Cramps During Pregnancy: 6 Main Causes & When To Worry

Updated in May 2023

Cramps during pregnancy are normal, especially at the beginning of pregnancy as the mother’s body adapts to the baby’s growth. They can also be common at the end of pregnancy, at around 37 weeks gestation, as they indicate the beginning of labor.

However, there are other conditions that can cause strong, persistent pregnancy cramps, and these should be assessed by a doctor. If cramping does not resolve on its own or if it is accompanied by symptoms like vaginal bleeding, discharge, or fever, you should inform your obstetrician.  

It is important to contact your OB or proceed to the hospital if your cramping is persistent, painful and does not resolve with rest. The doctor will evaluate you thoroughly to determine the underlying cause, and initiate treatment as needed. 

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The most common causes of pregnancy cramps are:

1. Ectopic pregnancy

An ectopic pregnancy occurs when the embryo does not develop in the uterus but rather in the fallopian tubes. This usually leads to bleeding and miscarriage. Learn more about the symptoms of an ectopic pregnancy and how it is treated. 

2. Ovular detachment

Ovular detachment is caused by the detachment of the gestational sac before the 20th week of pregnancy and is characterized by the presence of a hematoma originating from blood accumulation between the uterus and the gestational sac. This hematoma can worsen with exertion and the larger the hematoma, the higher the risk of premature birth, miscarriage, and placental abruption. 

3. Placental abruption

Placental abruption happens when the placenta is separated from the uterine wall as a result of inflammation and changes to placental blood flow. It can happen as a result of intense physical effort, high blood pressure or pre-eclampsia, which causes vaginal bleeding and intense cramping. This is a dangerous condition that requires immediate intervention.  

4. Miscarriage

Miscarriages can happen at the beginning of pregnancy due to several situations, such as excessive physical activity, medication or teas, infections, and direct trauma.  Read more about the symptoms that present with a miscarriage, what can cause one and how it is treated.

5. Labor

Cramps that arise after 37 weeks of pregnancy and that progress in terms of consistency and intensity can indicate the onset of labor. 

6. Other possible causes

Other possible causes of cramps during pregnancy are viruses, food poisoning, appendicitis, or urine infections. Therefore, we recommend going to a doctor if you experience new cramping.

How to relieve pregnancy cramps

Treatment for pregnancy cramps will vary according to the cause and your doctor’s recommendations. In some cases, the doctor may prescribe medication to relieve pain and discomfort.  

In general, cramps will subside with rest, but it is important to note how many times a day the cramps appear and in which situations they get better or worse. 

Cramps at the beginning of pregnancy 

At the beginning of a pregnancy, it is common to get cramps and this is normally one of the first signs of pregnancy. Cramps at the beginning of gestation happen due to the uterus growing and its adaptation from the implantation of the embryo. Urinary or vaginal infections with discharge are also causes of cramps at the beginning of pregnancy. 

During pregnancy, the accumulation of gas in the intestines can also cause cramps due to bad digestion of certain types of food such as beans, broccoli, or ice-cream. Pregnancy cramps after sexual intercourse are normal, as orgasms also cause uterine contractions. 

Cramps at the end of pregnancy 

Cramps at the end of pregnancy can mean that labor is approaching. These cramps are the result of the baby’s movement in the womb or its weight that presses on the muscles, ligaments, and veins, causing pain and discomfort.  

When to go to the doctor

It is important for you to go to the gynecologist or obstetrician if you have frequent, painful cramps that do not resolve with rest. Additionally, we recommend going to the doctor if you have vaginal bleeding, fever, chills, vomiting, or pain when urinating at the beginning or end of pregnancy, or if you suspect that labor has started. 

At the doctor’s appointment, you should mention all your symptoms so the doctor can identify what is causing the cramping and carry out the necessary procedures.