Cramping During Pregnancy: Causes, Treatment & When to Worry

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Abdominal cramps present themselves as a pulling sensation on one or both sides of the abdomen. Although not very common, some women may experience cramps during pregnancy (1) (2). Read this post to know about causes, management, and when to be concerned about cramping in pregnancy.

Is Cramping During Pregnancy Normal?

Most cases of abdominal cramping in pregnancy are normal. It occurs because the uterus expands to accommodate the growing embryo. Expansion of the uterus causes stretching of its supporting ligaments and muscles. The pain may be more apparent when the mother sneezes, coughs, or keeps her body in an incorrect or strained posture.

Some women experience leg cramps with or without abdominal cramps. Leg cramps are normal and may occur suddenly as a sharp pain in the calf muscles or feet. They are more common in late pregnancy and at night. Your doctor may prescribe vitamin or mineral supplements along with stretching exercises to relieve the cramps.

Causes Of Cramps During Pregnancy

Cramping in pregnancy could occur in one or all the trimesters of pregnancy. However, there are different reasons for pain and cramps in each trimester.

First trimester

  • Some pregnant women experience very mild cramping that may or may not be accompanied by bleeding when the fertilized egg implants in the uterus. It is known as implantation cramping.
  • Elevated progesterone levels in early pregnancy cause the ligaments and muscles around the uterus to expand (3) (4).
  • Constipation is also common in pregnancy. Constipation at any point may lead to pain in the lower abdomen during pregnancy.
  • There are many gastrointestinal issues during pregnancy due to hormonal changes. Heartburn, bloating, and gas are all commonly seen in pregnancy. Trapped wind may also cause pain and mild cramps. These pains could get better after changing position, having a bowel movement, or passing wind.
  • Abdominal cramps that worsen with time and are accompanied by bright red vaginal discharge might indicate an impending miscarriage (5).
  • Although vaginal bleeding and cramps may occur in early pregnancy, only a doctor can confirm if the bleeding is physiological or pathological.
  • Stomach pain with cramps on one side with or without bleeding may indicate an ectopic pregnancy. Symptoms of an ectopic pregnancy are usually reflected between weeks four and 12 (6).

Second trimester

  • Round ligament pain is a common reason for pain and cramps in the abdomen during the second trimester. It manifests as either unilateral or bilateral sharp pain in the abdomen or hip areas and may extend to the groin (7).
  • Urinary tract infections are common during the second trimester because the uterus sits on the bladder. The pressure from the growing uterus can block the drainage of urine from the bladder. Urinary tract infection may lead to pain and cramping in the lower abdomen (8).
  • Most women with uterine fibroids have normal pregnancies. Women with a previous history of fibroids may have regrowth of fibroids in pregnancy as fibroids grow due to high hormone levels in pregnancy (9). Fibroids may lead to abdominal cramps in pregnancy.

Third trimester

  • Experiencing cramps in the third trimester of pregnancy is the most common (10).
  • In the third trimester, many women experience labor-like pains or contractions known as Braxton Hicks. These mimic labor contractions but do not occur at regular intervals and last for a short duration.
  • If cramps and contractions do not subside, do visit your healthcare provider as it may indicate preterm labor.
  • If the pain is located higher on the stomach or the chest, accompanied by headache, swelling of the hands and feet, blurry vision, and high blood pressure, it might be a sign of preeclampsia. It needs immediate medical attention.
  • If you experience severe stomach pain that doesn’t go away and sense tenderness on touching the stomach or have back pain, it may indicate placental abruption. Visit your healthcare provider to rule out placental abruption.

When To Call The Doctor?

Contact your obstetrician, midwife, or emergency medical care immediately if the following symptoms accompany abdominal cramps (3) (11).

