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Abdominal Pain During Pregnancy – Causes and Concerns

Dr. Minu Justin
MBBS., MD (Ob & Gyn) 
Consultant – Obstetrics & Gynaecology

Pregnancy is the time your body undergoes several changes to accommodate the baby growing inside your womb. As a result of such changes, many difficulties may occur. One such is abdominal pain. The causes of abdominal pain during pregnancy is usually harmless. However, in some cases they may be serious, which need urgent medical treatment.
It is important for an expectant mother to differentiate causes that are normal and serious.

Common, Harmless Causes

Excessive Gas and Constipation

The increased level of progesterone release during pregnancy causes intestinal muscles to relax leading to the slow movement of food through the intestine. Similarly, as your pregnancy progresses, owing to the pressure your enlarged uterus may put on other organs, the process of digestion may slow down. Besides this, fluctuating hormones, iron pills and anxiety can cause indigestion, excessive gas, constipation and heart burning during pregnancy leading to abdominal pain. Especially, gas can cause severe pain in the abdomen.

By doing regular exercises, eating small frequent meals through the day, drinking plenty of water, by avoiding gas-triggering food and taking fiber-rich food, this can be controlled to a great extent.

Round Ligament Pain

As the uterus stretches to hold your growing baby, the two large round ligaments that run from the uterus through the groin also stretches which may cause sharp stabbing pain, especially when you change positions or coughing or sneezing, around the abdomen. Get up slowly if you are sitting or lying down. Do daily stretching. Ensure not to give pressure on the ligament area while coughing or sneezing.

Braxton Hicks Contractions

The pain that you experience as the uterus contracts for about two minutes is called Braxton Hicks Contractions. These ‘false’ contractions aren’t labour and are a normal part of pregnancy. These contractions are not regular and unlike labour contractions don’t get increasingly painful. These contractions usually occur in the third trimester of pregnancy.

Serious Causes


Mild to severe back pain and abdominal pain due to true contractions can be a sign of miscarriage. Most often, miscarriage occurs in the first 13 weeks of pregnancy. If you experience such pain accompanied by bleeding with or without cramps, immediately consult your doctor.

Preterm labour

Labour that begins before the completion of 36 weeks of pregnancy is termed preterm labour or premature labour. You may experience menstrual-like aching cramps in the lower part of your abdomen, which may be continuous or occur in a rhythmic pattern. You may have lower backache and abdominal or intestinal cramps with or without diarrhoea. In addition to this, you may also experience frequent contractions, an increased amount of vaginal discharge and pressure in the pelvic area. Consult your doctor if you experience these symptoms because they may be signs of early labour.

Placental abruption

It is a serious condition in which the placenta separates from the uterus before the baby is born. One of the main symptoms of this condition is the constant severe abdominal pain that stays for a longer period of time. Other symptoms of this condition include premature breakage of water, back pain and bloody fluid. Consult your doctor immediately if you experience these symptoms.

Ectopic Pregnancy

An ectopic pregnancy occurs when the egg is implanted anywhere other than the uterus.  Mostly, in such cases, the egg is implanted in the fallopian tube.  In such conditions, you may experience severe pain and bleeding between the 6th and 10th weeks of pregnancy. This is a serious condition that needs emergency medical treatment.


Preeclampsia is a condition in pregnant women marked by increased blood pressure and high level of protein in the urine after 20th week of pregnancy. The symptoms of Preeclampsia are upper abdominal pain, nausea, vomiting and swelling in the feet, legs, and hands. Check with your doctor if you have these symptoms.

Urinary Tract Infection

Urinary tract infection during pregnancy can cause pain, discomfort, burning feel while urinating and lower abdominal pain. If these symptoms are accompanied by fever, nausea, sweats or chills, it may indicate that the UTI has spread to your kidneys. If untreated, UTI can lead to complications. Seek medical help as soon as possible after you have these symptoms.

When To See Your Doctor?

Seek immediate medical help if you have the following symptoms:

  • Severe and continuous pain
  • Fever and Chills
  • Bleeding/ blood clots passage
  • Unusual/bloody vaginal discharge
  • Nausea and vomiting
  • Discomfort while urinating
  • Swollen feet, legs and hands
  • Severe back pain
  • Contractions that persists



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