Pregnancy gets you accustomed to a small amount of discomfort all over, from tender breasts to an achy back. But if you experience abdominal cramps and pain at any point when you're expecting, you might be a bit concerned.
Some abdominal discomfort during pregnancy is normal, but it can sometimes signal a problem that warrants medical attention. Here's how to tell when cramps during pregnancy are likely nothing to worry about — and when they might be linked to something more serious.
Are cramps during pregnancy normal?
Some abdominal cramping and stomach pain in pregnancy is common. Early pregnancy cramps can be linked to many run-of-the-mill pregnancy symptoms, including constipation and increased blood flow to the uterus.
Later on in pregnancy, pregnancy pains could be linked to normal symptoms like Braxton Hicks contractions and round ligament pain.
Sometimes, however, abdominal pain during pregnancy can be a sign of a condition that requires medical attention, like a urinary tract infection, miscarriage, preterm labor or preeclampsia. It's always safest to call your doctor about any symptom that concerns you. You can use the My Journal tool in the What to Expect app to keep track of how frequent and severe your pain is.
The following are common causes of abdominal pain and cramps during pregnancy that can occur during any trimester:
Gastric distress
Gas and bloating are common pregnancy complaints due to elevated levels of progesterone, a hormone that relaxes the smooth muscles in your digestive tract.
As a result, your digestion slows down. This can lead to pregnancy-related bloating as well as constipation — both of which can bring on crampy feelings in your abdomen.
Your discomfort is probably digestion-related if passing gas or having a bowel movement provides some short-term relief. You can help prevent gastrointestinal issues by eating fiber-rich foods, having several small meals a day instead of three larger ones, taking your time when eating and drinking plenty of water.
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If these changes don't help, your doctor may recommend a stool softener for constipation.
Cramps after orgasm
Cramping during and after orgasm (sometimes paired with a lower backache) is normal and harmless in a low-risk pregnancy. It's due to increased blood flow to the pelvic area and normal uterine contractions that happen when you orgasm.
Worried about orgasm hurting the baby during sex? It absolutely won't. Post-sex cramps are absolutely not a reason to stop enjoying sex, if you're feeling up to it and your practitioner has given you the green light.
To relieve the cramps, try lying down for a while or taking a nap.
Blood flow to the uterus
During pregnancy, your body sends more blood than usual to your uterus. This can feel like more pressure in the area. Lying down to rest or soaking in a warm bath may help relieve these pregnancy pains.
Urinary tract infection (UTI)
An infection in the urinary tract can be symptomless, but often it causes pain or pressure in the pelvic area. Other symptoms include foul-smelling, cloudy or bloody urine, pain and burning when urinating, fever, or the need to pee more often.[1]
A UTI can become serious if left untreated. Fortunately, a short round of antibiotics usually takes care of the infection.
Dehydration
Dehydration can cause Braxton Hicks contractions, or practice contractions that usually start midway through pregnancy and are very normal. Being thirsty is usually no big deal, but it's important to drink up, since some research does suggest extreme dehydration may increase the risk of preterm labor.
Drinking enough water during pregnancy means aiming for about eight to 10 glasses a day. You'll know you're hydrated if your urine is pale yellow or colorless and you're taking frequent bathroom breaks.
Cramping during the first trimester of pregnancy
Implantation
Very early on in your pregnancy, you may experience menstrual-like cramping. These implantation cramps happen around the time your period is due, before you even know for sure that you've conceived.
Slight twinges and light implantation bleeding are a result of a fertilized egg attaching to the uterine wall, which happens about 6 to 12 days after fertilization and lasts only a day or so at most. A little R and R usually eases the discomfort.
Ectopic pregnancy
An ectopic pregnancy — when a fertilized egg implants somewhere other than the uterus, usually a fallopian tube — can cause cramps, usually in the lower abdomen.[2]
It may begin as a dull ache and progress to spasms or cramps that may worsen with time. Ectopic pregnancies often also cause vaginal bleeding, shoulder pain, lightheadedness and faintness.
If you think you may be experiencing an ectopic pregnancy, see a doctor right away. Ectopic pregnancies are diagnosed with ultrasounds and blood tests around week 5 to 6.
So if you've already had your first trimester ultrasound and everything looked normal, an ectopic pregnancy isn't the cause behind your cramping.
Miscarriage
What do miscarriage cramps feel like? First trimester cramping during pregnancy that's linked to a miscarriage can be dull or similar to bad period cramps. It usually occurs in the abdomen, lower back and/or pelvic area and is accompanied by bleeding. Although most miscarriages happen in the first trimester, they can occur in the second trimester as well.
It can be difficult to tell if your early pregnancy cramps are a miscarriage — or simply implantation or your uterus expanding. The most important miscarriage symptom to look out for is bleeding.[3] Unlike implantation cramping, miscarriage cramping is usually accompanied by bleeding that continues for several days and often gets heavier with time.
