Is Cramping During Early Pregnancy a Sign of Miscarriage?

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If you're pregnant, you're likely paying extra close attention to your body. If you feel a cramp, you may worry that it is a sign of a miscarriage, especially if it is early in your pregnancy.

While the first trimester is the most common time for miscarriages, there are other reasons for cramps. Whether cramping signals a miscarriage depends on when it occurs, severity, and whether you're experiencing other symptoms with it.

Cramping in Early Pregnancy

Having cramps in your lower abdominal area or lower back in early pregnancy (the first trimester) most likely signals one of three things:

  • Ectopic pregnancy: Faintness and/or severe abdominal cramping may be a symptom of ectopic pregnancy. This occurs when the egg implants outside of the uterus, usually in a fallopian tube. While rare, ectopic pregnancies are not viable and can put your life in danger. If you suspect this issue, go to the emergency room right away.
  • Miscarriage: When cramping is accompanied by spotting or vaginal bleeding, it can be a sign of miscarriage. Call your doctor for advice; they may suggest testing to determine whether you are having a miscarriage. A miscarriage can occur within the first 20 weeks of gestation, but the risk is higher in the first trimester.
  • Normal pains: Cramping without bleeding is usually not a sign of miscarriage. Cramps or short-lived pains in your lower abdomen can happen early in normal pregnancy as your uterus adjusts to the implanted embryo, or even if you have a urinary tract infection. These pains are likely mild and brief. If you feel anything severe and/or prolonged, always call your doctor to be safe.

Symptoms of Miscarriage

Look out for these signs and symptoms of miscarriage in the first trimester.

  • Bleeding that is brown or bright red
  • Clots of tissue passing from the vagina
  • Mild to severe back pain that's worse than normal menstrual cramps
  • A sudden decrease in the signs of pregnancy, such as breast tenderness or morning sickness
  • Very painful contractions every five to 20 minutes
  • Weight loss
  • White-pink mucus-like vaginal discharge

Contact your doctor if you notice any of these symptoms. Miscarriage is the most common cause of early bleeding in pregnancy.

However, it's important to note that early bleeding could actually be a threatened miscarriage. This is diagnosed when there's uterine bleeding but the cervix is closed and an ultrasound shows that the baby's heart is beating.

Fortunately, threatened miscarriages don't always result in pregnancy loss, even when there's a lot of blood on more than one occasion. If you experience spotting or bleeding that's concerning, your doctor may perform an ultrasound to check on the baby's status.

Cramping in Late Pregnancy

Cramping in the second or third trimester could be harmless or concerning—it depends on the situation.

  • Preterm labor: Cramps occurring at regular intervals (try timing them) may indicate preterm labor. More than six cramps or contractions in 1 hour, a change in vaginal discharge such as bright red vaginal bleeding, a sudden gush of clear fluid, a low, dull backache, or intense pelvic pressure are all possible signs. For any of these symptoms, call your doctor immediately.
  • Round ligament pain: You may experience shooting pains in the lower abdomen or around your hips due to a phenomenon called round ligament pain, which occurs as your body accommodates your growing uterus. These types of pains are normal and will pass, but you should discuss them with your doctor.

A Word From Verywell

A little bit of anxiety is totally normal in early pregnancy. After all, your life is about to change with the addition of this tiny bundle of joy. Your instinct is to protect your little one and make sure that he or she is as healthy and as safe as possible.

Talk to your doctor whenever you are concerned about any level of cramping during pregnancy. It can be a stressful time, and talking to your doctor about your symptoms can be very reassuring.

4 Sources
Verywell Family uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Sapra KJ, Buck Louis GM, Sundaram R, et al. Signs and symptoms associated with early pregnancy loss: findings from a population-based preconception cohort. Hum Reprod. 2016;31(4):887-96.doi:10.1093/humrep/dew010

  2. Fanchin R, Ayoubi JM. Uterine dynamics: impact on the human reproduction process. Reprod Biomed Online. 2009;18 Suppl 2:57-62.

  3. Qureshi NS. Treatment options for threatened miscarriage. Maturitas. 2009;65 Suppl 1:S35-41. doi:10.1016/j.maturitas.2009.10.010

  4. National Institute of Child Health and Human Development. What are the symptoms of preterm labor?.

By Krissi Danielsson
Krissi Danielsson, MD is a doctor of family medicine and an advocate for those who have experienced miscarriage.