Pregnancy can be a time filled with anticipation and excitement as you wait for your new arrival. But if you develop left-side abdominal pain during your pregnancy, you may wonder if something is wrong.
Although mild abdominal pain can be a completely normal part of the aches and pains that accompany growing another human being, persistent or severe pain on the left side might indicate a problem that should prompt an immediate visit to your doctor.
Here are some common causes of pain on the left side during pregnancy, as well as what other symptoms you should watch for and when to seek medical attention.
Some of the most common causes of left-sided pain during pregnancy are round ligament pain, gas or constipation. And while uncomfortable and inconvenient, the common complaints often pose no threat to you or your baby, notes Clara Ward, MD, a maternal-fetal medicine specialist with McGovern Medical School at UTHealth and UT Physicians in Houston. "Anything that causes abdominal pain outside of pregnancy can also cause pain during pregnancy," she adds.
1. Round Ligament Pain
One of the most common causes of pain near the abdomen during pregnancy is due to round ligament pain. This type of pain — which can range from a dull ache to a sharp, stabbing spasm — is caused by the stretching of the ligaments that support the uterus, says Dr. Ward. She explains that sudden movements, even ones that don't seem unusual or strenuous, such as rolling over in bed or turning to the side, or even coughing, sneezing and laughing, can trigger it. "The ligaments also stretch during movement, so you may notice that there is more discomfort on days when you are more active," she adds.
Read more: Abdominal Belt After Pregnancy
Marcos Cordoba Munoz, MD, a maternal-fetal medicine specialist with Spectrum Health in Grand Rapids, Michigan, provides some insight on how to identify round ligament pain: "Typically, for patients who have round ligament pain, the pain is intermediate, while contractions have more of a pattern," he explains.
If the pain is on the left side, it is likely because your uterus is tipped toward the right side, relaxing the ligament on the right while stretching the left ligament. Ligament pain is usually intermittent and sharp, often brought on by sudden movement, laughing or coughing. Sometimes the pain extends into the groin. Changing positions slowly or resting often relieves the pain, and identifying triggers and then modifying or slowing down your movements may reduce the pain.
You may also experience lower left abdomen or left upper-quadrant pain during pregnancy simply as a result of your baby's movements and the pressure of your uterus moving upwards. "Later in pregnancy, constant pain under the ribs can be due to the pressure of the uterus on the rib cage and stretching of the ribs," explains Dr. Ward.
2. Gastrointestinal Causes
Hormonal changes during pregnancy may upset your digestive system, commonly leading to excess gas and constipation — both of which might cause left side abdominal pain. "Hormones produced during pregnancy make bowel move slower, which means patients experience increased gas and bloating," explains Dr. Cordoba Munoz. "This pain can affect both the left and right side of the body."
Constipation is also very common in pregnancy, thanks to the slowed-down digestive system. "The sigmoid colon is on the left side, so if this is full of stool, pain can occur there," explains Yvonne Bohn, MD, an ob-gyn at Providence Saint John's Health Center in Santa Monica, California.
Other digestive system problems unrelated to pregnancy, such as pancreatitis, can also produce midline or left-sided pain. An August 2016 study in Hepatobiliary & Pancreatic Diseases International involving 25 pregnant women with pancreatitis identified abdominal pain as the most common symptom. The pancreas is located behind your stomach and might become inflamed if you have gallstones or another condition that causes pancreatic irritation. Pancreatic pain typically flares after eating high-fat foods or when you lie on your back and could radiate to your back or your left shoulder blade.
Appendicitis, pancreatitis and gallstones may be overlooked because of pregnancy, adds Dr. Ward.
"Diagnosis is often delayed because the organs may not be in their usual spots or present with the classic symptoms, or symptoms may overlap with common complaints of pregnancy," she says, adding that they are usually accompanied by other GI symptoms, such as pain before or after meals, loss of appetite, nausea or vomiting. "Be aware of your body — you know your body best, so if something doesn't feel right, don't hesitate to ask your doctor."