If you're concerned that you may be miscarrying, it's always a good idea to call your practitioner.
Cramping during the second trimester of pregnancy
Round ligament pain
Round ligaments are bands of tissue that hold the uterus in place. As pregnancy progresses, these ligaments stretch, which can cause aches and cramps or sharp pain that occurs on one or both sides of the lower abdomen.
Round ligament pain usually starts in the second trimester but can occur any time in the second half of pregnancy. It often occurs during exercise; after you get out of bed, sneeze, cough or laugh; or when you move suddenly. These cramps during pregnancy can last for anywhere from a few seconds to a few minutes. For relief, get plenty of rest and try to change positions slowly.
Braxton Hicks contractions
These so-called "practice contractions" can begin at around 20 weeks of pregnancy and are your body's way of warming up for real labor. Braxton Hicks contractions are relatively short (only seconds to a couple of minutes) and irregular.
When you experience a Braxton Hicks cramping during the second trimester of pregnancy onwards, change positions. Sit or lie down if you're standing (and vice versa), for example, and it should subside.
Keep in mind that placental abruption, preeclampsia and preterm labor can occur during the second trimester as well. Keep reading below for more information on these conditions.
Cramping during the third trimester of pregnancy
Placental abruption
If the placenta separates (partially or completely) from the uterine wall before a baby is born, it can cause a severe and persistent abdominal pain as well as back pain and vaginal bleeding.
Placental abruption is most common in the third trimester, but it can occur in the second trimester. If you're experiencing abdominal pain with bleeding any time in the second half of pregnancy, it's important to get immediate medical attention.
Preeclampsia
Preeclampsia develops in the second half of pregnancy, usually in the third trimester, and is characterized by sudden high blood pressure and protein in the urine.
It can cause upper abdominal pain along with severe headaches that don't go away with painkillers, severe swelling in the face and hands, sudden weight gain that's unrelated to eating, vision changes, nausea or vomiting, and shortness of breath.
It's important to see your doctor right away if you're experiencing any of the above symptoms. Left untreated, preeclampsia is dangerous for both you and your baby, since it can decrease the amount of oxygen and nutrition that flows to a fetus and increase the risk of placental abruption. If it's caught early and treated, you have excellent odds of having a healthy pregnancy.
Labor contractions
Labor contractions come at regular intervals, last between 30 to 70 seconds, get closer together and stronger over time and don't go away when you change positions. Other signs of labor include feeling pressure in the pelvic area (like your baby is pushing down) and a change in vaginal discharge (leaking fluid or light bleeding).
Your doctor should have told you when to call if you experience cramping during the third trimester of pregnancy that you think may be labor contractions. Always be sure to call if you're bleeding, your water breaks or you have signs of preeclampsia like sudden swelling or blurry vision.
If you experience these symptoms before 37 weeks, you could be experiencing preterm labor. If you think you're in preterm labor, contact your doctor even if you're not sure or go to the hospital right away.
How to relieve pregnancy cramps
Pregnancy cramp relief depends on the cause behind the pain you're experiencing. These tips can relieve the most common causes of abdominal cramps during pregnancy:
- Lie down and relax for a while, which can relieve pregnancy cramps related to implantation, orgasm, increased blood flow to the uterus and round ligament pain.
- Drink plenty of water, which may ease any cramping related to dehydration, bloating or constipation.
- Soak in a warm bath, which can help ease pregnancy cramps related to increased uterine blood flow.
- Wear a belly band, which can help relieve abdominal cramps linked to round ligament pain in the second half of pregnancy.
- Change positions (lie down if you're standing, for example) if you think you're having Braxton Hicks contractions
When to call your doctor
When should you be concerned about cramps during pregnancy? To be on the safe side, always contact your practitioner if you're worried about pregnancy pains including cramping.
Be sure to get in touch with your practitioner right away if you're experiencing:
- Severe lower abdominal pain in the center or on one or both sides that doesn't subside (even if it isn't accompanied by bleeding)
- A sudden increase in thirst, accompanied by a decrease in urination, or no urination for a full day
- Severe headache that won't go away, vision changes, sudden swelling and/or unexplained weight gain (which are symptoms of preeclampsia)
- Fever or chills
- Heavy bleeding, or bleeding with cramps or severe pain in the lower abdomen
- Bloody diarrhea
- Pain or burning during urination, difficulty urinating or blood in your urine
- Dizziness or feeling faint
- More than four contractions in one hour (especially if it happens before 37 weeks of pregnancy), as it may be a sign of labor
Chances are good that cramps during pregnancy are perfectly normal. But it's smart to be aware of more serious potential causes of cramping during pregnancy so you can get the medical care you may need.
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