Some short-term achiness in the belly is normal during pregnancy. Severe cramping or pain never is. Don't hesitate to call your health care provider when you feel strong pain, especially if your pain doesn't go away or if you also have cramps, bleeding from your vagina, fever, chills, lightheadedness, faintness, or discharge from your vagina.
There are different causes for mild achiness or pain in the abdomen during the different stages of pregnancy. For example:
- Implantation. Many women have low, period-like pain or cramps for a day or so early in pregnancy around the time the embryo is embedding itself in the lining of the uterus.
- Stretching of ligaments. In the second trimester, the muscles and ligaments that support your uterus stretch. (Ligaments are tough bands of tissue.) This can cause a dull ache across the belly or a sharp pain on one side. Many women feel this pain most severely when getting up from a bed, chair, or bathtub or when coughing.
- False labor. In the second and third trimesters, you may feel contractions or an irregular tightening of your uterus muscles, often called Braxton-Hicks contractions. These are usually painless, but can sometimes be painful. They tend to increase in the weeks right before your due date and can be confused with early labor. How can you tell the difference? Braxton-Hicks contractions are irregular. Labor contractions are regular, coming every 5-10 minutes.
- Cramping. In the last weeks of pregnancy, cramping may be a sign that labor is almost ready to begin. At the start of labor, you may have strong cramps that:
- Come regularly every 5-10 minutes
- Feel like a bad backache or menstrual cramps
Normal abdominal pain may also be caused by:
- Gas pains and bloating caused by hormones that slow your digestion
- The pressure of your growing uterus
- Constipation
- Heartburn
Abdominal Pain: What You Can Do
When you feel abdominal achiness, sit down, put your feet up, and relax. Resting comfortably should quickly relieve your symptoms. Other tips include:
- Avoid quick changes in position, especially turning sharply at the waist.
- When you do feel a pain, bend toward the pain to relieve it.
- Walking, doing light housework, or changing position may help relieve gas pains
When to Talk to Your Health Care Provider
Severe pain. While some pain or achiness is normal, severe abdominal pain or cramps could be a sign of a serious problem. Many conditions can cause this type of pain, whether you're pregnant or not. Severe pain may be a sign of stomach virus, food poisoning, appendicitis, urinary tract infection, kidney infection, kidney stones, gallbladder disease, or complications of pregnancy (such as preeclampsia).
Ectopic pregnancy. During the first three months of pregnancy, abdominal pain can be a sign of ectopic pregnancy.
In an ectopic pregnancy, the fertilized egg is implanted outside of the uterus. This serious condition requires immediate medical attention. Call your health care provider right away if you notice slight, irregular vaginal bleeding a week or more after you miss your period. The bleeding is often followed by pain in the lower abdomen, usually on one side. Without treatment, the pain will get worse and may be accompanied by shoulder pain, faintness or dizziness, nausea or vomiting.
Preterm labor. Before the 37th week of pregnancy, abdominal cramping can be a sign of preterm labor. Call your health care provider or go to the hospital right away if you experience abdominal pain that includes any of the following:
- Contractions (your abdomen tightens like a fist) every 10 minutes or more often
- Pelvic pressure—the feeling that your baby is pushing down
- Cramps that feel like your period
- Abdominal cramps with or without diarrhea
Other signs of preterm labor are:
- Change in vaginal discharge (leaking fluid or bleeding from your vagina)
- Low, dull backache
False labor. Abdominal pain during the second and third trimesters can be caused by Braxton-Hicks contractions. These contractions tend to increase in the weeks right before your due date. You are probably having “false” labor if the contractions:
- Stop when you walk
- Are irregular
- Don't get stronger or closer together over time
Labor. Call your health care provider when:
- Your contractions are between 5 and 10 minutes apart.
- Your water breaks, especially if the fluid is stained dark, greenish brown.
- You have bleeding from your vagina.
- You can no longer walk or talk during contractions.
- You are concerned about your health or the health and well-being of the baby.
