It can be frightening to have cramps during pregnancy, as a million things might run through your mind. But most women will experience some discomfort, after all, the body is changing every day. And let’s be honest, it’s not that easy to carry a growing baby in your belly. Today, let’s find out what’s normal, what isn’t, and how to tell the difference.
Note: it might help to know that cramping is a common symptom, a kind of response from the uterus to virtually anything happening to or near it.
What is Cramping?
The uterus is a muscle, and the only thing a muscle knows how to do is contract. A contraction feels like a cramp, and at any moment the uterus can be stimulated, be it by a full bladder, vigorous exercise, or something else. So, the natural response to uterine stimulation is contraction. The important thing is to determine when cramping during pregnancy is a concern and when it doesn’t require more attention1.
What Can Cause Cramping in Pregnancy?
Some factors that can trigger cramping in pregnancy are:
- Having a full bladder;
- Having an orgasm;
- Doing physical exercise;
- Having sexual intercourse;
- Urinary tract infections.
Is Cramping Early in Pregnancy Normal?
Cramping early in pregnancy is common. And the good news is there are many normal and non-concerning reasons why a woman might experience cramps early in pregnancy:
First trimester – for some women, cramping during pregnancy may be the first sign they’re pregnant. This is because, it’s common to feel cramps when the fertilized egg implants into the uterine wall. These are called implantation cramps or nidation2, and they may feel like a period is about to start.
The rapid growth of the uterus in the first two trimesters can also cause cramping in pregnancy. In addition, constant changes in hormone levels can increase gas, bloating, and even constipation.
Most women will have mild and intermittent cramps in pregnancy during the first 16 weeks. A common concern among women experiencing these early cramps is that they might be having a miscarriage. But cramps alone are not a sign of miscarriage and they also do not cause miscarriage.
Generally, miscarriages occur when there is abnormal development of the ovum or embryo (such as chromosomal abnormalities), and the body responds by ending the pregnancy.
Second trimester – usually, the second trimester is the period when cramping is less likely, as well as other uncomfortable symptoms.
However, an exception is women who are pregnant with more than one baby, since the uterus grows very quickly and reaches third-trimester proportions already in the second trimester.
Another common exception is round ligament pain3, which happens when the ligament supporting the uterus is stretched as it grows. This kind of benign pain is usually sharp and quick.
A more serious but also rarer cause of cramps in the second trimester are fibroids. This condition is characterized by the growth of benign tumors inside and on the outer walls of the uterus.
The tumors can stop growing in the second trimester due to insufficient blood supply to sustain their growth. When this happens, the pain can be quite severe and concerning. Generally, this occurs between 15 and 18 weeks of pregnancy, and any woman with a family history of fibroids should stay alert, as hospitalization may be needed to manage the pain until it subsides.
Third trimester – in the third trimester, the famous practice contractions (Braxton Hicks) usually start to appear4. These are the same contractions a woman will experience when labor begins, but the difference is that they do not progress to true labor.
Of course, when cramps occur in the third trimester, or even in the second, it’s important to rule out the possibility of preterm labor.
When Is Cramping During Pregnancy Not Concerning?
During sexual intercourse – intercourse is one of the most common causes of cramping during pregnancy. That’s because semen contains prostaglandins, which stimulate the uterus.
Without a doubt, sex is a great way to relax, but pregnant women will often experience cramps after intercourse, sometimes quite strong ones. Feeling cramps right after sex can be normal. However, if a woman has been diagnosed with low placenta or is experiencing bleeding, the medical recommendation is to avoid sex. In these cases, it is advisable to talk to a doctor.
When changing position – if you feel cramps during pregnancy and they improve when you change position, don’t worry! This is usually a sign that the cramps are related to stretching of the uterus or its supporting ligaments.
Before going to the bathroom – if you feel cramps but passing gas or having a bowel movement relieves them, it’s probably related to a gastrointestinal problem rather than the uterus.
When to Be Concerned About Cramps During Pregnancy
- Several contractions in a row – if you feel 6 or more contractions in one hour, it may be a sign of preterm labor;
- Dizziness and bleeding – cramps accompanied by dizziness or bleeding (especially if the pregnancy hasn’t yet been confirmed by ultrasound) may be a sign of an ectopic pregnancy. Bleeding may also be a symptom of miscarriage or placenta previa, a condition where the placenta covers the cervix;
- Pink discharge – cramps with this kind of discharge is a serious sign of preterm labor, as it may mean your cervical length is changing;
- Persistent cramps – when pregnant with multiples (which increases the risk of preterm birth), have a history of preterm labor or ectopic pregnancy, or have been diagnosed with cervical incompetence, the symptom may be concerning;
- Back or abdominal pain – if this pain is intense and associated with cramps, nausea, vomiting and/or fever. These can be symptoms of appendicitis, kidney stones, or gallbladder disease;
- Pain that doesn’t improve – if cramping doesn’t improve over time or doesn’t get better when you change position, this is a reason for concern.
How to Relieve Cramps in Pregnancy
The first recommendation is to unplug, rest, and drink plenty of fluids. If you need pain relief, it’s important to consult your doctor to find out exactly what medication to take.
Do not use a heating pad on your abdomen, as raising the uterine temperature is dangerous during pregnancy, especially in the first trimester. Reducing physical activity, doing stretches, and taking sitting breaks throughout the day can help. Cramps tend to be worse after long periods in the same position. Taking a warm, relaxing bath every night before bed is also a good idea.
Wearing a belly support band can also provide some comfort against cramping during pregnancy. It’s recommended to use a simple elastic band with velcro, worn under the belly and adjustable, but not too restrictive. And most importantly: you should always feel comfortable reaching out to your doctor whenever you have concerns about cramping in pregnancy. As I always say: better safe than sorry!
Important tip: Did you know that Methylfolate is the metabolized form of folic acid? That’s why it’s very beneficial in pregnancy, and its use is recommended from the first days of pregnancy to help prevent possible problems with the baby. You can find Methylfolate here.
See Also: Contractions: How to Know When It’s Time for Labor?
