Cramps During Pregnancy: 11 Causes (In 1st, 2nd and 3rd Trimesters)

Updated in January 2024

Feeling cramps during pregnancy are normal, especially at the beginning of pregnancy. They occur early on due to the implantation of the embryo, but can also be felt as a result of the physical changes occurring within the woman's body. They can also be felt at the end of pregnancy, around 37 weeks of gestation, as a sign the labor and delivery is imminent. 

However, there are other situations that can cause severe cramps, such as an ectopic pregnancy, ovular or placental abruption, or miscarriage. These conditions occur with cramps that may be accompanied by other symptoms such as vaginal bleeding, discharge or fever.

It is important to contact your OBGYN or proceed to the nearest hospital if you notice that your cramps are frequent, painful and do not stop even when resting. A doctor will evaluate them and initiate the most appropriate treatment, which depends on the underlying cause.

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Cramps in the first trimester

The main causes of cramps in the first trimester of pregnancy (weeks 1 to 13) are:

1. Embryonic implantation

Cramps at the beginning of pregnancy are normal and can be caused by the implantation of the embryo in the uterus. This occurs around 6 to 12 days after fertilization, and may be followed by some scant bleeding that lasts around 2 days. Read more about implantation bleeding and what it bloods like.

In this initial phase of pregnancy, the fertilized egg implants itself in the uterus, which initiates the division of the embryo's cells. This process stimulates the woman's body to produce beta-HCG hormone which may lead to symptoms such as morning sickness or breast tenderness. These are often confused for PMS symptoms

Also recommended: Implantation Symptoms: Top 5 Signs That Occur Before Pregnancy

How to relieve: When experiencing cramps at the beginning of pregnancy, you are advised to rest and relax to relieve discomfort. These cramps usually improve within a few days. 

2. Ectopic pregnancy

An ectopic pregnancy occurs when the embryo develops outside the uterus. It most commonly occurs in the fallopian tubes. This condition can lead to intense cramping on just one side of the belly and which worsens with movement. 

Cramps from an ectopic pregnancy are usually accompanied by other symptoms such as vaginal bleeding, pain during sex, dizziness, nausea, vomiting or fainting.

How to relieve: If you suspect you may be experiencing an ectopic pregnancy, proceed to the nearest emergency room immediately for testing. If confirmed, treatment will be initiated promptly, which involves removal of the embryo and affected fallopian tube. 

3. UTI

Urinary tract infections, or UTIs, are very common during pregnancy, and may not cause symptoms in the early stages of infection. UTIs are associated with cramps in the pelvic region, burning, difficulty urinating, an urgent urge to urinate even though there is little urine, fever and nausea. Complete our online UTI symptoms quiz to determine your risk for a UTI.

UTIs are more common at the beginning of pregnancy, but they can  appear at any stage of pregnancy. Pregnant women are prone to them due to specific body changes that favor the development of bacteria in the urinary tract.

How to relieve: You should consult your OBGYN for a urine test to confirm whether an infection is present and to start treatment with antibioticse.Your doctor may also advise rest, increased fluid intake and avoiding holding your urine.

4. Subchorionic hemorrhage

A subchorionic hemorrhage is a condition that occurs due to the accumulation of blood between the placenta and the uterus caused by the detachment of the gestational sac from the wall of the uterus.  which can lead to cramping, bleeding or abdominal pain.

This condition can happen during the first trimester of pregnancy and, in milder cases, can resolve on its own by the end of the second trimester of pregnancy, as any bleeding is reabsorbed into the woman's body.

Large hematomas, however, are associated with a greater risk of premature birth, miscarriage, or placental abruption.

How to relieve: It is important to proceed to the nearest hospital for an ultrasound to determine whether any inventions are required. Treatment usually requires partial or absolute rest, avoiding sex, and in some cases, hormonal treatment with progesterone, as prescribed by a doctor. Furthermore, it is also important to drink at least 2 liters of water per day. 

5.  Miscarriage

A miscarriage can cause intense cramping in the lower back and pelvis, and is associated with brown, heavy bleeding with clots or tissue. Bleeding usually worsens over the span of a few days. Cramps and pain may be accompanied by other symptoms such as intense or constant headache, or general malaise.

Read more about miscarriage symptoms that you should not ignore.

A spontaneous miscarriage is more common to occur in the first trimester of pregnancy, but it can also occur in the second trimester of pregnancy, prior to 20 weeks, for various reasons  such as excessive physical activity, use of medications, consumption of certain teas, infections or trauma.

