Why does the lower abdomen hurt during pregnancy
Pain in the lower abdomen during pregnancy is one of the most common complaints of women. Sometimes you should not panic, as discomfort occurs for physiological reasons. But there are situations when medical intervention is mandatory and only the lives of the mother and child depend on it.

Probably, the dream of any pregnant woman is simple – the birth of a healthy baby. Therefore, any discomfort in well-being is perceived by the expectant mother as a potential threat. It is especially disturbing if the lower abdomen hurts. In what cases is this the norm, and when is it worth sounding the alarm?

– Most often, such problems can torment a woman in the first and third trimesters of pregnancy. In the first, this is due to the action of the hormone progesterone, which reduces intestinal motility, which leads to bloating and cramps. In the later stages, intestinal peristalsis also slows down, but already due to squeezing by the pregnant uterus, – says obstetrician-gynecologist Natalia Osokina.

At an early date

Pain in the lower abdomen at the beginning of pregnancy can occur for various reasons – sometimes this is a variant of the norm, so significant hormonal changes occur in a woman’s body. But situations are also possible when pain signals problems that need to be urgently addressed. Therefore, it is important not to waste time and at the first sign of malaise, consult a doctor.

In the first trimester

The abdomen in the first trimester of pregnancy can hurt for physiological reasons.

  • Attachment of the fetal egg to the endometrium of the uterus. At this point, there is a slight violation of the integrity of the endometrial mucosa, which can lead to mild discomfort, accompanied by unpleasant sensations in the lower abdomen.
  • Hormonal changes. The production of the hormone progesterone by the body increases – it affects the functioning of the intestines, reducing its peristalsis. This can cause cramps and pain in the abdomen.
  • Stretching of ligaments and muscles. The uterus of a pregnant woman gradually begins to grow – the changes are still minimal, but often very noticeable.

Physiological changes do not pose any harm to the health of the mother and child. However, it is far from always possible to immediately understand the cause of the pain, since it can also be pathological. Immediate medical attention is necessary in the following cases.

  • Ectopic pregnancy. It occurs when the fetal egg is attached not in the uterus, but in the cavity of the fallopian tube, where there are no normal conditions for the development of the embryo. This leads to damage to the pipe and its rapid rupture (1). An ectopic pregnancy is often manifested by sharp and cramping pains in the lower abdomen. You can’t hesitate here – you need to urgently call an ambulance, because sometimes minutes count.
  • Frozen pregnancy. Sometimes the development of the embryo freezes for some reason, for example, due to a severe flu or hormonal failure. The fetus dies, and the body tries to reject it naturally. As a result, the woman feels painful cramps in the lower abdomen. This condition also requires prompt medical attention.  
  • Risk of miscarriage. In the early stages, detachment of the fetal egg may occur. As a rule, it is accompanied not only by pain in the lower abdomen, but also by spotting. If you seek medical help in time, the pregnancy can be saved.   
  • Corpus luteum cyst. At the very beginning, the corpus luteum is used to maintain and develop pregnancy, which produces the hormone progesterone, which is necessary for the formation of the placenta. The resulting cyst provokes pulling pains, aggravated after physical exertion. Specific treatment is not required, but the situation must be monitored, as the cyst may rupture.

– With the threat of termination of pregnancy, aching or cramping pain is possible, which is not stopped by painkillers, radiating to the lower back, spotting is likely. This situation requires immediate medical attention. obstetrician-gynecologist Natalia Osokina.

At a late date

In the later lines, the load on the body of a pregnant woman increases, so pain in the abdomen often increases. It is important not to self-medicate, but to complain to your doctor.

In the second trimester

By the middle of the second trimester of pregnancy, the uterus grows so much that the muscles that support it begin to experience quite a lot of tension. Often it is accompanied by pain, which is aggravated by walking and physical activity. To reduce discomfort, doctors advise wearing a special bandage (2). However, it should be noted that it is selected individually after consultation with the attending physician.

In the third trimester

The third trimester is considered the most difficult – a grown belly increases the load on the spine and internal organs of the expectant mother. Often it is on the later lines that all chronic diseases become aggravated. Therefore, pain in the lower abdomen can also be caused by causes that are literally not related to pregnancy.

  • Bowel problems.

    Almost all pregnant women experience constipation. To reduce their risk, you should monitor the water balance – drink enough water, eat more fiber – vegetables, fruits, whole grain bread. Also remember that it is better to eat in small portions and chew food as thoroughly as possible, says obstetrician-gynecologist Natalia Osokina.

