Abdominal Achiness and Pains During Pregnancy

From the time you find out you are pregnant, you can experience any number of abdominal aches and pains. While some of these aches are just mildly uncomfortable, sometimes they can be truly awful.

In episode 49 of the parenting podcast The Longest Shortest Time, host Hillary Frank speaks with pelvic floor physical therapist, Hollis Herman. Herman tells Frank that most people don’t realize that by the time a woman is eight weeks pregnant, she is 50 to 70 percent physiologically ready to have her baby. This means that her body has undergone massive changes, even very early in pregnancy. In addition to changes in her circulatory system and heart function, her pelvis has softened and the ligaments have changed. Plus, hormonal changes, especially in estrogen and progesterone, have occurred.

Most people worry if they experience aches and pains, especially early in pregnancy, but as this interview suggests, it is very normal to have abdominal aches and pains during pregnancy, even early on. So many things change in your body, particularly as the baby grows bigger, and your body prepares even further for baby to be born. Read on for some of the causes of abdominal aches and pains during pregnancy and for ideas that may help you cope.

Aches and Pains in a Healthy Pregnancy

Implantation. It is not uncommon for implantation to be associated with period-like cramps. Many people think they are starting their period, when actually it is just the fertilized egg implanting in your uterine lining. If these cramps don’t go away in a day or so, you might be starting your period.

Uterine stretching. As discussed above, a lot changes in your body early in pregnancy. Your uterus or womb must grow to be nearly a thousand times its original size by the end of your pregnancy, and it gets started soon. Sometimes the uterine stretching is accompanied by a painful ache, cramping, or sense of heaviness in your abdomen, especially in second and subsequent pregnancies.

Round ligament pain. The round ligaments are thick tissues that connect the front of your uterus to your groin. As your uterus grows, these ligaments must stretch along with it, and it’s not always a pleasant feeling. Sometimes you might feel round ligament pain as a dull ache on one or both sides of the front of your lower abdomen, but round ligament pain can also be sharp, shooting, or throbbing. Round ligament pain is most common in the second trimester, but can show up as soon as you know you’re pregnant and continue throughout pregnancy.

Braxton-Hicks contractions. These are practice contractions and essentially get your body ready for labor. While they generally involve a tightening across the uterus that is not especially painful, some people do experience discomfort and even pain with them. If they become rhythmic or are extremely painful, it’s a good idea to check in with your care provider.

Gas or constipation. As if being pregnant didn’t come with enough weird symptoms, you can add digestive upset to your experiences. Both gas and constipation, which are both common thanks to the slowing of digestion due to the hormones progesterone and relaxin, can lead to abdominal pain during pregnancy.

Most people worry if they experience aches and pains, especially early in pregnancy, but it is very normal to have abdominal aches and pains during pregnancy, even early on.

Coping with Aches and Pains

For many of the aches and pains discussed above, there is not a one-size-fits-all solution, so here are several things to try to figure out what works for you:

  • Rest, especially if you can support your body with pillows as you do so.
  • Stay hydrated, particularly if you are experiencing a lot of Braxton Hicks contractions or constipation.
  • Heat might help, particularly with round ligament pain or uterine stretching. You might use a rice sock heated (not too hot!) in the microwave on the area where you are experiencing pain or soak in a warm (again, not too hot) bath.
  • Support your abdomen. A special maternity support belt or kinesiology tape applied by someone knowledgeable, such as a doctor or physical therapist, might help.
  • Take acetaminophen. This over the counter pain medication is generally considered safe during pregnancy when taken at the recommended dosage. If you have questions or concerns about taking medication, speak with your care provider. Ibuprofen is generally not considered appropriate to take during pregnancy.
  • Incorporate exercise (benefits of exercise), like yoga, walking, or swimming. Sometimes movement can help things stretch more easily or ease aches.
  • Talk to your care provider. If you’re in tons of pain, you don’t have to suffer in silence. Your doctor or midwife might have an idea that you haven’t tried yet, or be able to refer you to a physical therapist or other specialist to help you address your symptoms.

Aches and Pains to Watch Out For

While most abdominal aches and pains are normal, if you experience symptoms that point to any of the following conditions, it’s important to call your care provider right away:

  • Ectopic pregnancy happens when a fertilized egg implants and starts to grow in a spot other than your uterus, often in the fallopian tube. As the embryo grows, this can lead to severe abdominal pain, often on one side of the abdomen.
  • Miscarriage is often accompanied by intense period-like cramps or even rhythmic pains in your uterus that feel like contractions.
  • Preterm labor happens when your body goes into labor before 37 weeks of pregnancy. If you experience contractions that are rhythmic or especially painful or intense pressure in your pelvis and your pregnancy is not yet full term, you might be in preterm labor.
  • Placental abruption, where the placenta separates away from the uterine wall, can lead to abdominal pain, contractions, and uterine tenderness, among other symptoms.
Abby Olena
Dr. Abby Olena has a PhD in Biological Sciences from Vanderbilt University. She lives with her husband and children in North Carolina, where she writes about science and parenting, produces a conversational podcast, and teaches prenatal yoga.

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