Abdominal Pain During Pregnancy

Pregnant woman experiencing abdominal pains

Abdominal pain during pregnancy can be a normal part of the process as your body changes to accommodate your growing baby. While there are many harmless causes of abdominal pain in pregnancy, some may be more serious. As an expectant mother, it is important to educate yourself on all potential causes so that you are able to recognize symptoms that may cause concern.

Common Abdominal Pain During Pregnancy

Mother with serious abdominal pain during her pregnancy Some abdominal aches and pains during pregnancy are quite common and generally pose no threat to you and your baby.

These include:

  • Round Ligament Pain: This can be characterized by a sharp stabbing pain when you change positions or it can also be an achy, dull lingering pain. Round ligament pain is caused by the two large ligaments that run from your uterus to your groin. As the uterus grows, these ligaments are stretched and create discomfort. This pain is generally reported in the second trimester, and considered to be harmless. Read the full Round Ligament Pain article.
  • Gas and Constipation: Gas during pregnancy is caused by increased levels of progesterone.  As more of this hormone is released, your gastrointestinal tract slows down which makes food travel more slowly. Drinking plenty of water, eating fiber rich foods, exercising, and using stool softeners are excellent ways to combat excessive gas and constipation. Learn more about Constipation during Pregnancy.
  • Braxton Hicks Contractions: Sometimes labeled “practice contractions” Braxton Hicks are more of a mild annoyance than a risk to you or your baby. Many women report that Braxton Hicks feel like a tightening of the stomach muscles so that your stomach feels firm or hard. It is important to differentiate Braxton Hicks from true contractions. True contraction will be closer together, last for a longer period of time and are painful. True contractions will take your breath away, so a general rule of thumb is that if you are able to carry on your normal activities, then it is Braxton Hicks. Doctors report that Braxton Hick can be caused by dehydration, so drinking plenty of water can help eliminate this problem. Read more on Braxton Hicks Contractions.
  • Common Discomforts: In addition to those listed above, there are several other common abdominal discomforts that can be experienced during pregnancy and are generally non-threatening. Your growing uterus, stomach viruses, kidney stones, fibroids and food sensitivities are all valid forms of harmless abdominal pain.

Serious Abdominal Pain During Pregnancy

Pregnant woman with abdominal pain Although many women have healthy pregnancies, unfortunately there are times when abdominal pain can pose a serious risk.  If you exhibit any severe symptoms of the types of abdominal pain below, please consult your medical care professional immediately.

  • Ectopic Pregnancy: Occurring in 1 out of 50 pregnancies, an ectopic pregnancy is when the egg is implanted anywhere other than the uterus.  Most often, the egg is implanted in the fallopian tube.  Sadly, an ectopic pregnancy cannot continue to term and requires medical treatment.  In the unlikely event that you have an ectopic pregnancy, you may experience intense pain and bleeding between your 6th and 10th weeks of pregnancy. Women at increased risk for an ectopic pregnancy include those who have had an ectopic pregnancy in the past, or have had endometriosis, a tubal ligation or an intrauterine device (IUD) in place at the time of conception.  Learn more about Ectopic Pregnancies.
  • Placental abruption: Placental abruption is a life-threatening condition in which the placenta separates from your uterus before the baby is born. One symptom of placental abruption is constant pain that causes your stomach to stay hard for an extended period of time without relief. Another sign is bloody fluid or premature breakage of your water. Additional signs include tenderness in your abdomen, back pain, or fluid discharge that includes traces of blood. You can access the complete Placental Abruption article here.
  • Miscarriage: The unfortunate truth is that 15 to 20 percent of pregnancies end in miscarriage making it the most common form of pregnancy loss. Sometimes referred to as “spontaneous abortion,” miscarriage most often occurs in the first 13 weeks of pregnancy. Signs of a miscarriage include mild to severe back pain, true contractions (happening every 5-20 minutes), brown or bright red bleeding without cramps, tissue or clot-like material passing from the vagina and a sudden decrease in other signs of pregnancy. Read the full article on Miscarriage.
  • Urinary Tract Infection: While easily treated during pregnancy, if ignored, a urinary tract infection can cause complications. Most often recognized by pain, discomfort, and/or burning when you urinate, UTIs can also produce lower abdominal pain. Should you notice pain in your lower back, the sides of your body under your rib cage or above your pelvic bone accompanied by fever, nausea, sweats or chills then it is possible that the UTI has spread to your kidneys. If this is the case, seek medical attention as soon as possible.
  • Preeclampsia: Preeclampsia is a condition in pregnancy characterized by high blood pressure and protein in the urine after 20 weeks gestation. Upper abdominal pain, usually under your ribs on the right side, can accompany other symptoms used to diagnose preeclampsia. Nausea, vomiting and increased pressure on your abdomen are additional symptoms that will affect your abdomen. Learn more about Preeclampsia.

When Should I Call My Doctor?

Please call your medical care professional immediately if any of the following symptoms accompany abdominal pain or discomfort:

  • Severe or persistent pain
  • Spotting or bleeding
  • Fever
  • Chills
  • Vaginal discharge
  • Light-headedness
  • Discomfort while urinating
  • Nausea and vomiting

Compiled using information from the following sources:

Clinic, Mayo, Complete Book of Pregnancy and Baby’s First Year. New York, NY: William Morrow and Company, Inc.

Current Obstetric & Gynecologic Diagnosis & Treatment Ninth Ed. DeCherney, Alan H., et al.

Williams Obstetrics Twenty-Second Ed. Cunningham, F. Gary, et al, Ch. 10.

American Academy of Family Physicians, http://www.aafp.org/