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Stomach pain during pregnancy is normal but it can be scary. As a pregnant woman’s body changes to accommodate her growing baby, it is normal to experience abdominal pain during that time. There are many harmless causes of abdominal pain during pregnancy but sometimes these causes can be serious. Sometimes, stomach pain could be an indication of pregnancy-related complications, which require immediate medical intervention. Read on to understand the symptoms and causes of severe abdominal pain in pregnancy.
Is It Normal to Experience Abdominal Pain While Pregnant?
Most expectant women experience abdominal pain or cramps at some point in the nine months of their pregnancies. If you experience abdominal pain during pregnancy, you need not panic as most of the time it is normal. As you carry your baby in the womb, the extreme pressure on the muscles and joints can make your belly feel uncomfortable at certain times and you might experience stomach pain. It is normal for pregnant women to have mild abdominal pain during early pregnancy. However, any severe or sharp pain in your abdominal area is a matter of great concern. If the abdominal or stomach pain persists for longer or is severe, it could be an indication of a severe pregnancy-related complication and you must consult a doctor immediately.
Abdominal Pain in Pregnancy
As an expectant woman, you may experience different types of abdominal pain during the 3 trimesters of your pregnancy. This section discusses the common causes of abdominal pain during each of these trimesters.
1. Abdominal Pain in the First Trimester of Pregnancy
During your first trimester, you may experience cramping pain in your abdomen, which occurs as your baby develops. Cramping is experienced during the expansion of the uterus, which causes the supporting ligaments and muscles to stretch. Cramping during pregnancy is considered normal and can also occur due to other causes including gas and bloating, constipation, or sexual intercourse.
Women, who have undergone IVF treatment to get pregnant, can be diagnosed with a condition called ovarian hyperstimulation syndrome (OHS), which results in abdominal pain. This pain is mainly caused due to the over-stimulation of the ovaries by the fertility drugs. This pain usually lasts for a few weeks of pregnancy. One must consult a doctor immediately.
2. Abdominal Pain in the Second Trimester of Pregnancy
In the second trimester of pregnancy, most women experience round ligament pain. There are two round ligaments that run from the uterus to the groin. These ligaments support the uterus. When the uterus expands to accommodate the growing baby, the round ligaments stretch too. This leads to sharp pain in the abdomen. Some women have also reported this type of pain in the hip or groin area. The round ligament pain is considered normal during pregnancies and does not lead to any major complications.
3. Abdominal Pain in the Third Trimester of Pregnancy
During the third trimester, you may experience pain in different parts of your body including the abdomen, back, and hips. In preparation for childbirth, the connective tissues in your body will loosen, thus enhancing the flexibility of your birth canal. Most pregnant women experience pain in their hips or lower back due to the loosening and stretching of the connective tissues. Abdominal pain in the third trimester can also be experienced because of the following.
- Gas and Constipation
Pregnant women often complain of gas and constipation problems during pregnancy. These problems arise primarily because of an increase in the levels of the progesterone hormone. With the increasing level of this hormone, the intestinal muscles relax and the food passes through the intestine slowly. As the food remains in the colon for long, more gas is developed. But gas and constipation can be prevented by consuming more water, exercising, along with the regular consumption of fibre-rich foods.
- Braxton-Hicks Contractions
Braxton-Hicks contractions are similar to labour contractions, but NOT the same. They are a false form of contractions, commonly resulting in the tightening of the stomach muscles. These contractions may make your stomach very tight and stiff. For some women, Braxton-Hicks Contractions can start as early as in the second trimester, and others may experience them right around delivery. Braxton-Hicks contractions are very different from actual contractions, which occur more frequently, are of longer duration, and can be very painful. These are caused more due to dehydration, so drinking plenty of water and regular rest can help in eliminating this condition.
Reasons for Stomach Pain in Pregnant Women
All women experience abdominal discomfort during pregnancy, and it is normal. A primary reason for stomach or abdominal pain in pregnant women is the growing size of the uterus, which grows as the baby grows. Lower abdominal pain is experienced regularly because of the stretching of the uterus. The increase in the weight and size of the uterus can also exert tremendous pressure on its supporting ligaments and muscles, which is the reason for regular cramping.
