Are abdominal pains during pregnancy normal?

As your baby develops and your bump gets bigger by the day, your body will adapt to the little one growing inside you. These changes can sometimes cause a bit of discomfort, like stomach pain or cramping in early pregnancy. Most of the time, these aches and pains that some pregnant women experience are nothing to worry about - they’re all part and parcel of your body adjusting to your pregnancy journey and growing uterus.

From round ligament pain due to your growing bump to Braxton Hicks and constipation, here we’re talking about some of the potential culprits behind stomach pain in pregnancy.

If you have any concerns or need a bit of reassurance, get in touch with your midwife who will be able to put your mind at rest or provide the best advice for you and your baby. The C&G Care Team is also on hand with friendly, expert advice if you want to talk anything through – give us a call at 0800 977 8880.

What causes abdominal pain in pregnancy?

Stomach pain in pregnancy can vary each time it happens. It might be that you experience mild cramping in early pregnancy, similar to period pains1. Sometimes, stomach pain in pregnancy is sharp or dull and doesn’t last all that long.

There are some times, however, when pregnant women experience severe pain in their tummy or abdomen, and occasionally this can be a sign of something more serious.

You should call your midwife straight away if you have stomach pain that’s accompanied by1:

  • bleeding or spotting
  • cramps or tightening
  • vaginal discharge that’s different to your normal
  • lower back pain
  • burning or pain when you have a wee

It’s also a good idea to seek medical advice if the pain hasn’t gone away after you’ve rested for 30-60 minutes, just to be on the safe side. 

Ultimately, there are lots of different things that can cause stomach pain in pregnancy, many of which are completely harmless. Rest assured that if you’re not in severe pain and the discomfort goes away after a short rest, there’s likely nothing to worry about1

Common causes of abdominal pain in pregnancy

There are a few potential causes of stomach pain in pregnancy, the majority of which won’t cause any harm to your growing baby. Let’s take a look at some of the things you might experience plus some handy tips on easing the symptoms.

Growing uterus

Feeling full a little quicker than usual, getting bloated or suffering from indigestion, nausea, or belly cramps? The likelihood is that you’re feeling the effects of your growing uterus. This is completely normal as the pregnancy hormone progesterone can result in water retention and bloating – both very common in early pregnancy.  

You can help to ease any discomfort by eating smaller meals more regularly, doing some gentle exercise, getting plenty of rest and going to the toilet as soon as nature calls!

Round ligament pain

Round ligament pain is also known as ‘growing pains’. This is because they’re caused by the ligaments on the sides of your tummy stretching as your uterus grows. These round ligaments attach your womb to your pelvis, and as your baby gets bigger they can go into spasm, leading to sharp pain in your lower belly and down into your groin2.

Round ligament pain is completely normal and harmless to you and your baby. It usually begins in the second trimester, but some pregnant women can feel them earlier. They’re similar to a stitch or sharp cramp, and they can feel worse if you change positions suddenly or increase abdominal pressure by sneezing, coughing or laughing2.

Constipation and trapped wind

Constipation and trapped wind are some of the less glamorous symptoms, but they’re very common causes of cramping in early pregnancy. The changes in your hormone levels can slow down your digestion, leaving you with stomach pain if you can’t go to the loo3.

You can help ease the symptoms and keep everything moving by drinking plenty of water, exercising regularly, and eating high-fibre foods like wholemeal bread, fruits, vegetables, beans, and lentils3.

Whilst it’s not the same for every pregnant woman, constipation can continue during your second trimester4 and your third trimester, too5. Especially if you’ve been started on some iron tablets by your midwife!

Braxton hicks contractions

Braxton Hicks contractions are a completely normal part of pregnancy that most women start to notice in their second or third trimester6. They happen when the muscles in your uterus tighten and relax as your body practices for when you go into labour.

If this is your first pregnancy, it’s easy to mistake Braxton Hicks for real contractions - but there are some key differences6:

  • Braxton Hicks contractions could well be uncomfortable but shouldn’t be painful.
  • They’re usually pretty irregular and unpredictable compared to real contractions which have a clear pattern.
  • Braxton Hicks don’t get more intense, more frequent, or closer together as time goes on.

If you’re still not sure whether the stomach pain you’re experiencing is Braxton Hicks, it’s best to check with your midwife at the hospital. During your antenatal appointment, your midwife should have given you the telephone number for the assessment centre at the hospital. The number is available 24 hours a day, and should be your first port of call if you need to speak to someone urgently.  

