Is it normal to have some abdominal pain during pregnancy?
Occasional abdominal pain is a common pregnancy complaint, and while it may be harmless, it can also be a sign of a serious problem. (Severe or persistent abdominal pain should never be ignored.)
Below we’ll describe the most common causes of abdominal pain and discomfort during pregnancy, but don’t try to diagnose yourself. If you experience abdominal pain or cramping along with spotting, bleeding, fever, chills, vaginal discharge, faintness, discomfort while urinating, or nausea and vomiting, or if the pain doesn’t subside after several minutes of rest, call your practitioner.
What serious problems can cause abdominal pain during pregnancy?
An ectopic pregnancy occurs when a fertilized egg implants outside the uterus, typically in one of the fallopian tubes. It may cause some cramping and other symptoms in early pregnancy.
If left untreated, an ectopic pregnancy can be life-threatening. Call your practitioner immediately if you have any of the following symptoms: abdominal or pelvic pain or tenderness, vaginal spotting or bleeding (can be red or brown, copious or scant, continuous or intermittent), pain that gets worse during physical activity or while moving your bowels or coughing, or pain in your shoulder.
If you’re bleeding heavily or having signs of shock (such as a racing pulse, dizziness, fainting, or pale, clammy skin), call 911.
Miscarriage is the loss of a pregnancy in the first 20 weeks. Vaginal spotting or bleeding is generally the first symptom, followed by abdominal pain a few hours to a few days later.
The bleeding may be light or heavy. The pain may feel crampy or persistent, mild or sharp, and may feel more like low back pain or pelvic pressure.
Call your practitioner if you have signs of a miscarriage. If you have severe pain or heavy bleeding, you need to be seen immediately.
You’re in preterm labor (also known as premature labor) if you start to have contractions that efface or dilate your cervix before 37 weeks of pregnancy.
Call your doctor or midwife right away if you’re having any of the following symptoms in your second or third trimester (before 37 weeks):
- An increase in vaginal discharge or a change in the type of discharge (if it becomes watery, mucus-like, or bloody – even if it’s just pink or tinged with blood)
- Vaginal spotting or bleeding
- Abdominal pain, menstrual-like cramping, or more than five contractions in one hour (even if they don’t hurt)
- An increase in pressure in the pelvic area
- Low back pain, especially if you didn’t previously have back pain
Placental abruption is a life-threatening condition in which your placenta separates from your uterus, partially or completely, before your baby’s born.
There’s wide variation in symptoms. A placental abruption can sometimes cause sudden and obvious bleeding, but in other cases there may not be any noticeable bleeding at first, or you might have only light bleeding or spotting. Or you might see bloody fluid if your water breaks.
You might have uterine tenderness, back pain, or frequent contractions, or the uterus might contract and stay hard – like a cramp or contraction that doesn’t go away. You might also notice a decrease in your baby’s activity. Immediate medical attention is a must.
Preeclampsia is a serious condition of pregnancy that causes changes in your blood vessels and can affect a number of organs, including your liver, kidneys, brain, and the placenta. You’re diagnosed with preeclampsia if you have high blood pressure after 20 weeks of pregnancy and protein in your urine, liver or kidney abnormalties, persistent headaches, or vision changes.
Symptoms may include swelling in your face or puffiness around your eyes, more than slight swelling in your hands, and excessive or sudden swelling of your feet or ankles. (This water retention can lead to rapid weight gain.)
You may also have intense pain or tenderness in the upper abdomen, a severe headache, visual disturbances (such as blurred vision or seeing spots), or nausea and vomiting. If you have symptoms of preeclampsia, call your doctor or midwife immediately.
Urinary tract infections
Being pregnant makes you more susceptible to urinary tract infections of all kinds, including kidney infections.
Symptoms of a bladder infection may include pain, discomfort, or burning when urinating; pelvic discomfort or lower abdominal pain (often just above the pubic bone); a frequent or uncontrollable urge to pee, even when there’s very little urine in the bladder; and cloudy, foul-smelling, or bloody urine. Call your caregiver if you have any of these symptoms because an untreated bladder infection can lead to a kidney infection and premature labor.
Signs that the infection has spread to your kidneys – and that you need medical attention immediately – include a high fever, often with shaking, chills, or sweats; pain in your lower back or in your side just under your ribs, on one or both sides (and possibly in your abdomen as well); nausea and vomiting; and possibly pus or blood in your urine.
Many other conditions can cause abdominal pain, whether you’re pregnant or not. Some of the most common causes of abdominal pain that your practitioner will consider are a stomach virus, food poisoning, appendicitis, kidney stones, hepatitis, gallbladder disease, pancreatitis, fibroids, and bowel obstruction.
Both gallbladder disease and pancreatitis are often a result of gallstones, which are more common during pregnancy. Fibroids may grow during pregnancy and cause discomfort. And the pressure of the growing uterus on previously scarred intestinal tissue may cause bowel obstruction, which is most likely to occur in the third trimester.
What are the most common causes of harmless abdominal discomfort?
Not all abdominal discomfort is a sign of a serious problem during pregnancy. For example, you may notice a bit of cramping during or right after an orgasm. As long as it’s mild and short-lived, it’s perfectly normal and nothing to be alarmed about.
Here are some other causes of ordinary abdominal discomfort. But remember, if you’re unsure what’s going on or your discomfort is severe or persistent, play it safe and call your caregiver.
Gas and bloating
You’re much more likely to have gas pain and bloating during pregnancy because of hormones that slow your digestion and the pressure of your growing uterus on your stomach and intestines.
Constipation is another common cause of abdominal discomfort throughout pregnancy, thanks to hormones that slow the movement of food through your digestive tract and the pressure of your growing uterus on your rectum.
Round ligament pain
Round ligament pain is generally a brief, sharp, stabbing pain or a longer-lasting dull ache that you may feel on one or both sides of your lower abdomen or deep in your groin, usually starting in your second trimester. It happens when the ligaments that support your uterus in your pelvis stretch and thicken to accommodate and support its growing size.
You may feel a short jabbing sensation if you suddenly change position, such as when you’re getting out of bed or up from a chair or when you cough, roll over in bed, or get out of the bathtub. Or you may feel a dull ache after a particularly active day, if you’ve been walking a lot or doing some other physical activity. Call your caregiver if this discomfort continues even after you’ve rested.
Braxton Hicks contractions
Sometime after midpregnancy, you may start to notice some tightening in your uterus from time to time. Before 37 weeks, these Braxton Hicks contractions should be infrequent, irregular, and essentially painless.
Call your provider if the contractions are accompanied by lower back pain, if you feel more than five contractions an hour (even if they don’t hurt), if they’re coming at regular intervals, if they’re accompanied by vaginal discharge or bleeding, or if you have any other signs of premature labor.
Once you’re close to your due date, cramping can be a sign of labor.
Is there anything I can do to ease abdominal pain?
Here are a few tips for dealing with abdominal discomfort that isn’t caused by anything serious:
- Move around or do some gentle exercises to relieve pain that might be caused by gas.
- Take a warm (not hot) bath or shower.
- Bend toward a pain when you feel it, for relief.
- Drink plenty of fluids. Dehydration can cause Braxton Hicks contractions.
- If the pain is caused by Braxton Hicks contractions, lying down may be helpful. Resting can also help you focus on and identify your symptoms.