Abdominal cramping is a common pregnancy ailment. Symptoms of cramping can begin as early as the first trimester and usually continue throughout a woman's pregnancy. Understanding the possible causes of abdominal cramping can provide peace of mind. In addition, an awareness of accompanying symptoms can help determine when urgent medical attention may be necessary.
Early Causes
Implantation bleeding is usually the earliest type of abdominal cramping. Sometimes accompanied by slight cramping, implantation bleeding occurs when the fertilized egg attaches to the uterine lining. This usually occurs 10 to 14 days after fertilization, around the time that menstruation would be normally due according to the Mayo Clinic. As the first trimester progresses, many women experience normal abdominal cramping due to gas, heartburn and constipation. According to the March of Dimes, this type of pain is usually the result of pregnancy hormones that slow a woman's digestive system to maximize the amount of nutrients that can be absorbed by the fetus. Later in pregnancy, the enlarging uterus will continue to cause these types of cramps.
Miscarriage
As many as 1/4 of pregnancies end in miscarriage, according to the American College of Obstetricians and Gynecologists, and the majority of these occur during the first trimester. Abdominal cramping that is reminiscent of menstrual cramps, lower back pain and bleeding are common warning signs of miscarriage, according to the American Pregnancy Association.
Later Causes
During the second trimester, the muscles and ligaments around the uterus must stretch to accommodate its growth. Many women experience aches, pains and cramp-like sensations when this occurs, and pain is most severe when getting up from a sitting or lying position, or when coughing.
False labor, or Braxton-Hicks contractions, are another common cause of cramping during the second and third trimester. While often painless, these cramp-like feelings are often harmless contractions that occur at irregular intervals. If the cramps or contractions stop during walking, occur at irregular intervals, there is no reason for concern according to the March of Dimes.
When contractions occur after week 37 of pregnancy, occur at regular intervals, and occur with menstrual cramps, it is usually a sign that labor has begun. In the last weeks of pregnancy, cramping may be a sign that labor is almost ready to begin.
Cramping Complications
Sharp abdominal pain or cramps that occur on one side of the body or even the shoulder can mean an ectopic pregnancy has developed. Doctors usually discover ectopic pregnancy during the first trimester, which occurs when the fertilized egg implants outside the uterus on its journey out of the fallopian tube. Without treatment, pain will get worse and may occur with dizziness, nausea and vomiting. Ectopic pregnancy requires immediate medical attention to ensure the health of the mother.
Preterm labor is abdominal cramping or contractions that occur at regular intervals before week 37 of pregnancy. They can sometimes occur with diarrhea and require a doctor's prompt attention to stave off an early delivery.
When to Call a Doctor
While there are several causes of abdominal cramping that are normal, severe pain never is. Pregnant women should get medical attention if cramps are accompanied by fever, bleeding or vaginal discharge, chills, lightheadedness or faintness.
