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Stomach Pain During Pregnancy: Common Causes And How To Ease It

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Occasional abdominal pain and cramping during pregnancy are often harmless and may be associated with the first trimester conditions, such as constipation and increased blood flow to the uterus, pain after eating. They may also be due to the second and third-trimester conditions, including Braxton-Hicks contractions and round ligament pain (1).

But sometimes, stomach pains during pregnancy could indicate an underlying condition, so carefully monitor these pains and visit your doctor if necessary.

MomJunction helps you decode the various causes of upper abdominal and stomach pain during pregnancy, when to seek medical advice, and how you can ease the discomfort.

Abdominal pain in early pregnancy

Stomach pain or discomfort in the first trimester is common. It is a part of the changes that your body undergoes to accommodate your baby for the next 40 weeks. Sometimes, abdominal pains are a reminder to watch what you eat as indigestion causes cramps. Even an orgasm could trigger abdominal pains. However, if the pain is localized, severe, and abrupt, and accompanied by nausea, vomiting, and vaginal bleeding, then it is best to consult your doctor (2).

Abdominal pain in the second trimester

Abdominal cramps in the second trimester aren’t usually a cause for worry unless followed by bleeding. There’s a decreased chance of a miscarriage during the second trimester. The abdominal pain may be the round ligament pain, which is due to the expansion of the uterus. If the cramps are followed by bleeding, visit the doctor immediately (3). However, be warned if you’re at risk of miscarriages or preterm births and see your doctor.

Abdominal pain in the third trimester

Besides false contractions, severe pain around the abdomen area during the third trimester is not common. The contractions are usually a sign of early (preterm) labor. Other symptoms of preterm labor include  change in the vaginal discharge, water breaking, pain around the pelvic area, a decrease in fetal activity, lower backache, and contractions (4). Call your doctor immediately if you experience one or all of these signs.

Cramps after 37 weeks may be an early sign of labor. If you experience abdominal pains after 37 weeks, look for other signs of labor such as bleeding or blood stained vaginal discharge, water breaking, contractions, etc. If none of these symptoms follow, there’s nothing to worry about; a stomachache is probably because of the baby (after assuming the head-down position) causing pressure around the pelvic area. Backache can also be due to wrong posture or weak back muscles.

Different Types Of Abdominal Pain During Pregnancy

You may experience pain in the upper abdomen, lower abdomen, upper right, lower left, lower right, mid stomach, and more. Here we tell you about each of them:

Upper abdominal pain

Any pain or discomfort that occurs in the area located between the lower ribcage margins and the navel is referred to as upper abdominal pain. In other words, the area is the center of the body, from under the breastbone to the umbilicus, and falls on both sides of the torso.

Upper left abdominal pain

This pain is felt from the left nipple to the umbilicus and can occur due to different structures or organs present in the upper left side of the abdomen, such as the spleen, the tail of the pancreas, left lower ribs, left kidney, a part of large intestine and bowel, a small part of the stomach, heart located on the upper left side, bones, skin, and muscles.

Upper right abdominal pain

Abdominal pain is felt from the right nipple towards the umbilicus level. The structures and organs responsible for causing the upper right abdominal pain are the liver, the lower part of the right lung, right kidney, adrenal gland, bones, skin, and muscles.

Lower abdominal pain

Any pain or discomfort that occurs in the abdominal region below the umbilicus or navel is called lower abdominal pain. It is also known as suprapubic pain and is caused due to various medical issues (5).

Lower left abdominal pain

This is more common than the lower right abdomen pain. The structures and organs responsible for causing this pain include Sigmoid colon, lower left kidney, left ureter, ovary and fallopian tube, a part of the urinary bladder and large descending bowel, as well as muscles, nerves, skin, and blood vessels present in the left abdomen area.

Lower right abdominal pain

It can be an acute or chronic pain in the lower right abdominal quadrant. However, it is not confined to the lower right quadrant and spreads to the left or the back.

The structures and organs present in this region include caecum, appendix, right ovary, fallopian tube and lower kidney, ascending colon, moderate part of the liver, right part of the womb, small intestine, muscles, nerves, blood vessels, and skin.

[Read: Round Ligament Pain During Pregnancy]

Common Causes Of Stomach Pain During Pregnancy

Some types of stomach pain in early pregnancy are common and pose no threat to the mother and the baby. However, if the pain is severe and persistent, or you are experiencing intense cramps and bleeding, you should see your OB-GYN. Here are some of the causes that may not be worrisome.

1. Round ligament pain (second trimester)

As the uterus expands, the round ligaments (two large ligaments which travel from the front of the uterus towards the groin) stretch, causing lower abdominal cramps. The pain may be sharp and stabbing or dull and achy when you move suddenly or change positions. These symptoms usually wear off after some time and aren’t a cause for worry (6).

