What is causing your abdominal pain during pregnancy?

Pregnancy is a natural experience that happens to hundreds of millions of women worldwide every year. Although it is natural and for most women uneventful, one of the main complaints women have is abdominal pain.

No matter what gestation many women will complain about abdominal pain at some stage to their doctor, midwife, friend’s family or husband. 99% of the time abdominal (or belly) pain is nothing to worry about. Rarely it can be something more serious or if you are approaching your due date, abdominal pain could signal the start of labour.

Here are some common and uncommon causes of abdominal pain during pregnancy:

First Trimester:

Common causes of abdominal pain –

Ligaments stretching. As the uterus grows out of the pelvis, it can cause discomfort in your lower abdomen. This is usually a pulling sensation at either side of your abdomen. It is not a cause for alarm and the pain is often described as a sharp pulling pain.

STD’s. Some sexually transmitted infections such as chlamydia can cause abdominal pain if left untreated. This is because they can cause pelvic inflammatory disease which requires treatment by antibiotics. If you feel you may have an STD, contact your doctor of local sexual health clinic for advice.

Ectopic Pregnancy. Occasionally an embryo fails to implant in the uterus and implants in the fallopian tube instead, this is called an ectopic pregnancy and can cause severe abdominal pain. This is an emergency that needs to be dealt with rapidly before the fallopian tube erupts.

Miscarriage. Abdominal cramping, usually accompanied with vaginal bleed can (not always) signify miscarriage. If you ever experience bleeding and abdominal pain during your pregnancy you should visit your local casualty/ emergency department for an evaluation.

Second & Third Trimesters:

During the second & third trimester, abdominal pain may persist but may change in type or frequency. Some common causes are –

Baby kicking. Babies in the womb are quite vigorous and kicking can be uncomfortable! Sometimes, your baby may get their foot stuck under your ribs and frequent kicking in that spot can cause the area to feel bruised.

SPD or pelvic girdle pain. This pain is much lower down at the bottom of your abdomen and mainly over your public bone. This is an aching pain that is made worse when you move, especially when you open your legs. This is caused by the softening of the ligaments that hold the pelvis together. SPD is managed by support belts, crutches in some cases and pain medication.

Kidney stones or Gallstones. These are incredibly painful and are rarely diagnosed in pregnancy. It is worthwhile telling your care provider if you suffered from them prior to falling pregnant.


Serious causes of abdominal pain in pregnancy:

Rarely, severe abdominal pain is the symptom of a more serious potentially life-threatening issue such as:

Placental abruption – This is where the placenta starts to detach from the lining of the uterus. This is often accompanied with bleeding but not always. Placental abruption can happen after trauma such as a car accident or any blunt force trauma to the abdomen. It is imperative that you are assessed if you suffer any kind of abdominal accompanied whit bleeding in late pregnancy

Uterine rupture – Again this is rare and is seen more in women who have had previous C- Sections. The risk is higher with each C-section. In general, most women who have had just one C-section are considered safe to try for a natural birth next time as the risk of uterine rupture is around 0.21%. With women planning a repeat C-section there is still a chance of uterine rupture, of around 0.03%.

Essentially, most cases of mild abdominal pain are usually nothing to worry about and are common in pregnancy. If, however you are concerned, have reduced fetal movements, vaginal bleeding or have severe persistent abdominal pain then you should get checked out by a doctor straight away



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