Abdominal Pain in Pregnancy: 9 Causes & What to Do

April 2022
  1. Urinary tract infection
  2. Ectopic pregnancy 
  3. Miscarriage
  4. Pre-eclampsia 
  5. Placental abruption
  6. Braxton-Hicks contractions
  7. Constipation and gas 
  8. Round ligament pain
  9. Labor pain

Abdominal pain during pregnancy can occur for many reasons, such as normal uterine growth, constipation, or excess gas. Many times, this pain can be relieved through a balanced diet, regular physical activity or by drinking tea. 

However, abdominal pain can also happen in more serious situations, like an ectopic pregnancy, placental abruption, pre-eclampsia or even abortion. In these cases, pain will generally be accompanied by vaginal bleeding, swelling or discharge. 

When pain is very intense, does not improve, or if it is accompanied by other symptoms, you should proceed to the hospital or consult your obstetrician immediately to identify the cause of pain and start treatment as necessary. 

First trimester 

The main causes of abdominal pain during the first trimester, which occurs during weeks 1 and 12 of pregnancy, include: 

1. Urinary tract infection

A urinary tract infection, or a UTI, is a common problem during pregnancy. It happens most frequently at the start of pregnancy. Many women present with symptoms  like lower abdominal pain, burning or difficulty urinating, urinary urgency, fever and nausea. If you suspect you have a UTI, report your symptoms to our online UTI symptoms checker

What to do: You should see your doctor and complete a urine test to confirm whether a UTI is present. It can be treated with antibiotics, rest, and fluids.

2. Ectopic pregnancy 

An ectopic pregnancy occurs when the fetus starts to grow outside of the uterus. It most commonly occurs in the fallopian tubes and can be identified until up to the 10th week of pregnancy. An ectopic pregnancy usually presents with symptoms like intense abdominal pain on just one side of the abdomen, pain that worsens with movement, vaginal bleeding, pain during sex, dizziness, nausea and vomiting.

Read more about what an ectopic pregnancy is and other symptoms associated with it. 

What to do: If you suspect you have an extopic pregnancy, you should proceed immediately to the hospital to confirm a diagnosis and initiate treatment. This condition is usually treated with surgical removal of the embryo. 

3. Miscarriage

A miscarriage, also referred to as a spontaneous abortion, is a medical emergency that most commonly occurs prior to 20 weeks of gestation. It can cause symptoms like lower abdominal pain, vaginal bleeding, loss of fluid or clots through the vagina, and headaches. 

What to do:  You should proceed immediately to the hospital to get an ultrasound which will look for the baby’s heart rate. Women who have miscarried will usually undergo a minor surgical procedure called a dilation and curettage (or D&C) to remove fetal tissue. If the baby’s heart rate is detected, then other interventions can be initiated to prevent miscarriage. 

Second trimester

Pain during the second trimester, which occurs during the 13th to 24th weeks of pregnancy, is normally caused by problems like: 

4. Pre-eclampsia 

Pre-eclampsia is a sudden increase of blood pressure during pregnancy that is difficult to treat. It can be life-threatening for the mother and the baby. The most common signs and symptoms are upper right abdominal pain, nausea, headache, swelling in the extremities and face, and blurry vision. 

What to do: You should consult your obstetrician as soon as you can to check your blood pressure and start treatment. Serious situations require admission to the hospital for continuous monitoring of the mother and baby. 

5. Placental abruption

Placental abruption is a serious problem that can happen after the 20th week of pregnancy. It can trigger premature birth or miscarriage, depending on how far along the mother is. This condition can cause symptoms like intense abdominal pain, vaginal bleeding, contractions and lower back pain. 

What to do: You should go to the hospital immediately to assess fetal heart rate and start treatment. Treatment may involve the use of medications to stop contractions, and total bed rest. In most serious cases, delivery may need to occur earlier than expected. 

6. Braxton-Hicks contractions

Braxton-Hicks contractions occur as a way for the uterine muscles to "practice" and get stronger for the actual delivery day. They can usually happen after 20 weeks and last for less than 60 seconds. They can occur several times during the day, and are associated with mild abdominal pain.

When Braxton-Hicks contractions occur, the abdomen will become hard for a few moments. Although some women may not feel any pain with these contractions, other may feel vaginal pain or lower abdominal pain that lasts for a few seconds and disappears. 

What to do: When you feel Braxton-Hicks contractions, remain calm, rest and get into a comfortable position. You can lie on your side and place a pillow under your belly or between your legs. 

Third Trimester

The main causes of abdominal pain during the third trimester of pregnancy, which occurs during the 25th and 41st weeks of pregnancy, include: 

7. Constipation and gas 

Constipation is more common at the end of pregnancy and occurs due to the hormonal changes and uterine pressure on the intestines. This pressure can slow down intestinal functioning, which can lead to constipation and gas. Both of these symptoms can cause abdominal pain or discomfort, especially on the left side, and cramping. You may also feel that your belly feels harder in the painful area. 

What to do: You should eat food that is rich in fiber, like wheat germ, greens, grains, watermelon, papaya, lettuce and oatmeal. Ensure you increase your fluid intake to at least 2 L of water per day, and engage in physical activity, like 30 minute walks, at least 3 times per week. You should see your doctor if your pain does not resolve within a day, if you do not have a bowel movement for over 2 days, or if you have other symptoms like fever or increasing pain. 

8. Round ligament pain

Round ligament pain emerges due to excessive stretching of the ligament that attached the uterine to the pelvis. This pain occurs due to belly growth, and is characterized by lower abdominal pain that goes to the groin. The pain usually comes in pangs that last for seconds. 

What to do: Sit down, relax and try to get into a position that relieves the pressure you may feel. You can try bending your knees toward your abdomen or lie down on your side with a pillow between your knees and another under your belly. 

9. Labor pain

Labor pain is the most common cause of abdominal pain at the end of pregnancy. It is associated with symptoms like abdominal pain, cramping, thick vaginal discharge, vaginal bleeding, and regular uterine contractions. 

What to do: You should go to the hospital to determine whether your labor. Some women may experience contractions for several hours which then disappear overnight, and then reemerge the next day. If possible, you should consult your obstetrician to describe your contractions and head to the hospital if advised to do so. 

When to go to the hospital

You should seek medical attention immediately if you feel persistent right-sided lower abdominal pain and fever, as these are signs of appendicitis. This condition can happen at any point during pregnancy and is best treated if identified early. In addition, you should also proceed to the hospital or call your obstetrician if you are pregnant and have any of the following symptoms: 

  • Abdominal pain that occurs before 12 weeks, with or without vaginal bleeding 
  • Vaginal bleeding with strong cramping 
  • Intense headaches
  • Over 4 contractions within 1 hour for 2 hours
  • Noted swelling in the hands, legs and face 
  • Pain or difficulty urinating, or bloody urine 
  • Fever and chills 
  • Abnormal vaginal discharge

These symptoms may indicate a more serious complication, like pre-eclampsia or ectopic pregnancy. Therefore, you should consult your obstetrician or go to the emergency room for treatment as quickly as possible. 

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Updated by Tua Saude editing team, on April of 2022.
Our team made up of medical doctors and health professionals from various fields such as nursing, nutrition, physiotherapy, clinical analysis and pharmacy.