During very early pregnancy, most women experience abdominal cramping and discomfort, just like they might before their menstrual flow starts. Later on during pregnancy, they may suffer from round ligament pain, Braxton Hicks contractions, and may feel discomfort as their baby's kicks target the bladder (charming!). Abdominal pain or discomfort isn't unusual by any means, and is not always alarming.
To some extent, most pregnant women can be quite sure that their intuition and the sheer amount of pain they're experiencing will tell them whether or not the pain is caused by something serious something that would require a doctor's attention. Still, you should always err on the side of caution and feel absolutely free to "disturb" your doctor at any time if you are at all worried that something serious may be going on. We'll discuss both harmless and dangerous causes of abdominal pain during pregnancy, and list the other symptoms associated with the respective conditions too so you have more of an idea what to expect.
Along with bleeding, abdominal pain is the most reliable symptom of a miscarriage. The pain that women who are miscarrying experience may come in rhythmical patterns, as labor contractions would. Note that the bleeding associated with a miscarriage is quite heavy and may increase over time. The blood should be bright red (indicating it is fresh blood) and often includes noticeable clots and tissue. Back pain is another symptom some women who miscarry experience. Miscarriage may be the first and most obvious thing to think about when you start having heavy abdominal pain during the first trimester of pregnancy. Keep in mind that an ectopic pregnancy is another possibility.
An ectopic pregnancy is a pregnancy in which the fertilized egg implanted outside the uterus. The fallopian tubes are the most common target for an ectopic pregnancy. These pregnancies cannot be carried to term and can turn into a life-threatening emergency rather quickly, as the embryo grows and the tube can rupture. The pain associated with a tubal pregnancy may be noticeable on one side (that's the affected fallopian tube) and can be sharp, and either constant or intermittent. You may have some blood loss with a tubal pregnancy, but it is likely to be much less than with a miscarriage in the initial stages, and may be brown (indicating old blood). The pain you may encounter when you have a tubal pregnancy is likely to get worse with physical activity, and does not occur in a rhythmical fashion, as miscarriage contractions do.
Sharp and heavy pain should always lead you to call your OBGYN promptly, or to go to the ER. By the time you show signs of shock (shoulder pain, fever, dizziness, fainting), the ectopic pregnancy has already reached a critical stage and immediate medical attention is necessary. Don't wait to see if you develop any "real" symptoms, in other words act as soon as you are worried.
A placental abruption is a medical emergency during which the placenta starts to separate from the uterine wall prematurely either before or during labor. Vaginal bleeding is one symptom. There are more, however, and I'd urge you to read symptoms of placental abruption for more information. In short, women suffering from a placental abruption may have a hard and tender uterus and contractions that rapidly follow one another. Placental abruption can occur in the second or third trimester of pregnancy.
You've probably heard all about preeclampsia if you are currently expecting. This somewhat mysterious but very dangerous pregnancy complication is characterized by high blood pressure and protein spillage in the urine. Swelling (of limbs, extremities and face) and a tender and sometimes painful upper abdomen can be other symptoms.
Now that we have those biggies out of the way, we can discuss less catastrophic causes of abdominal pain during pregnancy. They can include:
- Urinary tract infections. UTIs may not constitute a true emergency, but you may be surprised that they can still potentially be quite dangerous. A UTI can go on to cause a kidney infection, which in turn can lead to premature labor. Read more about this in Urinary tract infections and pregnancy.
- Round ligament pain. That's your ligaments stretching as you grow. This stabbing, sharp pain may be annoying, but it is not dangerous.
- Braxton Hicks contractions are not usually painful, but they may start causing you discomfort as your baby's due date approaches.