Cramping during pregnancy

Cramping is a common early pregnancy symptom and usually nothing to worry about. Aches, twinges, and pulling or stretching muscle pain are typical and differ in length and intensity between people. However, some cramps accompanied by bleeding, fever, or discharge should prompt you to contact your doctor.
Cramping is a common early pregnancy symptom and usually nothing to worry about. Aches, twinges, and pulling or stretching muscle pain are typical and differ in length and intensity between people. However, some cramps accompanied by bleeding, fever, or discharge should prompt you to contact your doctor.

Many people experience cramps in early pregnancy. As your baby develops, so does your body. It is normal to experience cramping, or a mild pulling sensation in your abdomen. Cramping is not considered one of the early detection signs of pregnancy, but it is a common early pregnancy symptom and often nothing to worry about. 

Many home or over-the-counter remedies are readily available and effective in reducing pregnancy cramps. However, other treatments may be dangerous during part or all of your pregnancy. It is important to be able to distinguish between the two.

In fact, some types of cramping should prompt you to contact your doctor or even emergency medical services. Learn more about when cramping is a natural part of a healthy pregnancy and when you should seek medical attention to rule out potential complications.

Signs and symptoms of pregnancy cramps

It is important to be able to tell the difference between normal early pregnancy cramps and cramping that may point to pregnancy complications. The following types of pain are normal early pregnancy symptoms:

Implantation pain

In the earliest stage of pregnancy, you may experience implantation pain. This is when the fertilized egg implants in the uterus. Pain generally occurs around the time when your period would normally begin. It may be accompanied by light spotting

Implantation pain feels much like a mild menstrual cramp. You may experience an aching or pulling sensation in your lower abdomen. The duration of the pain and/or spotting differs between people. Many people experience no pain. Some experience only a few brief twinge, while others may have mild and intermittent pain for several days.

First trimester cramps

During the first trimester, your uterus and the supporting muscles and ligaments begin to stretch. You may experience occasional cramps. Your pain should be relatively mild and infrequent. It may be more pronounced when you cough, sneeze, or adjust your position. 

SLIDESHOW

16 Early Signs & Symptoms of Pregnancy: Could You Be Pregnant? See Slideshow

Causes of pregnancy cramping

There are several causes of cramps in early pregnancy. Some of them require medical intervention. The most common causes include:

Implantation

Mild cramping around the time of implantation is perfectly normal. You may feel anything from a few twinges to an irregular, minor pain over the course of a few days.

Bodily changes

Your body must adjust in order to make room for your growing baby. It will be stretched and flooded with hormones. Both of these may cause occasional cramping.

Intestinal symptoms

Pregnancy directly causes mild cramps. Your pregnancy may also come with other symptoms that will, themselves, produce cramping. These can include constipation, gas, and/or bloating.

Sexual intercourse

You may experience intense uterine cramping after sexual intercourse. This pain should go away quickly.

Urinary tract infection (UTI)

Pregnant people are typically at an increased risk for urinary tract infections by the sixth week of the first trimester. This is due to changes in the urinary tract. You may have a UTI if you have cramping in the lower abdomen and/or any of the following symptoms:

Early pregnancy loss

If you experience cramping in your pelvic area, lower back, or abdomen, these may be signs of a miscarriage. This cramping will often be accompanied by vaginal bleeding that may start as a brownish discharge. Initial bleeding may be light. Heavy bleeding may indicate the presence of pregnancy tissue passing from the body.

Ectopic pregnancy 

An ectopic pregnancy occurs when the egg is implanted outside the uterus. The most common location is in the fallopian tubes. This is why it is also called a tubal pregnancy. An ectopic pregnancy cannot proceed normally and is dangerous to the mother. It usually results in the loss of the embryo and must be treated immediately.

The most common symptoms of an ectopic pregnancy are cramping and heavy bleeding in the first trimester.

When to see the doctor for early pregnancy cramping

You should see a doctor if you have any of the following symptoms during your first trimester:

  • Severe and long-lasting pain
  • Cramping accompanied by fever, discharge, or dizziness
  • Cramping and heavy bleeding
  • Cramping along with pain in the shoulder or neck

You should also speak to your doctor about any concerns with cramping during your regularly scheduled appointments.

People over the age of 40 are more likely to experience early pregnancy loss. They should be particularly attentive to potential symptoms.

Diagnosing early pregnancy cramping

If your doctor is concerned about pregnancy complications, they will ask you questions about the intensity and duration of your cramping. They may also perform any of the following tests in order to determine the cause of your pain:

These tests will help your doctor evaluate the health of your pregnancy.

