Pain and Cramping During Pregnancy: When to Worry | Parents

Mom-to-bes can expect a fair amount of aches. Watch this trimester-specific guide on how to tell if your pain or cramping could be more serious.


-Pain is incredibly common in pregnancy. It’s not easy to carry around a growing uterus for nine months. And most of the pain that people get in pregnancy are related to growth spurts at the uterus and the fetus. In general, if pain is mild to moderate, it’s not persistent, it’s not severe, and it goes away with rest, it’s not gonna be something you need to worry about. I would say the warning signs are probably when it’s associated with fever, when it’s radiating to a different part of the body, when there is burning on urination, then these would all be things that I think you should talk to your doctor about. A lot of patients say that they feel abdominal cramping around the time of implantation of the pregnancy, so very early after conception. A lot of people will say they have lower abdominal midline cramping, almost like menstrual cramping. If you’ve already had an ultrasound and you’re bleeding, then we know it’s not an ectopic pregnancy, but we need to make sure that the bleeding hasn’t affected the pregnancy. In the second trimester starting from about 15 weeks going up until around 22, maybe 24 weeks, the most common cause of abdominal pain is probably around ligament pain. It’s caused by the ligaments that normally hold the uterus in the pelvis. It gets stretched under tension as the uterus grows out of the pelvis and that pain can usually be felt on one side or the other. I would say lower abdominal pain on one side or the other and kind of a pulling sensation. So, with round ligament pain, we ask patients, well, when they lie down and you rest, does it get better? And typically you will. In the third trimester, there can be new causes for abdominal pain that you may not have felt earlier. A lot of times patients will feel an intermittent contraction. Kind of out of the blue when they’re walking they stop. They kinda have to catch their breath for a moment and then they can keep going. And if it’s not persisting and it’s kind of an isolated cramp like that, it’s probably just a Braxton Hicks contraction and nothing more concerning than that. With labor, it’s a different issue. So, labor or preterm labor is typically a rhythmic pattern to the contraction. So, it comes and goes over time. If a patient is preterm, meaning less than 37 weeks, I often ask if you feel 5 or more of those an hour. If the answer is yes, then you need medical attention. And if you’re full term and you’re having 5 or more an hour, then that’s good news ’cause it probably means you’re going into labor. But regardless in any case, if you’re not sure about the abdominal pain that you’re having, you should just call your doctor.

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