- Avoid lifting heavy items
- Lie on your left hand side
- Eat small meals, more frequently
- Avoid caffeine
- Take magnesium supplements (but check with your care provider first).
If the uterine irritability is severe, your doctor might prescribe medication to prevent or reduce the intensity of the contractions.
If your doctor believes you to be at increased risk of preterm labour, you could be put on bed rest. This could be total bed rest (which means you spend almost all of your time in bed), partial bed rest (you spend an extra four hours a day resting in bed) or pelvic rest (which means no sexual activity, including masturbation).
When To Go To Hospital
If you haven’t reached 37 weeks pregnancy, you should seek medical advice if you experience any of the following:
- Painful contractions, contractions every 5-10 minutes, or more than five contractions in an hour
- Any vaginal bleeding or leaking from the vagina
- Reduced fetal movements
- Pressure in the pelvis or vagina
- Regular lower back pain; this can signal labour.
If you have any concerns about these symptoms, or about how you are feeling generally, don’t hesitate to speak to your care provider immediately. It’s important to be assessed in case you are at risk of preterm labour, and so appropriate measures can be taken.
If you are suffering from irritable uterus, you are probably feeling quite frustrated by the lack of information available about your condition.
Try to relax, and get as much rest as you can. If you find something that reduces the contractions, keep doing it!
Unfortunately, lack of research means irritable uterus remains one of the ‘unknowns’ of pregnancy.