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Abdominal Pain or Cramps during Pregnancy

Is it normal to have abdominal pain or cramps during pregnancy?

Having occasional mild to moderate abdominal pain is normal throughout pregnancy [1]. The pain is often more severe in women carrying twins than in single pregnancies. Severe pain with or without certain other symptoms may indicate a number of serious complications [2].

Are abdominal pain and cramping early signs of pregnancy?

Menstrual-like abdominal cramps that come and go are one of the earliest symptoms of pregnancy [3], often occurring even before you notice the missed period and a home pregnancy test shows positive results. It is generally accompanied by other symptoms like spotting (implantation bleeding) fatigue, breast tenderness, nausea and constipation [4] in the first months.

Why is lower right abdominal pain more common during pregnancy?

With the growth of the embryo, the uterus begins to tilt towards the right, causing the ligaments to stretch or contract. This often leads to lower right abdominal pain and cramping [5].

What causes upper/lower abdominal pain in pregnancy?

Common harmless causes

  • The embryo implanting itself to the uterus wall (constant low period-like pain in the upper abdomen, lasting for about a day) [1]
  • Indigestion, gas, bloating and constipation occurring as a result of the hormonal changes [6]
  • The growing uterus putting excessive pressure on the intestine, bladder, muscles and ligaments (the uterus pulling on the ligaments often cause pain around the bellybutton)
  • Exercising while pregnant, putting additional pressure on the muscles and ligaments [2]
  • The cramping may become more noticeable due to rapid movements such as standing up suddenly, coughing or sneezing
  • Round ligament pain, mainly occurring during the second and third trimester (caused by the extra stress on certain ligaments due to holding the growing uterus in suspension within your abdomen) [6]
  • Having a history of c-section delivery
  • Braxton Hicks contractions or false contractions
  • Pelvic girdle pain
  • Having intercourse

Serious causes

Non-pregnancy related causes

  • A viral stomach infection [10], food poisoning or allergies
  • Kidney and urinary tract infections [10]
  • Appendicitis
  • Gallstones [6]
  • Inflammatory bowel syndrome
  • Gastroesophageal reflux disease (GERD) [22]
  • Pelvic inflammatory disease
  • Hernia
  • Lactose intolerance

How to prevent lower abdominal pain while pregnant?

  • Drinking lots of fluid to stay hydrated [11]
  • Getting plenty of rest
  • Doing regular stretching exercise to keep the abdominal muscles strong and toned for avoiding conditions like round ligament pain (avoid exercises that require you to lie on your back for over a few minutes in the first trimester as they may be harm your baby by reducing the blood supply) [12]
  • Practicing relaxation techniques such as deep breathing
  • Avoiding lifting heavy objects or climbing stairs quickly (especially during the second and third trimesters) [13]

How to relieve pregnancy abdominal pain?

  • Taking a warm bath [14]
  • Lying down on the opposite side of the pain
  • Massage therapy by a licensed practitioner
  • If the symptom is resulting from round ligament pain, reducing the amount of daily activities and avoiding the sitting, standing and lying positions that trigger the pain can help manage it [15]
  • For sudden pain, bending forward to the point of pain relief and then relaxing the muscles again (this helps to reduce the tension of the muscles and tissues) [11]
  • Home remedies such as lemon juice and ginger may help with fast pain-relief (make sure to consult your doctor before using these natural remedies)
  • Walking or changing positions (helps to relieve pain caused by gas) [21]

When to call the doctor?

  • Severe pain that wakes you up at night
  • Sharp lower abdominal pain in early pregnancy accompanied by vaginal bleeding or passing blood clots and tissues (might indicate miscarriage or ectopic pregnancy) [16]
  • One sided abdominal pain [24]
  • Constant pain with or without bleeding (especially during the first trimester) [2]
  • Pain accompanied by fever or chills [5]
  • Pain along with the symptoms of faintness or lightheadedness
  • Intense pain in the upper abdominal area along with headache, nausea and vision disturbances, especially during the third trimester (might indicate preeclampsia) [17]
  • Abdominal cramps accompanied by a burning sensation while urinating (might indicate urinary tract infection)
  • Pain accompanied by lower back pain and diarrhea [18]
  • Menstrual-like cramping accompanied by over 5 contractions within an hour before the 37th week of pregnancy (might be a sign of premature labor) [7]

ICD-9 and ICD-10 Codes

The ICD-9 code used for indicating abdominal pain is 789.0 [19] while its ICD-10 code is R10 [20].

Published on January 9th 2014 by under Pain During Pregnancy.
Article was last reviewed on 9th January 2014.

  • Comments

      10 Responses to Abdominal Pain or Cramps during Pregnancy

      1. niki says:

        Hi, I have missed my period and have been getting this knot feeling on my left side with a little cramping . I have been sleeping more and kind of moody ,could I be pregnant?

        • Pregmed Editorial Team says:

          Having these signs does not always mean you are pregnant, as there are various other factors that may lead to such symptoms. How long has it been since you missed your period? Have you taken a pregnancy test? If not, then consider taking one after a couple of weeks. Make sure to take the test first thing after you wake up in the morning.

      2. Sravz says:

        Hi..I have abdominal right pain ,lower back pain and my sore breasts since 1 last period was March 21st and period after 10days I had dark blood probably on April 1st.this could be pregnent??

        • Pregmed Editorial Team says:

          I am assuming you did not have your regular period this month. Have you tried taking a pregnancy test? It is quite difficult to confirm that you are pregnant just because you are having abdominal and back pain. This article is about abdominal cramps in pregnancy, but there are many other factors that can lead to similar symptoms in a non-pregnant women. So, keep track of any other possible pregnancy symptom and take a home pregnancy test the first thing you wake up in the morning. It is the most reliable way to find out for sure. All the best.

      3. Briana says:

        I have been having upper abdominal pain for two days now, and noticed in my sleep I woke up really sweaty but freezing. Is it time to go to the doctor?

        • Pregmed Editorial Team says:

          Well, just because you have these symptoms it does not necessarily mean that you must be pregnant. But yes, there is a chance that you may be, so it is good that you are considering going to the doctor. Have you taken a home pregnancy test? In any case, seeing your doctor won’t harm as that way you can also find out if some other underlying problem is causing the symptoms, in case you are not pregnant. Take care and keep your fingers crossed. All the best.

      4. my mens was on 26th may and after completion i have a needle like pain in abdomen wherther i am preg or not

        • Pregmed Editorial Team says:

          It is not possible to confirm that you are pregnant just because you are having abdominal pain. Wait and see if you have some other signs. Usually, people suspect they are pregnant after they miss a period.

      5. Lax says:

        I have missed my periods almost more than 10 days(I missed my periods from 4 Jun) and I did the home pregnancy test and they are positive last week.
        now I am getting pain in my lower abdomen towards right side.. pain is not that much that .. but i feel when I am sitting down and getting up from the sitting position or changing position on bed. no bleeding when passing urine.

        Is it normal and how long it will remains usually( for days or weeks).
        I had a doctor appointment on 23 .. should I wait till that time or i have to go for visit this week ?
        I appreciate your advice.

        • Pregmed Editorial Team says:

          A little pain should not be a cause of concern as mild abdominal pain is quite normal in early pregnancy. And from what you are saying, it seems that the pain is not constant. So, try to relax and take care. But if the pain increases or becomes unbearable, or if you start experiencing stabbing pains in your side, Do contact your doctor as soon as possible. But for now, relax and don’t worry too much. All the best.

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