How to relieve: you should go to the emergency room immediately if symptoms of a miscarriage appear, to carry out tests such as ultrasound and evaluation of the fetal heartbeat, and thus obtain a diagnosis. In the case of confirmed miscarriage, treatment must be carried out by the doctor through curettage or surgery to remove the baby. Find out how curettage is done.

Also recommended: Bleeding During Pregnancy: Causes (by Trimester) & What to Do

Cramps in the second trimester

The main causes of colic in the second trimester (weeks 14 to 27) are:

1. Round ligament pain

Round ligament pain can lead to cramps on one or both sides of the lower abdomen,. These can last a few seconds or for several minutes, and usually appear when the woman changes position quickly or with coughing and sneezing.

This condition is caused by the stretching and narrowing of the ligaments that support the belly, due to the growth of the uterus. It is a normal finding during pregnancy.

How to relieve: Maintain optimal posture, avoid prolonged periods of standing or sitting, and change positions when lying down to help relieve and prevent discomfort. Furthermore, light stretching and practicing yoga or Pilates (as approved by your doctor) can help to strengthen your muscles to help with discomfort later on in pregnancy. However, if your pain does not improve, or if you develop a fever, you should contact your doctor immediately.

2. Placental abruption

Placental abruption occurs when the placenta is separated from the wall of the uterus as a result of inflammation or changes in circulation in the placenta. This condition intense cramps, lower back pain and vaginal bleeding, as is more common after 20 weeks of pregnancy.

Placental abruption can also be caused by intense physical exertion, high blood pressure or pre-eclampsia.

How to relieve: Placental abruption is a life-threatening condition that requires immediate medical attention. Seek urgent care as soon as possible to initiate treatment, which may involve hospitalization, oxygen and management of blood pressure and heart rate. 

3. Braxton-Hicks contractions

Braxton-Hicks contractions can appear around the 20th week of pregnancy. They are characterized by mild cramps from the muscles of the uterus contracting and relaxing. Their cause the belly to feel tight or hard hard at certain times of the day. Their purpose is to prepare the uterus and pelvic tissues for labor.

Also recommended: Why You May Feel A Hard Belly During Pregnancy (By Trimester)

How to relieve: Moving your body and exercising (as approved by your doctor) can help to relieve the discomfort associated with Braxton-Hicks contractions. However, strong contractions that are very frequent or accompanied by other symptoms such as back pain, vaginal bleeding or discharge should be assessed immediately.

Cramps in the third trimester

The main causes of cramps in the third trimester of pregnancy (weeks 28 to 41) are:

1. Constipation

Constipation is more common in the third trimester of pregnancy, and occurs due to the pressure of the uterus on the intestines causing decreased bowel movements. It is associated with causing colic, pain on the left side, excess intestinal gas, in addition to the belly being more hard during this period. site of pain.

How to relieve: Ensure you are well-hydrated by drinking at least 8 glasses of water a day. Eat plenty of fiber in the form of whole grains, fresh fruits and vegetables. Exercising regularly, as approved by your doctor, can also help improve intestinal flow and relieve constipation. You should consult your OBGYN if the pain does not improve within the same day, if you do not have a bowel movement for 2 days in a row or if you have other symptoms such as fever or increasing pain.

2. Pre-eclampsia

Pre-eclampsia is the sudden increase in blood pressure during pregnancy, usually in the second half of pregnancy or in the third trimester. It is associated with symptoms such as cramps in the upper right part of the abdomen, nausea, headache, swelling of the hands, legs and face, as well as blurred vision.

Pre-eclampsia is a serious pregnancy complication that is difficult to treat and can be life-threatening to both the woman and her baby.

How to relieve: You are advised to consult an OBGYN  as soon as possible to assess your blood pressure and begin treatment.

3. Premature labor

Cramps that appear after 37 weeks of pregnancy, which gradually worsen in intensity, become more consistent and do not improve when changing position may be a sign of premature labor.

These cramps may be accompanied by other symptoms, such as pelvic pressure, vaginal discharge or light bleeding. 

How to relieve: If you feel you are having labor contractions, inform your OBGYN and proceed immediately to the hospital.

When to go to the hospital

It is important that women consult their OBGYN or proceed to the nearest emergency room when cramps are persistent or accompanied by symptoms such as:

  • Vaginal bleeding
  • Fever
  • Chills
  • Nausea or vomiting
  • Pain or burning when urinating
  • Blood in the urine
  • Headache
  • Swelling in the hands, feet or face

These symptoms may indicate a serious complication, which requires immediate care and treatment.