Serious Concerns Associated With Abdominal Pain During Pregnancy
While experiencing abdominal pain during pregnancy is normal, sometimes, it could indicate severe problems. This section discusses some of the serious complications that could arise due to severe abdominal pain during pregnancy.
1. Ectopic Pregnancy
An ectopic pregnancy occurs when the egg is implanted anywhere other than the uterus. In most cases, the egg is implanted in the fallopian tube. According to medical records, an ectopic pregnancy occurs once in every 50 pregnancies. Women, in this condition, usually experience abdominal pain and bleeding between the 6th and 10th week of their pregnancies. Most ectopic pregnancies are only diagnosed between the 4th and 8th week of the term.
Ectopic pregnancy is extremely difficult to differentiate from a regular pregnancy, particularly in the early stages of pregnancy. Some of the symptoms that could indicate to ectopic pregnancy include:
- Pain in the lower abdomen, followed by a sharp pain on one side of the belly, which then extends to the entire abdomen.
- Pain, which worsens each time the pregnant women moves.
- Mild bleeding
- Vaginal bleeding or spotting
- Dizziness or feeling faint
- Increase in urination along with pain while urinating.
Women, who are at a greater risk for ectopic pregnancy, include those who have:
- Had an ectopic pregnancy in the past
- Had endometriosis
- Undergone a tubal litigation
An ectopic pregnancy requires immediate medical treatment and cannot be allowed to continue for the full term. Your gynaecologist or doctor can easily confirm if the egg is implanted within the uterus by performing an ultrasound test.
Sometimes, experiencing abdominal pain in the first trimester of pregnancy could be a sign of an impending miscarriage. A miscarriage usually occurs in the first 13 weeks of the pregnancy term and impacts around 15-20% of all pregnancies.
Major symptoms of a possible miscarriage include:
- Extreme pain in the back
- Contractions occurring in every 5-20 minutes
- Severe bleeding with or without cramps
- Bleeding or vaginal spotting followed by either mild or sharp cramping
- Passing of tissues or clot-like substance from the vagina
3. Preterm Labour
If a pregnant woman experiences contractions regularly before the completion of 37 weeks of her pregnancy along with persistent backache, is more likely to have preterm labour. Preterm labour can occur anytime between the 24th and 37th week of pregnancy. During these weeks, one may feel pain in the pelvic area or lower tummy, caused by the contractions. The contractions are also followed by vaginal bleeding. The woman should consult her doctor immediately if she experiences abdominal pain during this time.
4. Placental Abruption
When the placenta detaches from the uterus before the completion of pregnancy, it is known as placental abruption. This can be life-threatening for a baby as the placenta is the only source of oxygen and nutrition to the baby. Placental abruption occurs once in every 200 births and usually occurs during the third trimester. Pregnant women, who have had a history of placental abruption in previous pregnancies, are at high risk of this complication, along with those with other medical complications such as high blood pressure, preeclampsia, and abdominal trauma.
Major symptoms of placental abruption include:
- Constant and worse abdominal pain
- Severe hardening of the uterus for an extended duration
- The flow of bloody fluid or premature water breakage
- Fluid discharge with blood traces
- Tenderness in the abdomen
Most women go into immediate labour when the placenta detaches and deliver their babies by undergoing an emergency caesarean operation. In the case of mild abruption, doctors may either allow the pregnancy to continue or perform induced labour or vaginal delivery.
Preeclampsia is a condition that affects 5-8% of pregnant women. It occurs after 20 weeks of pregnancy and is characterized by high blood pressure along with protein in the urine. Preeclampsia can slow the growth of the baby, as the high blood pressure can cause the constriction of the blood vessels in the uterus, thus reducing the flow of oxygen and nutrients to the uterus. Preeclampsia also increases the risk of placental abruption.
Severe preeclampsia has the following common symptoms:
- Severe pain in the right side of the abdomen
- Pain in the upper part of the stomach
- Visual disturbances
After 20 weeks of pregnancy, most doctors and gynaecologists regularly check the blood pressure of pregnant women, in order to detect any abnormality.
6. Urinary Tract Infections
Around 10% of pregnant women get a urinary tract infection (UTI) at some point during their pregnancy term. While early detection of UTI can be treated through antibiotics, ignoring this problem can lead to serious infections in the women’s kidney that increases the chances of preterm labour.
