Abdominal Pain in pregnancy

As the baby grows, it is normal to experience some twinges and aches. It can be tricky to know what kinds of pains are normal, and which are abnormal. I hope the flow charts below provide some clarity on when you need to speak to your doctor. If you are ever in any doubt, it is always safer to seek medical help.

Pain in the 1st Trimester

Miscarriage

A miscarriage can present with period like cramps and bleeding. You can find out more information on the section about bleeding in pregnancy.

Ectopic Pregnancy

An ectopic pregnancy can present with pain on one side of the tummy. You may also feel dizzy and have some shoulder tip pain. There may be associated bleeding. If you have any of these symptoms you need to go to the emergency department for an urgent scan.

Urinary Tract Infection

You can get a urinary tract infection at any point in your pregnancy. They are more common in the second and third trimester as the growing baby presses on the bladder. Symptoms include cloudy smelly urine and pain when passing urine. It is important to get treated promptly to avoid any complications.

Pain in the second trimester

Pelvic ligament pain

As the baby grows in the womb, it is fairly common to feel some discomfort in the hip area. The pain can be felt over the pubic area as well as over the hips and the back. The pain may be worsened by walking, going up the stairs or turning over in bed. If you have any such symptoms, please speak to your midwife about being referred for antenatal physiotherapy.

Heartburn

The growing baby can put pressure on the stomach leading to reflux. It can present as a burning pain after eating or sometimes with simply a cough which is worse on lying down. You can take Gaviscon to ease any reflux symptoms. It is safe to use in pregnancy.

Constipation

The hormonal changes in pregnancy and the pressure from the growing baby can make you feel more constipated, especially in the 2nd and third trimester. It is important to have a diet high in fiber and drink lots of water. It is important not to strain, to avoid getting piles, and if needed you should speak to your doctor about trying a laxative like fybogel. Another useful tip is to ensure you have good toileting position. See the following link for more information 7 Toilet Positions To Relieve Constipation | Bladder & Bowel Community

Pre-eclampsia

Pre-eclampsia is a condition which causes raised blood pressure in pregnancy. It is associated with pain in the upper right part of the tummy. See section on pre-eclampsia for more information.

early labour

Early labor may present with contraction pains (strong period like cramps). There may also be light bleeding or breaking of waters. If you think you are in early labor, you must go to your local hospital immediately.

Urinary Tract Infection

Urinary tract infections present with lower tummy pain, difficulty passing urine and burning when passing urine. If you experience any of these symptoms, you must seek urgent treatment. Untreated urinary tract infections in pregnancy can cause complications and therefore it is important to seek prompt treatment.

Abdominal Pain in the Third Trimester

All of the causes of abdominal pain in the second trimester can also cause pain in the third trimester. Additional causes include:

Placental abruption

Placental Abruption occurs when the placenta separates from the womb before birth. This can lead to complications as it affects the growth and development of the baby. The symptoms include bleeding as well as tummy pain. The level of pain can vary. If you have any of these symptoms it is important to seek urgent help.

Labor

You should start to feel labour pains in the days leading up to the birth. If you experience this before 37 weeks you need to seek urgent help as this may be premature delivery.

Labour pains feel like a regular cramping pains. The more the labour progresses, the more close together and intense the contractions become.