Treatments for early pregnancy cramping

Early pregnancy cramps may be relieved without medication. Try the following home treatments to relieve pain:

  • Lie down, sit, or change positions
  • Take a warm bath
  • Place a heating pad or hot water bottle at the site of the cramp
  • Perform relaxation exercises

Drinking plenty of fluids may also help with cramp prevention

In the case of more persistent cramping, you may want to try over-the-counter pain relievers. You may need to avoid some of the following medications, but a few are perfectly safe in your first trimester:

Acetaminophen (Tylenol)

Most pregnant people can take low doses of acetaminophen without fear of harming either their fetus or themselves.

Aspirin

Aspirin can contribute to maternal or fetal bleeding. Low doses of the drug are most likely safe, but use sparingly. You may also want to avoid it if you are spotting.

Ibuprofen (Advil) and Naproxen (Aleve)

These NSAIDs are safe for pregnant people during the first trimester. However, during late pregnancy they have been associated with an increased risk for a rare but serious fetal heart problem called premature ductal closure. If your doctor is concerned about this, they may recommend alternative pain-relieving medications.

What are some uncommon signs of early pregnancy?

The first week of the pregnancy is when the egg has been released from the ovum, the egg then combines with sperm and conception occurs. Progesterone and estrogen hormones, which are a part of the normal menstrual cycle, rise dramatically. A new hormone called human chorionic gonadotropin (hCG) begins to be produced as well. These hormones promote the increase in blood flow to the uterus and prepare the uterus lining for the implantation of the fertilized egg.

In the early stages of pregnancy, the female may be unaware of the pregnancy. The woman may experience symptoms similar to a menstrual period. The first week of pregnancy usually does not cause any noticeable symptoms and may vary in different females. Some common and uncommon symptoms include

  • Amenorrhea: Sudden cessation of regular menstruation is the most common symptom denoting pregnancy. However, pregnancy may occur during lactational amenorrhea. Also, bleeding may occur early in pregnancy, which could be similar to threatened abortion.
  • Bleeding: Implantation bleeding is an early sign of pregnancy and is different from the menstrual period. It precipitates light bleeding that may involve a single spot of blood or a small amount of pink discharge. The spotting may last for a few hours or days.
  • Cramping: Women may also feel mild cramping when the embryo attaches to the uterus wall. Women may feel these cramps in the abdomen, pelvis, or low back area. The cramping may feel like a pulling, tingling, or pricking sensation. Some women experience only a few minor cramps, whereas others may feel occasional discomfort that comes and goes over a few days.
  • Other variable symptoms include
    • Nausea with or without vomiting
    • Breast changes, including tenderness, swelling, tingling feeling, or noticeable blue veins
    • Frequent urination
    • Headache
    • Raised basal body temperature
    • Bloating in the abdomen or gas
    • Mild pelvic cramping or discomfort without bleeding
    • Tiredness or fatigue
    • Food cravings or aversions
    • Irritability or mood swings
    • A heightened sense of smell
    • Metallic taste in the mouth

Pregnancy symptoms are different for every woman. Some women may notice symptoms, such as spotting or a headache, during the first week of pregnancy. Others may only experience a missed period. Some women will have no symptoms at all.

How is pregnancy diagnosed?

The diagnosis of pregnancy can be made by several methods. A woman with a 28-day cycle who presents with a missed period and has the typical history and physical exam findings can be diagnosed with a viable intrauterine pregnancy test if she progresses accordingly. Most women are diagnosed with pregnancy after a missed menstrual cycle. The positive result depends on the presence of human chorionic gonadotrophin (hCG) in maternal serum and urine.

  • Urine pregnancy tests
    • Agglutination test: Latex particles or sheep erythrocyte (tube) coated with anti-hCG.
    • Agglutination inhibition tests
    • Dipstick test
    • Rapid and simple tests based on enzyme-labeled monoclonal antibodies assay can detect low level of hCG in urine
  • Serum pregnancy tests
    • Radioimmunoassay of beta-subunit of hCG
    • Radio receptor assay

QUESTION

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Medically Reviewed on 2/25/2022
References
American College of Obstetricians and Gynecologists: "Early Pregnancy Loss: FAQs."

American Family Physician: "Diagnosis and Management of Ectopic Pregnancy."

American Pregnancy Association: "Pregnancy Cramps."

American Association of Pregnancy: "Urinary Tract Infection During Pregnancy."

American Pregnancy Association: "What is Implantation Bleeding?"

Canadian Family Physician: "Treating pain during pregnancy."

Harvard Health Publishing: Harvard Medical School: "Miscarriage."

March of Dimes: "Sex During Pregnancy."

Stöppler MC, MedicineNet: "Early Pregnancy Signs and Symptoms: Am I Pregnant."

WebMD: "Early Pregnancy Symptoms."