Common symptoms associated with UTI include:
- Pain in the lower abdomen
- Discomfort or a burning sensation during urination
- Constant urge to urinate
- Cloudy and smelly urine
- Irritation in the genital area
- Constant feverish sensation, sweating, and chills
- Pain in the lower back, under the rib cage, or above the pelvic bone.
Most doctors and gynaecologists conduct regular urine tests to check the presence of bacteria that can lead to UTI. When detected early, UTI can be easily treated using antibiotics.
Appendicitis during pregnancy can be difficult to diagnose. This is primarily because as the uterus develops, the appendix is pulled up and is located near the belly button or liver.
Common symptoms of appendicitis in pregnant women include:
- Pain in the right side of the abdomen
- Lack of appetite
Gallstones are the presence of stones in the gallbladder of a pregnant woman. Gallstones are focused in the upper right part of the abdomen. In some instance, the pain may be felt around the back and below the right shoulder.
Gallstones are common in pregnant women, who:
- Are overweight
- Are above the age of 35 years
- Have a medical history of stones
Some Other Causes of Abdominal Pain in Pregnancy
In addition to the above conditions, there are a host of other reasons that could lead to abdominal pain during pregnancy:
- Food poisoning
- Sensitivity to food
- Growth of the uterus
- Kidney stones
- Gallbladder disease and pancreatitis, both of which are commonly a result of the presence of gallstones.
- Fibroids, which grow during pregnancy
- Bowel obstruction, which commonly occurs during the third trimester.
Stomach Cramps During Early Pregnancy
Most pregnant women also experience stomach cramping in the early stages of their pregnancies. Experiencing mild stomach cramps is normal and not a cause of worry. Listed below are some of the common causes of stomach cramps in the early days of pregnancy:
- A woman may have cramps after sexual intercourse.
- A woman may experience cramps along with a little bleeding if the embryo is implanted within the walls of the womb. Cramping is also likely to happen when the embryo changes its shape to accommodate the baby.
- After 12 weeks, a pregnant woman may experience sharp pains on both sides of the groin, particularly while standing up, stretching, or twisting her body. This is primarily due to the stretching of the ligaments supporting the womb.
In case you experience stomach cramps in the early stages of your pregnancy, you are advised to report this to your gynaecologist or midwife.
Remedies for Stomach Pain During Pregnancy
If you are experiencing any symptoms that indicate a serious complication, it is best to consult your doctor or gynaecologist immediately. However, pregnant women feeling mild pain in the abdomen can try out any of the following remedial treatments at home:
- Resting or lying down for some time can provide relief immediately, particularly if it is because of Braxton-Hicks contractions.
- Taking a warm (and not hot) water bath can help provide relief from lower abdominal pain and cramping.
- Applying a hot water bottle (wrapped in a piece of cloth) or bag on the painful areas can help provide relief from the pain.
Additionally, you can try out the following remedies too to get rid of abdominal pain:
- Gentle exercises such as stretching and yoga, particularly in the first trimester, can treat gas problems. You can speak to your midwife or any other specialist regarding the antenatal exercises that are suitable for you.
- Drink plenty of water throughout the day. Dehydration is among the primary causes of the Braxton- Hicks contractions.
- Have small but more frequent meals. Follow a healthy diet that is rich in fibre, such as fruits and vegetables.
- Urinate often and empty your bladder. Do not control your urge to urinate.
- Create a habit of standing up or sitting more gradually, instead of sudden movements. This will help you in reducing your spasms.
When to Consult a Doctor
If you are experiencing any of the symptoms mentioned below during any stage of your pregnancy, it could be indicative of a more serious complication, in which case you must consult your doctor:
- Bleeding or a burning sensation while peeing
- Abdominal pain before the completion of 12 weeks of your pregnancy
- Vaginal spotting or bleeding in the early stages of your pregnancy
- Having more than 4 contractions in an hour
- Severe or unbearable abdominal pain
- Severe headaches
- Regular vomiting or fever
- Unusual swelling in face, legs, or hands
- Any unusual vaginal discharge
In some instances, these symptoms may not be related to your pregnancy and may be caused due to some other medical condition such as an ovarian cyst, kidney abnormalities, urinary tract infections, or gallbladder problems.
While stomach cramps are not a serious cause of worry, it is advisable to see a doctor if they are very severe and unbearable for you.