If the pain is unbearable, you may ask your healthcare provider if you can take a painkiller (acetaminophen).

2. Gas and constipation

These two common complaints during pregnancy are caused due to increased progesterone levels. As progesterone increases, the gastrointestinal tract slows down, making the food travel slower than usual, and resulting in gas formation and constipation.

Drinking more water, eating foods high in fiber, and regular exercising help relieve the problem. Your doctor may also prescribe a fiber supplement or a stool softener (7). Avoid lying down immediately after food consumption.

[Read: Postpartum Constipation During Pregnancy]

3. Braxton-Hicks contractions (second and third trimesters)

They are mild and referred to as “practice contractions”. You will experience a tightened feeling of the stomach muscles similar to the real contractions. However, unlike the actual contractions, these are not progressive, and stop after you change positions (8).

Dehydration is the most prominent reason for these false contractions, so drink enough water to avoid them. If the contractions extend for a longer time, contact a healthcare provider.

4. Growing uterus

With the expansion of the uterus, your bowel is slightly displaced, leading to abdominal distention and nausea (9). To avoid the discomfort, you should eat frequently, have smaller meals, exercise regularly, get ample rest, and empty your bladder regularly.

5. Painful orgasm

Cramping during and after orgasm is quite common during early pregnancy. There is nothing to be worried about, as they are mild and short. The abdominal pain is mainly due to the normal contractions or the increased blood flow to the pelvic region. You need not worry about the baby getting hurt if you have an orgasm (10). However, in some situations, restricting sexual intercourse may be necessary.

6. Common discomforts

Apart from the above harmless causes, stomach viruses, fibroids, kidney stones, and sensitivity to certain foods might cause discomfort in the abdomen.

However, not all causes are harmless and should be ignored. Some have the potential to lead to serious complications.

Serious Causes Of Stomach Pain During Pregnancy

A few serious complications require immediate medical attention to avoid any risk to you and the baby. They include:

7. Ectopic pregnancy (first and second trimesters)

Ectopic pregnancy is where the egg implants outside the uterus, especially in the fallopian tube. As a result, you could suffer from a one-sided sharp pain in the lower abdomen and bleed (11).

Women who’ve had an ectopic pregnancy in the past, are aged over 35 years, got pregnant while having an intrauterine device inside, have tied fallopian tubes, have many sexual partners, or have some sexually transmitted diseases could be at an increased risk of ectopic pregnancy.

[Read: Causes Of Ectopic Pregnancy]

8. Miscarriage (first and second trimesters)

Miscarriage refers to the loss of pregnancy before the baby reaches 20 weeks. Vaginal bleeding is the first symptom, followed by abdominal pain lasting for a few hours to a few days. The pain may be mild or severe, and you may also have cramps. You will also suffer from lower back pain and pelvic pressure.

Most of the miscarriages happen in the first trimester, and sometimes in the second trimester. Sometimes, it is hard to say whether the pain is due to miscarriage, implantation, or expansion of the uterus. The pain and cramping during miscarriage can be differentiated through bleeding, which continues for some days (12).

See your doctor if you notice the signs of miscarriage.

9. Preterm labor (second and third trimesters)

If you happen to experience labor contractions before 37 weeks of pregnancy, you may be in preterm labor. This leads to persistent abdominal pain (feels like menstrual cramps), vaginal bleeding, heightened pelvic pressure, and reduced fetal movements (13).

You need to check with your doctor right away if you show the above symptoms.

[Read: Causes Of Preterm Labor]

10. Placental abruption (second and third trimesters)

It usually occurs in the third trimester when the placenta detaches itself from the uterus. Symptoms include progressive and severe abdominal cramps, bleeding (without clots), and contractions. Sometimes, a woman may go into labor immediately after the placenta detaches, necessitating an immediate C-section.

Get immediate medical attention if you experience any of these symptoms. High blood pressure, drug abuse, or placental abruption in the past are some of the reasons for the problem (14).

11. Preeclampsia (second to third trimesters)

Preeclampsia, which can develop any time in the second half of pregnancy, is indicated by high blood pressure and high level of protein in the urine. This is one of the reasons why doctors often monitor blood pressure levels during every prenatal visit. A severe type of preeclampsia is HELLP (Hemolysis, Elevated Liver enzymes, Low Platelet count) syndrome, which is a life-threatening condition.

Preeclampsia is associated with symptoms such as right upper quadrant abdominal pain, severe headache, difficulty in breathing, changes in vision, swelling of the face, eyes, hands, feet, and ankles, and rapid weight gain. If you suspect preeclampsia or HELLP, you should see your doctor (15).

