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Lower abdominal pain might have been your constant companion right at the beginning of pregnancy, but now that you have reached your third trimester, it's much more likely to represent something out of the ordinary that should be looked at.

We'll discuss some of the more common causes of lower abdominal pain during the third trimester of pregnancy in this post.

When does the third trimester actually begin?

Pregnancy is said to last 40 weeks because it is calculated from the time of ovulation. Babies actually tend to spend about 38 weeks in your uterus before they're born. When does the third trimester actually begin? Some sources say it begins at 26 weeks gestation, while others prefer to count the third trimester from the 28th week of pregnancy. When we're looking at lower abdominal pain in the third trimester, chances are that people will think "labor!" immediately. Before doing this, it is good to remember that the third trimester actually goes on a fair bit. Whether you think it starts at 26 or 28 weeks, you definitely know that that is not the right timing for labor.

Even babies born at 36 weeks gestation have a disadvantage compared to their full-term peers. Lower abdominal pain before the 38th week of pregnancy should always be investigated further. Because there is more of a risk of preterm labor at this final stage of pregnancy and other possible causes also tend to be more serious, it is important to always give your OBGYN or midwife a call when you experience lower abdominal pain in pregnancy. In addition, persistent pains definitely warrant a trip to the ER or your maternity ward. Think it's just a stomach bug? You wouldn't be the first to end up with a baby.

Braxton Hicks contractions

Third-trimester women have been experiencing Braxton-Hicks contractions for quite a while now. They may have grown used these contractions, forming a set idea about how they should feel. Before considering other possibilities, it might be useful to know that Braxton-Hicks contractions can indeed change during the final stage of pregnancy. They may become more intense and even painful, and can last longer and occur more frequently. Remember, Braxton-Hicks contractions usually subside almost immediately if you change positions. Try sitting down or standing up to see what happens next. If the sensation goes away, you might well be dealing with simple Braxton-Hicks contractions. Braxton-Hicks contractions may also be triggered by vigorous physical activities including running, cycling, walking up stairs, and sex.[1]

Preterm labor

Preterm labor or premature labor, whatever you like can be defined as experiencing effective contractions before your baby is full term. Unlike Braxton-Hicks contractions, labor contractions do not stop when you change positions. They start off feeling quite a lot like Braxton-Hicks contractions (or really bad period pains), but they grow longer and will appear more frequently. Labor contractions tend to follow a fairly predictable pattern.[2] That can be summed up as:

  • "Huh, what's this? Oh, it's gone!"
  • "Oh, there it is again!"
  • "Oh no, there seems to be a pattern here."
  • "Ouch!"

If you're experiencing this, you should go to a hospital. If you're not at term yet, you may well be dealing with preterm labor. Preterm labor can sometimes be halted, so go in as soon as possible call an ambulance if you need to. Sometimes, preterm labor starts when the bag of waters breaks rather than with contractions. Amniotic fluid is a clear fluid with a fairly distinct but not usually unpleasant smell.[3] Losing your mucus plug can be a warning sign that premature labor is about to start. The mucus plug consists of rubbery mucus and blood.

A placental abruption

Placental abruption occurs when the placenta detaches from the uterine wall before the baby is born, either during or before labor. It is sometimes accompanied by heavy bleeding, but some women only bleed a little and others don't notice any bleeding at all. Other possible symptoms include back pain, abdominal tenderness, and crazy contractions that don't seem to stop at all. Since placental abruption is a life-threatening emergency, these symptoms warrant calling the emergency services right away.[4

Women who experience light abdominal bleeding without any other symptoms should also always consult their OBGYN immediately if they are in their third trimester.

Urinary tract infections

You might have experienced a urinary contraction or several already. In that case, you are more likely to recognize the symptoms. If you have never had a UTI before, you need to know that its signs include lower abdominal pain, a burning sensation while urinating, very frequent urination but low urinary output, and weird looking or smelling urine. If your UTI has reached the kidneys, you are also likely to experience a fever, chills, heavy, stinging abdominal pain, and sometimes blood or puss in the urine. Both bladder and kidney infections should be taken seriously all by themselves.[5] Doctors will usually treat UTI with antibiotics, but the antibiotic chosen should be safe for both the mother and the child.[6] In women who are also in their third trimester of pregnancy, these infections can further lead to preterm labor. The moral is clear: get to a doctor.

  • Thanks to George Ruiz/Flickr Creative Commons.
  • Photo courtesy of stock photos

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