When Should You Worry About Early Pregnancy Cramps?

See Your Physician If Your Cramping Is Bad

causes of early pregnancy cramps

Illustration by Emily Roberts, Verywell 

Experiencing cramps early in your pregnancy can lead to anxiety. You might wonder if it is just normal uterine stretching and growth or a sign of an impending miscarriage. Because there are numerous causes of cramping and your body is changing rapidly, the answer isn't always obvious. 

Even though cramps can sometimes indicate problems, mild and transient cramping early in your pregnancy is usually normal and not a sign of miscarriage. There's probably no immediate cause for concern if the pain isn't severe, one-sided, or accompanied by bleeding. Here are some pointers to keep in mind when you're deciding what to do.

Normal Early Pregnancy Cramps

During the first trimester, your body is preparing for the growing baby. These changes can cause cramping that would be considered normal. It is typically mild and temporary.

Once you become pregnant, your uterus will begin to grow. 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.

As you progress through the first two trimesters, it's possible that you'll 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 or the constipation, gas, and bloating which many pregnant women experience. Cramps may also occur during exercise—indicating you should take some time to rest—or after sex and an orgasm.

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

Pregnant women are also 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 Later in Pregnancy

As the uterus continues to grow larger, abdominal cramps can also occur later in 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 cramping during the second trimester 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 signs of preterm labor. These include dull backaches, intense pelvic pressure, blood or fluid from your vagina, or more than five contractions or cramps in an hour.

Abnormal Pregnancy 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), it only occurs in fewer than 2 percent of pregnancies. However, it is the leading cause of death for women in the first trimester.

An ectopic pregnancy occurs when the fertilized egg implants outside of the uterine cavity and signs typically appear when your 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 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 the 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 should be able to order hCG blood tests or an ultrasound to figure out what's going on.

Relief From Normal Cramping

There are ways to find relief from the normal cramping that comes with pregnancy. Quite often, it can be as simple as changing position 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 calming yourself down by using relaxation techniques such as meditation or controlled breathing.

Many women 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 early on in your pregnancy. That doesn't mean you shouldn't ask your doctor any questions you have, especially if it's your first baby or 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.

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Article Sources
  • American Pregnancy Association. Cramping During Pregnancy. 2017.
  • Barash JH, Buchannan EM, Hillson C. Diagnosis and Management of Ectopic Pregnancy. American Family Physician. 2014;90(1):34–40.