When stomach pain becomes more serious

There are a few symptoms that you should watch out for that could be a sign of something more serious. We’ll cover all these signs and what they might mean below, but bear in mind that you might not experience all of the symptoms listed. It’s always best to stay on the safe side, so get in touch with your doctor or midwife if you’re not sure. 

Ectopic pregnancy

An ectopic pregnancy happens when a fertilised egg implants itself somewhere other than the womb - usually in one of the fallopian tubes. The egg can’t develop into a baby in an ectopic pregnancy, and it can be a risk to your health7.

Not all ectopic pregnancies cause symptoms, but if they do they usually happen between the 4th and 12th week of pregnancy. Symptoms of ectopic pregnancies include7:

  • stomach pain in your lower belly or on one side of your abdomen
  • brown, watery vaginal discharge or vaginal bleeding
  • pain in the tip of your shoulder or neck
  • discomfort going to the toilet

If you think you might be experiencing an ectopic pregnancy, get in touch with your GP or ring 111 straight away. You should always go to A&E if you feel dizzy or sick, or have a sudden sharp pain in your stomach or shoulder7

Miscarriage

Having abdominal pain in pregnancy doesn’t necessarily mean you’re having a miscarriage, but it’s important to seek medical advice if you’re concerned. 

The most common sign of miscarriage is vaginal bleeding which may be followed by pain (but not all vaginal bleeding is a sign of miscarriage). Other symptoms include8:

  • cramping in your lower stomach
  • discharge of fluid or tissue from the vagina
  • no longer having other symptoms of pregnancy like nausea or tender breasts

Call your midwife at the hospital, A&E, or Early Pregnancy Unit immediately if you have any of these symptoms. 

Premature labour

Premature labour means going into labour before your 37th week of pregnancy9. Call your hospital where you’re booked to have your baby straight away if you’re less than 37 weeks pregnant and have any of the following symptoms:

  • regular contractions or tightening feelings
  • cramping pains similar to period pains
  • fluid coming from your vagina (this could be your waters breaking)
  • lower back pain that’s unusual for you

The earlier in pregnancy a baby is born, the more vulnerable they are to complications linked with being premature. But it is possible for a baby to survive if they’re born at 24 weeks onwards - they’ll just need extra care in a special neonatal unit9.

Placental abruption

The placenta is a temporary organ that grows inside your womb when you’re pregnant and provides your baby with the nutrients they need to grow10. Placental abruption is when the placenta partly or completely separates from the inner wall of the uterus before the delivery of your baby.11.

Symptoms include:

  • bleeding from the vagina
  • stomach pain
  • back pain
  • frequent contractions coming one after the other

Placental abruption is a serious but rare condition, so if you have any of these symptoms you should be checked by a doctor or midwife straight away.

Pre-eclampsia

Pre-eclampsia affects some pregnant women in their second and third trimester (from 20 weeks) or soon after they’ve given birth12. Most of the time pre-eclampsia is fairly mild, but it needs to be monitored to avoid complications for you and your baby.

Most symptoms of pre-eclampsia should be picked up during the midwife appointments you have throughout your pregnancy. But sometimes other symptoms might develop, like12:

  • severe headache
  • blurred vision
  • pain below the ribs
  • being sick
  • swollen face, hands or feet

The earlier symptoms of pre-eclampsia are caught, the better it is for you and your baby. Talk to your midwife if you’re worried about pre-eclampsia.

Urinary tract infection (UTI) 

If you’ve ever been unlucky enough to have a UTI, you’ll know they can be pretty uncomfortable. They’re also more common during pregnancy thanks to changes in your hormone levels13.

Symptoms of UTIs include14:

  • stomach pain or lower back pain
  • needing to pee more often (usually urgently)
  • pain or burning when you have a wee
  • wee that’s cloudy, smelly or has blood in it
  • a very high or very low body temperature

UTIs can usually be treated easily, but it’s best to talk to your GP or midwife as soon as you can if you have any symptoms. Find out more about UTIs and cystitis during pregnancy

Appendicitis

Appendicitis is pretty common in and outside of pregnancy. It’s caused by your appendix swelling, leading to symptoms like15:

  • abdominal pain
  • loss of appetite
  • feeling sick
  • constipation or diarrhoea

Appendicitis is a little trickier to diagnose in pregnant women because the symptoms are so similar to being pregnant, but the main thing to look out for is severe pain in the abdomen. If it’s caught early enough, appendicitis is easy enough to treat by removing your appendix. As always, make sure to get in touch with your GP or A&E Labour ward if you have any doubts about your symptoms.