  • Heavy bleeding or spotting
  • Painful tightening of muscles
  • Lower back pain
  • Burning sensation while peeing
  • Cloudy or reddish urine
  • Pain that does not go away even after resting for 30 to 60 minutes
  • Pain on the tip of the shoulder
  • Feeling faint or dizzy
  • Slow trickle or a sudden gush of clear, pink, or red fluid from the vagina
  • Sudden swelling in the face, hands, or feet
  • Dull or persistent headache
  • Blurred or flashing vision
  • Vomiting
  • Pelvic pressure
  • Fever
  • Six or more contractions an hour

How To Relieve Cramps During Pregnancy?

The following measures may help you get relief from cramps in pregnancy (1).

  • Avoid standing for too long. Sit whenever possible to reduce strain on the leg, back, and abdominal muscles.
  • Do not sit or sleep in the same position for too long. Change position whenever your muscles or joints feel sore.
  • Get off the chair at regular intervals if your work involves sitting for several hours.
  • Invest time in simple relaxation exercises, such as walking or deep breathing. You may try mild stretching exercises under your doctor’s guidance.
  • Eat a healthy, well-balanced diet. Drink plenty of fluids.
  • Acetaminophen is usually the safest medicine in pregnancy to relieve painful cramps. However, make sure to consult your doctor before consuming any OTC drugs (12).

Frequently Asked Questions

1. Do pregnancy cramps feel like period cramps?

Yes, pregnancy cramps may feel like menstrual cramps in the first few weeks of pregnancy. If the cramps are on and off and are mild, it is usually not a cause of concern (11).

2. Can cramping be a sign of miscarriage?

Lower abdominal cramps accompanied by bleeding may indicate miscarriage (5). However, do not arrive at conclusions and see a doctor to determine the problem.

Several mothers experience leg and abdominal cramps during pregnancy. In most cases, these cramps aren’t usually a cause for concern. However, sometimes, they may indicate an underlying problem. Eating a healthy, well-balanced diet, doing mild exercises, and avoiding standing or sitting for too long are a few ways you can avoid cramps during pregnancy. Yet, you should consult your healthcare provider if you have severe cramps or if cramps are accompanied by additional symptoms such as fever or pelvic pressure.

Key Pointers

  • Abdominal cramps during pregnancy mainly occur because of the expansion of the uterus.
  • Cramps may also occur due to constipation, gastrointestinal problems, round ligament pain, and preeclampsia.
  • Heavy bleeding, spotting, vomiting, pelvic pressure, and blurred vision are a few symptoms that you should not ignore and contact your doctor promptly.

References:

MomJunction's articles are written after analyzing the research works of expert authors and institutions. Our references consist of resources established by authorities in their respective fields. You can learn more about the authenticity of the information we present in our editorial policy.
1. Pregnancy Cramps; American Pregnancy Association
2. Abdominal pain or cramping; March of Dimes
3. Stomach pain in pregnancy; NHS
4. 4 weeks pregnant – all you need to know; Tommy’s
5. Signs of Miscarriage; Ada Health
6. Miscarriage symptoms; Tommy’s
7. Round Ligament Pain During Pregnancy; American Pregnancy Association
8. Urinary Tract Infection During Pregnancy; American Pregnancy Association
9. Uterine Fibroids; New York State Department of Health
10. Third trimester (week 28 onwards); HSE, Ireland
11. Stomach (abdominal) pain or cramps in pregnancy; Tommy’s
12. Is acetaminophen safe in pregnancy?; National Library of Medicine
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Dr. Shashwat Jani

(MS)
Dr. Shashwat Jani is a consultant obstetrician & gynecologist in Smt. N.H.L. Municipal Medical College, Ahmedabad. His field of interests are High Risk Pregnancy, Infertility and Endoscopy. He has written 12 chapters in reference books of Ob/Gyn and published 18 articles in Index journals. Dr. Jani has been invited as faculty in more than 200 national and international conferences. He... more

Dr. Ritika Shah

Dr. Ritika Shah is a dental surgeon with more than seven years of clinical experience across various cities in India. During her clinical practice, pediatric dentistry was her particular area of interest, and she constantly thrived to inculcate the latest advancements in the field of dentistry into her practice. She also holds a certificate in lactation counselling from iNational Health... more