When to Worry About Cramping During Pregnancy

Occasional, erratic cramps without bleeding are usually normal

causes of early pregnancy cramps

Verywell / Emily Roberts

Experiencing cramps early in your pregnancy can naturally lead to anxiety and worry that something is wrong. You might wonder if the cramping is from normal uterine stretching and growth or a sign of an impending miscarriage. Also, because there are numerous causes of cramping and your body changes so rapidly in pregnancy, the answer to what's going on isn't always obvious. 

Even though cramps can sometimes indicate problems, mild and transient cramping early in pregnancy is usually normal and not a sign of miscarriage. 

How Long Does Cramping Last in Early Pregnancy?

Cramps similar to menstrual cramps can be common during the first and second trimesters. This normal early pregnancy cramping lasts from a few minutes to a few hours. The cramps are usually mild and may lessen with position changes. Another common pain is known colloquially as lightning crotch. It is a quick, sharp pain in the vagina, which many people experience without any harm to their pregnancies.

In most cases, there's probably no immediate cause for concern if the pain you feel isn't severe, one-sided, or accompanied by bleeding. Call your OB/GYN if you have any questions or worries about cramping (or any other concerns) in pregnancy. In the meantime, here are some pointers to keep in mind when you're evaluating what might be going on.

Cramps in the First and Second Trimesters

During the first trimester, your body is preparing for the growing fetus. These changes can cause cramping that is typically mild and temporary. This is expected and not a cause for concern as long as the pain doesn't become intense, chronic, or occur alongside other more worrisome symptoms, such as vaginal bleeding.

As your pregnancy progresses, your uterus will continue to grow and expand. As it does this, you'll likely feel mild to moderate cramping in your lower abdomen or lower back. This may feel like pressure, stretching, or pulling. It may even be similar to your typical menstrual cramps. This is also normal and expected.

As you progress through the first two trimesters, it's possible that you'll continue to experience cramping every now and then. Since the uterus is a muscle, any time it contracts, there's potential for a little discomfort. This can be caused by a full bladder, constipation, gas, or bloating, which many pregnant people experience.

Cramps may also occur during exercise—indicating you should take some time to rest. It's also common to experience some cramping after sex.

Even if your cramps may be normal, it is something to bring up to your physician at your next prenatal appointment.

Pregnant people are also more susceptible to yeast infections and urinary tract infections, either of which may cause mild cramps. Your doctor will want to treat these as soon as possible to ensure you have a healthy pregnancy.

Cramps in the Third Trimester

As your uterus continues to grow larger up until childbirth, abdominal cramps from stretching and growing may also continue to occur throughout pregnancy. You should experience the least amount of cramps during the second trimester. However, this is when your round ligament—a muscle that supports the uterus—will begin to stretch. During this time, it's normal to feel sharp pains or dull aches in the lower abdomen.

If you are pregnant with multiples, expect some extra soreness or cramps during the second half of pregnancy as your body makes extra room for the babies. This final growth spurt (along with the increased pelvic pressure it causes) usually doesn't occur in a single pregnancy until the third trimester.

While some cramping is normal, be on the lookout for symptoms of preterm labor. These include dull backaches, intense pelvic pressure, blood or fluid from your vagina, cramps or contractions that increase in intensity and frequency, or more than five contractions or cramps in an hour.

When to Worry About Cramps

If your cramping is persistent or severe, do not hesitate to call your physician. It's better to check on anything that doesn't seem right rather than ignore something that may be a serious concern.

Severe cramping, in particular, should always be investigated to rule out ectopic pregnancy. According to the American Academy of Family Physicians (AAFP), the condition occurs in fewer than 2% of pregnancies. However, it is the leading cause of death for pregnant people in the first trimester.

An ectopic pregnancy occurs when the fertilized egg implants outside of the uterine cavity, and signs typically appear when you are six to eight weeks pregnant. It's most often accompanied by one-sided cramping as well as pain in the neck or shoulder and a constant urge to have a bowel movement.

If you think you have signs of a ruptured ectopic pregnancy, go to the emergency room right away because it can be life-threatening. Also, if your cramping seems to be focused on one side of your lower abdomen, call your physician to be on the safe side, even if the cramping isn't severe.

If you are having any kind of vaginal bleeding along with cramping in early pregnancy, you should call your physician—it's possible that you are having a miscarriage. These symptoms don't always mean a miscarriage, but your physician will be able to order hCG blood tests or an ultrasound to figure out what's going on.

Ways to Find Relief

There are ways to find relief from the normal cramping that comes with pregnancy. Quite often, it can be as simple as changing position, drinking a glass of water, or sitting or laying down for a while to get some rest.

Sometimes, cramping is a sign that you're doing too much or stressed. Taking a few minutes for yourself can help both your body and mind relax. Try recuperating or calming yourself by using relaxation techniques such as meditation, taking a shower, going on a walk, using a heating pad, watching a comedy, or practicing controlled breathing.

Many pregnant people find that a nightly bath works wonders. A hot water bottle gently placed on your aches and pains can also bring relief. Some doctors recommend an elastic belly band as well.

A Word From Verywell

In general, it's normal to experience some cramping in your pregnancy, particularly early on. That doesn't mean you shouldn't ask your doctor any questions you have, especially if it's your first baby or what you feel is different than previous pregnancies. It's better to err on the side of caution, so take note of how long and frequent your cramps are and, if you have concerns, bring them up to your healthcare team.

6 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. March of Dimes. Abdominal pain or cramping.

  2. Cleveland Clinic. Expecting twins or triplets.

  3. March of Dimes. Preterm labor and premature birth: Are you at risk?

  4. Barash JH, Buchanan EM, Hillson C. Diagnosis and management of ectopic pregnancy. Am Fam Physician. 2014;90(1):34-40.

  5. March of Dimes. Stress and pregnancy.

  6. Cleveland Clinic. Pregnancy discomforts: Back pain, round ligament pain, nausea.

Additional Reading

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