12. Urinary tract infections

If you ignore urinary tract infections during pregnancy, it may lead to certain complications such as abdominal pain and discomfort, burning sensation while urinating, blood in the urine, and pain in the lower back. If you also suffer from fever, sweats, nausea, or chill along with the above signs, then it can progress to a kidney infection.

You need prompt medical intervention. The good thing is UTIs can be treated with antibiotics (2).

[Read: Urinary Tract Infection During Pregnancy]

13. Appendicitis

Appendicitis is a serious condition during pregnancy and is difficult to diagnose. Symptoms of appendicitis — nausea, vomiting, loss of appetite – are all similar to pregnancy-related symptoms, making it hard to diagnose the condition. Although appendicitis pain develops in the lower right quadrant of the abdomen, you could experience the pain a little higher during pregnancy as the appendix gets moved closer to the liver or the belly button (16).

14. Gallstones

You have a higher chance of having gallstones if you are older than 35 years, overweight, and have a history of the condition. You will have intense pain in the upper right quadrant of the abdomen and radiating pain in the back and below the right shoulder blade (9). Twisted ovarian cysts or hemorrhaigc cysts can also cause acute pain during pregnancy and needs to be evaluated and treated.

How To Ease Abdominal Pain During Pregnancy?

If there is mild to moderate pain, you might try to follow these simple tips to relieve it:

  • Exercise regularly or move around to relieve gas pain.
  • Rest as often as you can to get relief.
  • Drink plenty of water or fluids.
  • Choose fiber-rich foods such as bran, fruits, and vegetables.
  • Have small and frequent meals.

When To Consult A Doctor?

Do not hesitate to check with your OBS-GYN if you are suffering from any abdominal pain or cramping. Call the doctor right away under the following circumstances:

  • Sharp pain accompanied by bleeding or spotting during the first trimester.
  • Abdominal pain with or without bleeding.
  • A headache, vomiting, nausea, and dizziness.
  • Severe edema or swelling of the hands and feet.
  • Burning sensation during urination and pain while urinating.
  • Fever or chills.
  • Changes in the vision, such as sensitivity to light, blurred vision, temporary blindness, or seeing flashlights.
  • Steadily timed contractions or around four contractions in an hour as it can be a sign of preterm labor.

You don’t have to panic if you get abdominal pain during pregnancy. It could be due to a simple reason as the formation of gas. But at the same time, you cannot ignore persistent pain or the one that recurs regularly. Keep observing your condition and see a doctor if necessary.

This article is for informational purposes only and not meant to diagnose or treat your obstetric condition.

References:

1. Sangeeta Devarajan, Edwin Chandraharan; Abdominal pain in pregnancy: a rational approach to management; Obstetrics, Gynaecology and Reproductive Medicine
2. Charlie C. Kilpatrick; Abdominal Pain in Early Pregnancy; Agency for Healthcare Research and Quality- US Department of Health and Human Services
3. Tips to manage common pregnancy symptoms by trimester; UChicago Medicine
4. Michael Katz, MD, Karen Goodyear, MD, Robert K. Creasy; Early signs and symptoms of preterm labor; American Journal of Obstetrics and Gynecology
5. Emily R. Howell; Pregnancy-related symphysis pubis dysfunction management and postpartum rehabilitation: two case reports; The Journal of the Canadian Chiropractic Association
6. Round Ligament Pain; RLatta Teaching tool
7. Tina Sara Verghese, Kaori Futaba, b Pallavi Latthe; Constipation in pregnancy; The Obstetrician and Gynaecologist
8. Philip Steer and Caroline Flint; Preterm labour and premature rupture of membranes; The British Medical Journal
9. Sanoop Koshy Zachariah, et al.; Management of acute abdomen in pregnancy: current perspectives; Dovepress- International Journal of Women’s Health
10. Mohamed EL-Gharib; Orgasm during pregnancy; Research Gate
11. Ectopic pregnancy; Medline Plus; US National Library of Medicine
12. Miscarriage – threatened;  Medline Plus; US National Library of Medicine
13. Preterm labor; Medline Plus; US National Library of Medicine
14. Katheryne L Downes, Edmond D Shenassa, Katherine L Grantz; Neonatal Outcomes Associated With Placental Abruption; American Journal of Epidemiology
15. Suarez B, Alves K, Senat MV, Fromageot J, Fischer C, Rosenberg P, Ville Y; Abdominal pain and preeclampsia: sonographic findings in the maternal liver; NCBI
16. Matthew M. Thompson, Alexei U. Kudla, and Chris B. Chisholm; Appendicitis During Pregnancy with a Normal MRI; West J Emergency Medicine

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