What Causes Stomach Pain During Pregnancy?

Updated on 2024-03-26 10:49:31 0 0

By Michelle Pugle

Medically reviewed by Renita White, MD

There are different types of stomach pain during pregnancy. Some pain comes from gas, constipation, or heartburn and is to be expected as your body changes to accommodate a growing fetus. Braxton Hicks contractions can also cause harmless discomfort.

However, there are many serious conditions associated with pregnancy pain including ectopic pregnancy and miscarriage or pregnancy loss. Knowing the differences between types of pain can help you determine what the next best steps are for relieving pain and when to seek immediate medical care.

In this article, we’ll go over the causes of stomach pain in pregnancy, including potential pregnancy complications and risk factors. We’ll also share some expert tips for relieving different types of stomach pain, and list the symptoms that signal immediate medical attention is necessary.

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Causes of Upper Stomach Pain in Pregnancy

Many causes of upper stomach pain in pregnancy are considered “normal” or harmless and non-threatening. For example, people may experience upper stomach pain in the first trimester as their body changes to accommodate the growing fetus.1 However, there are some situations in which upper stomach pain in pregnancy is cause for concern.

If the pain is located under your ribcage, especially on the right side of your body, you’ll want to see a healthcare provider immediately to rule out potential preeclampsia. Preeclampsia is a serious pregnancy concern characterized by high blood pressure and protein in the urine after 20 weeks gestation. It occurs in 5-8% of all pregnancies.2

Dangers of Untreated Preeclampsia

Untreated preeclampsia can lead to liver or kidney failure and cardiovascular issues for the pregnant person. It can also lead to eclampsia or severe preeclampsia characterized by seizures and hemolysis, mevated liver enzymes and low platelets (HELLPP) syndrome. HELLPP syndrome is characterized by reduced liver functioning and blood clotting ability.32

Causes of Lower Stomach Pain in Pregnancy

Lower stomach pain can occur as your uterus grows. Lower stomach pain, cramping, and bladder tenderness in pregnancy could be caused by a urinary tract infection or UTI. While UTIs during pregnancy are treatable and do not cause harm, complications can arise if symptoms are ignored.41

Signs UTI Is Spreading to Kidneys

If you experience pain in the lower back, sides of your body under the ribcage, or above your pelvic bone, and if that pain is accompanied by fever, chills, nausea, or sweats, it’s a sign the infection has spread to the kidneys.5 Consult with a healthcare provider right away.

Complications and Risk Factors

While some pain and cramping can be considered normal during pregnancy, severe pain requires immediate medical attention.

Ectopic Pregnancy

Ectopic pregnancy is when the embryo is implanted anywhere but the uterus. It occurs in about one in 50 pregnancies.1 Ectopic pregnancies cannot continue to term because the egg cannot develop, and they can damage the structure they attach to. Signs of ectopic pregnancy include severe, intense abdominal pain between six and ten weeks of pregnancy.6

Miscarriage

Miscarriage is pregnancy loss by natural causes before 20 weeks. It happens in about 15-20% of pregnancies, and in most cases cannot be prevented. Bleeding is the most common sign of pregnancy loss. The types of pain associated with miscarriage include severe back pain, contractions occurring every 5–20 minutes, and cramping or abdominal pain.7

Contact your healthcare provider right away if you have any bleeding during pregnancy.

Placental Abruption

Constant abdominal pain accompanied by your stomach staying hard for an extended period of time may be a sign of placental abruption.6 This complication can be mild or severe. The pain is caused by the placenta separating from the uterus.

Risk Factors for Pregnancy Complications

Risk factors for pregnancy complications include:8

Existing health conditions, including uncontrolled diabetes
Age at pregnancy
Lifestyle factors like smoking
Pregnancy conditions like pregnancy with twins or previous pre-term birth
Genetic conditions in the fetus

Describing Stomach Pain Symptoms in Pregnancy

Not all stomach pain during pregnancy is the same. Some pain is severe, intense, and unrelenting while other sensations are more accurately described as discomfort. Some ways of describing different stomach pain symptoms in pregnancy include:

Round Ligament Pain

When you move around while sleeping, sitting, or standing, there is potential for a sharp, stabbing pain sensation. This pain is coming from the stretching of your round ligaments as the uterus grows. Round ligaments are the two large ligaments running from your uterus to your groin.9

Round ligament pain is most commonly reported in the second trimester and affects between 10-20% of pregnancies.101

Digestive Pain

Gas and constipation triggered by the natural increase in progesterone during pregnancy can cause pain. This type of pain is not cause for concern.1 Heartburn during pregnancy can also cause harmless upper abdominal pain sensations.11

Braxton Hicks Contractions

Braxton Hicks contractions are not true contractions. They can start happening as early as your second trimester but are more common as your due date approaches. They are caused by the tightening of the top of your uterine muscles. Braxton Hicks contractions spread downwards and are described as more uncomfortable than painful, but this is of course individual. They can range in intensity and last from 15-30 seconds.12

How to Relieve Mild Pregnancy Stomach Pains

If you’re experiencing mild pregnancy stomach pains from upset stomach or heartburn, there are several ways of getting relief.

Try these tips for relieving digestive pain:11

Avoid tight clothing
Eat small meals
Sip liquids and have most fluid in between meals
Move your body after eating (i.e., go for a short walk)
Avoid lying down right after eating
Elevate your head while sleeping

Try these tips for relieving Braxton Hicks discomfort:12

Switch positions (i.e., if you’re sitting, stand up and walk or if you’re walking, sit down and rest)
Try a warm bath for 30 minutes (or less)
Stay hydrated (contractions can be caused by dehydration)
Sip warm tea or warm milk

When to Check In With a Provider

If you experience abdominal pain or discomfort and any of the following symptoms, seek medical attention immediately:1

Severe or persistent pain
Spotting or bleeding
Fever and/or chills
Vaginal discharge
Light-headedness
Discomfort while urinating
Nausea and vomiting

Summary

Experiencing abdominal pain during pregnancy is not always cause for concern. As the body changes to accommodate pregnancy, ligaments stretch, digestive discomforts occur, and Braxton Hicks contractions can start. Some stomach pains, especially when accompanied by other symptoms such as vaginal bleeding, may indicate a more serious condition or pregnancy complication. When in doubt, or if you can’t get relief at home, always check-in with a healthcare provider.

Sources

American Pregnancy Association. Stomach pain in pregnancy.

American Pregnancy Association. Preeclampsia.

Preclampsia Foundation. HELLP syndrome.

Office on Women’s Health. Urinary tract infections.

American Pregnancy Association. Urinary tract infections during pregnancy.

Office on Women’s Health. Pregnancy complications.

American Pregnancy Association. Symptoms and signs of miscarriage.

Eunice Kennedy Shriver National Institute of Child Health and Human Development. What are some factors that make a pregnancy high risk?

American Pregnancy Association. Round ligament pain during pregnancy.

Zachariah SK, Fenn M, Jacob K, Arthungal SA, Zachariah SA. Management of acute abdomen in pregnancy: Current perspectives. International Journal of Women’s Health. 2019;11:119-134. doi:10.2147/IJWH.S151501

Minnesota Women, Infants, and Children Nutrition Program. Heartburn and upset stomach during pregnancy.

American Pregnancy Association. Braxton Hicks contractions: Causes, symptoms and pain relief.