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Severe stomach pain during pregnancy can be an indication of pregnancy-related complications and deserves a complete medical intervention.
This article discusses the symptoms and causes of severe abdominal pain in pregnant women, the serious medical conditions in pregnant women, along with the recommended treatment methods.
What is Abdominal Pain?
Most expectant mothers experience normal pains, aches, and cramps in their stomach at some point during their pregnancy. Abdominal pain is normal because carrying a growing baby can put extreme pressure on your muscles and joints, thus making your belly feel uncomfortable at certain times.
You can reduce abdominal pain by resting (which can ease the cramping), having a warm water bath, or by applying a hot water bottle or bag on the painful areas.
However, if your abdominal or stomach pain persists or is more severe, it could be an indication of a more severe pregnancy-related complication or problem.
Abdominal Pain in Pregnancy
As an expectant mother, you may experience different types of abdominal pain during the 3 trimesters of your pregnancy. This section discusses the common abdominal pains during each of these trimesters.
1. Abdominal Pain in First Trimester
During your first trimester, you may experience cramping pain in your abdomen, which occurs due to the normal development changes occurring in your baby. Cramps can be described as a pulling sensation on both sides of your abdomen. Cramping is experienced during the expansion of your 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 the Ovarian hyperstimulation syndrome (OHS), which can cause 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 the pregnancy and must be reported to the fertility clinic if it persists beyond that period.
2. Abdominal Pain in Second Trimester
A common form of abdominal pain in the second trimester of pregnancy is the Round ligament pain, which is caused by the 2 large ligaments that connect the uterus to the groin. The round ligament muscle supports the uterus, and when it stretches, you can feel a sharp stabbing pain, or a mild ache in the lower 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 Third Trimester
During the third trimester, pregnant women experience pain in different parts of their body including the abdomen, back, and hips. In preparation for child birth, the connective tissues in your body loosens, 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 is caused due to multiple reasons including:
- Gas and Constipation
Gas in pregnant women is primarily caused due to increase in the levels of the progesterone hormone. With increasing level of this hormone, the gastrointestinal tract is slowed down, which slows the flow of food. Gas and constipation can be prevented by consuming more water, exercising, along with the regular consumption of a fibre-rich diet. Other remedies can be the use of medical stool softeners or the consumption of artificial fibre supplements.
- Braxton-Hicks Contractions
Braxton Hicks contractions are a false form of contractions, commonly resulting in the tightening of your stomach muscles. Braxton Hicks contractions are very different from actual contractions, which occur more frequently, are of longer duration, and can be very painful. Braxton Hicks is caused more due to dehydration, so drinking plenty of water and regular rest can help in eliminating this condition.
Symptoms Of Pregnancy Stomach Pain
If you are experiencing any of the following symptoms 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 when you pee.
- 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 headache
- Regular vomiting or fever
- Unusual swelling of your 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 infection, or gallbladder problems.
Reasons for Stomach Pain in Pregnant Women
All women experience abdominal discomfort during pregnancy, which is considered normal.
A primary reason for stomach or abdominal pain in pregnant women is the growing size of your uterus, which gets bigger with the increasing size of your baby. Lower abdominal pain is experienced regularly because of the stretching of the uterus. The increase in the weight and size of your uterus also exerts tremendous pressure on its supporting ligaments and muscles, which is the reason for regular cramping.
Is It Normal to Have Abdominal Pain While Pregnant?
It is normal for pregnant women to have mild lower left abdominal pain during early pregnancy. However, any severe or sharp pain in your abdominal area is a matter of great concern.
Lower abdominal pain along with cramping, termed as Round ligament pain, is considered normal even for the entire duration of pregnancy. Abdominal pain is an indication of your uterus getting prepared to carry the foetus for the entire 9 months of pregnancy.
Serious Concerns Associated with Abdominal Pain During Pregnancy
This section discusses some of the serious complications that could be developing due to severe abdominal pain during a 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 pregnancy. Most ectopic pregnancies are only diagnosed between the 4th and 8th week of the pregnancy term.
Ectopic pregnancy is extremely difficult to differentiate from a regular pregnancy, particularly during early pregnancy. Some of the symptoms that could indicate ectopic pregnancy include:
- Pain sensation 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
- Feeling of sickness, dizziness, or fainting
- Increase in urination along with pain during urinating.
Women, who are at a greater risk for ectopic pregnancy, include those who have undergone a:
- Ectopic pregnancy in the past
- Tubal litigation
- Intrauterine device (IUD) at the time of conception
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 planted in the uterus by performing an ultrasound test.