Gallstones

Gallstones are small stones made of cholesterol that can form in the gallbladder. Most of the time they have no symptoms, but if they get trapped they can cause severe pain in your stomach16.

It’s pretty common for pregnant women to experience symptoms of gallstones because increases in hormones like oestrogen can cause an increase in cholesterol levels17. If you’re experiencing intense abdominal pain in pregnancy, get in touch with your midwife. They’ll be able to check for gallstones and other possible causes of abdominal pain and get you the treatment you need.

Recap: abdominal pain in pregnancy

Stomach pain in pregnancy is usually a completely normal and harmless side effect of growing a baby. Slight discomfort from growing pains and gas is all part of the journey and often nothing to worry about.

But you know your body best and you should always trust your instincts. If something doesn’t feel right, or you just need some reassurance, your midwife will be more than happy to put your mind at ease.

  1. NHS (2021). Stomach pain in pregnancy [online] Available at https://www.nhs.uk/pregnancy/related-conditions/common-symptoms/stomach-pain/ [Accessed May 2024]
  2. Tommy's (2023). Stomach (abdominal) pain or cramps in pregnancy [online] Available at https://www.tommys.org/pregnancy-information/pregnancy-symptom-checker/stomach-abdominal-pain-or-cramps-pregnancy [Accessed May 2024]
  3. NHS (2024). Common health problems in pregnancy [online] Available at https://www.nhs.uk/pregnancy/related-conditions/common-symptoms/common-health-problems/ [Accessed May 2024]
  4. NHS Start for Life. 27 weeks pregnant [online] Available at https://www.nhs.uk/start-for-life/pregnancy/week-by-week-guide-to-pregnancy/2nd-trimester/week-27/ [Accessed May 2024]
  5. NHS Start for Life. Week 34 [online] Available at https://www.nhs.uk/start-for-life/pregnancy/week-by-week-guide-to-pregnancy/3rd-trimester/week-34/ [Accessed May 2024]
  6. Raines, DA & Cooper, DB (2023). Braxton Hicks contractions [online]. Available at https://www.ncbi.nlm.nih.gov/books/NBK470546/ [Accessed May 2024]
  7. NHS (2022). Ectopic pregnancy [online] Available at https://www.nhs.uk/conditions/ectopic-pregnancy/ [Accessed May 2024]
  8. NHS (2022). Miscarriage [online] Available at https://www.nhs.uk/conditions/miscarriage/ [Accessed May 2024]
  9. NHS (2024). Premature labour and birth [online] Available at https://www.nhs.uk/pregnancy/labour-and-birth/signs-of-labour/premature-labour-and-birth/ [Accessed May 2024]
  10. Herrick, EJ & Bordoni, B (2023). Embryology, placenta [online] Available at https://www.ncbi.nlm.nih.gov/books/NBK551634/ [Accessed May 2024]
  11. NHS (2022). What complications can affect the placenta? [online] Available at https://www.nhs.uk/pregnancy/labour-and-birth/what-happens/placenta-complications/ [Accessed May 2024]
  12. NHS (2021). Pre-eclampsia [online] Available at https://www.nhs.uk/conditions/pre-eclampsia/ [Accessed May 2024]
  13. Habak, PJ, Carlson, K. & Griggs, RP (2024). Urinary tract infection in pregnancy [online] Available at https://www.ncbi.nlm.nih.gov/books/NBK537047/ [Accessed May 2024]
  14. NHS (2022). Urinary tract infections (UTIs) [online] Available at https://www.nhs.uk/conditions/urinary-tract-infections-utis/ [Accessed May 2024]
  15. NHS (2022). Appendicitis [online] Available at https://www.nhs.uk/conditions/appendicitis/ [Accessed May 2024]
  16. NHS (2021). Gallstones [online] Available at https://www.nhs.uk/conditions/gallstones/ [Accessed May 2024]
  17. Salari N, Hasheminezhad R, Heidarisharaf P, Khaleghi AA, Azizi AH, Shohaimi S, Mohammadi M. The global prevalence of gallstones in pregnancy: A systematic review and meta-analysis. Eur J Obstet Gynecol Reprod Biol X. 2023 Sep 6;19:100237. doi: 10.1016/j.eurox.2023.100237. PMID: 37711873; PMCID: PMC10497987.
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