  • Appendicitis. Acute appendicitis, in accordance with the research of surgeons (3), most often occurs in pregnant women in the second trimester. Of course, in this case, you can not do without surgery. Appendicitis manifests itself not only with pain in the lower abdomen, but also with high fever. Vomiting and loose stools are also possible.
  • Cystitis and urolithiasis. Cystitis is hard not to recognize – it is signaled by pain during urination and frequent urge to go to the toilet. To diagnose the problem, sometimes it is enough to take a urine test.

– Even during pregnancy, extragenital diseases, such as pancreatitis, cholecystitis and others, can worsen. Most often, the pain will be localized, nausea and vomiting may also join. In such cases, it is worth contacting the nearest medical institution as soon as possible – comments obstetrician-gynecologist Natalia Osokina.

At 37 weeks

Often pain in the lower abdomen at the 37th week can be normal. The body is preparing for childbirth, sometimes by this time the expectant mother’s stomach is already lowered, which is accompanied by unpleasant sensations. Also, from the 37th week, training contractions usually appear – the stomach comes in tone, hardens. As a rule, training bouts do not last long and there is no periodicity in them. However, it is worth considering that the cause of pain can be more serious, so it is better to consult your doctor.

At 38 weeks

By the 38th week, most women are faced with training contractions that provoke mild pain in the lower abdomen. The reasons discussed above remain relevant. Perhaps it’s time to start monitoring your diet more carefully so as not to give the body an extra load.

At 39 weeks

– A baby at 39 weeks is usually ready for birth. There may also be signs of childbirth. Also remember that the load on the muscles and ligamentous apparatus of the uterus is maximum during this period, so pain in the lower abdomen can occur with a sharp change in body position. They pass soon on their own and do not require the use of medications, says obstetrician-gynecologist Natalia Osokina.

At 40 weeks

At 40 weeks, the expectant mother can no longer wait to meet the baby, so almost any discomfort in well-being is perceived as a possible onset of childbirth. Labor pains, of course, are accompanied by pain in the abdomen, but it is quite easy to recognize them – the pain gradually increases, and the time between contractions decreases.

What to do if the lower abdomen hurts a lot

Do not self-medicate and try folk methods with severe pain in the lower abdomen. The only correct way in this case is to immediately consult a doctor. When bleeding occurs, you need to call an ambulance. While waiting for the doctors, it is better to lie down, calm down and try to normalize breathing.

Popular questions and answers

Why does the lower back and lower abdomen hurt at the same time?

Perhaps the pain is associated with an increasing load on the spine. Also, kidney disease should not be ruled out. For example, pyelonephritis often coexists with cystitis. Together, these ailments lead to simultaneous pain in the lower back and lower abdomen.

Why does the lower abdomen hurt when walking?

Often this pain occurs due to stretching of the muscles that support the growing uterus. The problem is solved by wearing the right bandage.

Why can the lower abdomen hurt on the right or left?

Depending on the gestational age, the reasons can be completely different. For example, in the early stages, such pain may indicate an ectopic pregnancy. In the later stages, training contractions often manifest themselves.

Why does the lower abdomen hurt when urinating?

Probably the cause is cystitis, that is, inflammation of the bladder. It is necessary to pass blood and urine tests, make an ultrasound of the kidneys and bladder. Based on the results, the doctor will prescribe a treatment that will lead to an improvement in the condition.

Sources of

  1. Abdominal pain. Parfenov A.I. “RMJ” No. 17 of 17.08.2011 https://www.rmj.ru/articles/bolezni_organov_pishchevareniya/Boly_v_ghivote/
  2. Pelvic pain and pregnancy. Engelen MJA , Diercks RL , Mensink WFA “RMJ” No. 12 dated 20.12.1996/XNUMX/XNUMX https://www.rmj.ru/articles/obshchie-stati/BOLY_V_OBLASTI_TAZA_I_BEREMENNOSTY/
  3. Diagnostic and prognostic criteria for acute appendicitis in pregnancy. Zhatkanbaeva G.Zh., Sakhipov M.M., Bazek M.E., Utebaeva Zh.A., Dzhamaeva G.A. https://cyberleninka.ru/article/n/diagnosticheskie-i-prognosticheskie-kriterii-ostrogo-appenditsita-pri-beremennosti

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