This is a major complication for women experiencing severe abdominal pain during the first trimester. Miscarriage, or spontaneous abortion, usually occurs in the first 13 weeks of the pregnancy term and impact 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
- Sudden reduction in other signs of pregnancy
3. Preterm Labour
Pregnant women, who are experiencing contractions regularly before the completion of 37 weeks of their pregnancy, along with persistent backache, are likely to have a preterm labour. Preterm labour can occur anytime between 24th to the 37th week of pregnancy. During these weeks, you may feel pain in your pelvic area or lower tummy, caused by the contractions. The contractions are also followed by the leaking of vaginal fluid or blood.
Experienced doctors or gynecologists advise pregnant women to call upon them for medical checkup immediately after experiencing contractions during these weeks.
4. Placental Abruption
This is a life-threatening condition for babies, caused by the separation of the placenta (which supplies oxygen and nourishment for the baby) from the uterus before the completion of the pregnancy term. 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 for 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 worsening abdominal pain
- Severe hardening of the uterus for an extended duration
- Flow of bloody fluid or premature water breakage
- Fluid discharge with blood traces
- Tenderness in the abdomen
Most women go into immediate labour on the separation of the placenta and deliver their baby 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 hypertensive disorder that occurs in an estimated 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 right side abdominal pain
- Upper stomach pain, commonly under the ribs on the right side
- Visual disturbances
After 20 weeks of pregnancy, most doctors and gynaecologists regularly check the blood pressure of the pregnant women, in order to detect any abnormality.
6. Urinary Tract Infections
According to medical estimates, around 10% of pregnant women get a urinary tract infection (UTI) at some point during their pregnancy term. While an 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 a preterm labour.
Common symptoms associated with UTI include:
- Pain in the lower abdomen
- Discomfort or a burning sensation during urination
- Constant urges 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. This could be a case of the spread of UTI to the kidney.
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 occurring in pregnant women can be difficult to diagnose, thus resulting in a delay and a higher risk for the women. 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 higher right side of the abdomen
- Lack of appetite
Gallstones are the presence of stones in the gallbladder of pregnant women. Gallstones is 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
- Have a medical history of stones
Other Causes of Pregnancy Abdominal Pain
In addition to the above conditions, there are a host of other reasons causing abdominal pain during pregnancy, which include:
- Stomach virus and 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 thus causing discomfort.
- Bowel obstruction, which commonly occurs during the third trimester. This is caused by the increasing pressure exerted by a growing uterus on intestinal tissue.
Stomach Cramps During Early Pregnancy
Most pregnant women also undergo stomach cramping during their early pregnancy days. Like in other cases, mild stomach cramps are normal and are not cause for any worry. Listed below are some of the common causes of stomach cramps in the early days of pregnancy:
- Cramping can be felt by women, following an orgasm during sexual intercourse.
- Cramping along with a little bleeding is felt when the embryo is implanted within the walls of the womb. Cramping is also likely to happen when the embryo changes shape to accommodate the baby.
- After 12 weeks, pregnant women may experience sharp pains on both sides of the groin, particularly when they stand up, stretch, or twist their body. This is primarily due to the stretching of the ligaments supporting the womb.
Most stomach cramps occurring during early pregnancy feel more heartburns or period pains. In case you are undergoing stomach cramps during early 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 relieve the immediate pain, particularly those caused by the Braxton Hicks contractions.
- Taking a warm (and not hot) water bath can help in relief from lower stomach pain and cramping.
- Applying a hot water bottle (wrapped in cloth) or bag on the painful areas can help in reducing the pain sensation.
Additionally, you can try out the following remedies to reduce the occurrence of abdominal pain:
- Gentle exercises such as stretching and yoga, particularly in the first trimester, can be of assistance, particularly from gas problems. You can speak to your midwife or any other specialist regarding the antenatal exercises that are suitable for you.
- Avoid body movements that require you to make sharp turns at the waist.
- Drink plenty of water throughout the day. Dehydration is among the primary causes of the Braxton Hicks contractions.
- Have smaller and more frequent meals. Choose a diet that is rich in fibre, such as fruits and vegetables.
- Urinate and empty your bladder regularly.
- Create a habit of standing up or sitting more gradually, instead of sudden movements. This will help you in reducing your spasms.
While stomach cramps are not a serious cause of worry, it is advisable to see a doctor if you are uncomfortable or if they are very severe.