3. Ovarian Cysts
According to Dr. Bohn, ovarian cysts can be present before pregnancy and can occur because of pregnancy. She explains that after ovulation, a cyst, called a corpus luteum, forms in the ovary. This cyst produces hormones early on to sustain the pregnancy before the placenta is formed. As described in a March 2015 review article in Facts, Views & Vision in ObGyn, these types of cysts usually disappear on their own after they are no longer needed.
However, she adds, other type of cysts, such as endometriomas or dermoids, may be present before pregnancy occurs and can grow or rupture during pregnancy. If they get very large and twist (called ovarian torsion), they may require surgery during pregnancy. Another type of cyst, called a functional cyst of the ovary, is full of clear fluid. These can burst during pregnancy but usually do not require surgery — just observation and pain management.
According to Dr. Cordoba Munoz, most cysts are benign, and it's rare to have a malignant cyst during pregnancy. It's also rare for ovarian cysts to burst during pregnancy, as they tend to stay the same size throughout. However, he notes that sometimes the cyst can get larger, and if they become larger than 5 centimeters, there is an increased risk of torsion, or twisting.
As the American College of Obstetricians and Gynecologists explains, most ovarian cysts during pregnancy go away without treatment, and many doctors advise simply watching the cyst with periodic ultrasound tests. In rare cases, the ovary twists or the cyst ruptures, causing severe pain and possible complications.
Read more: Causes of Ovarian Pain While Pregnant
4. More Serious Problems
In rare cases, a more serious problem during pregnancy might cause left-sided abdominal pain. This can happen, for example, if the fetus implants abnormally in the left fallopian tube, which is called an ectopic pregnancy. An ectopic pregnancy can be a life-threatening emergency if the tube ruptures.
An ectopic pregnancy will only occur in the first trimester and can cause left-sided pain, but in some cases, the bleeding is internal, so it can be difficult for a woman to know there is a problem. "If you know or suspect that you are pregnant or missed your period and you are having pain associated with dizziness or lightheadedness, seek medical attention, regardless of any bleeding you may see, as this can be life-threatening if not addressed right away," advises Dr. Ward.
Other potentially serious conditions that might cause left-sided abdominal pain include early or preterm labor, miscarriage, kidney stones and certain infections. Urinary tract infections, in particular, can be harmful if they are not treated because they can progress to the kidney, which can lead to overwhelming infection in the bloodstream and shock, Dr. Ward explains.
And, she adds, while not harmful to mom or baby, kidney stones are more common during pregnancy, since pregnancy hormones cause urine to move more slowly in a woman's body. "Pain related to kidney stones tends to be very characteristic, sharp waves of colic that radiate from the back through the groin," she says.
One other very serious condition that can lead to abdominal pain during pregnancy is preeclampsia. As the Preeclampsia Foundation explains, this pregnancy-related disorder typically occurs after 20 weeks and can threaten the health of the mother and her unborn baby. Symptoms include high blood pressure, swelling and protein in the urine.
Often times, preeclampsia will cause right side pain during pregnancy in the third trimester, but it can also lead to just general abdominal pain in some women, too. If you experience any sudden abdominal pain, especially accompanied by dizziness or seeing spots in your eyes, you should seek medical attention right away.
6. Placental Abruption
If you develop sudden bleeding in your pregnancy accompanied by abdominal pain, it may be a sign of a placental abruption. This occurs when the placenta tears away from the uterine wall before the baby is delivered, according to the US National Library of Medicine. This potentially life-threatening condition can deprive the unborn baby of oxygen and nutrients and cause the mother to lose a significant amount of blood. If you develop any sort of sudden bleeding during your pregnancy, with or without abdominal pain, seek medical attention right away.
Next Steps and Cautionary Notes
Talk with your health care provider if you develop left-sided abdominal pain during pregnancy to determine the likely cause and treatment options. Even if the pain is mild or only occurs occasionally, it's a good idea to mention your discomfort just to be sure it is not something serious.
Generally speaking, discomfort or pain that is not accompanied by any other symptoms or resolves is not concerning, says Dr. Ward. "Pain that is associated with fever, chills, vomiting, bleeding or a change in the vaginal discharge — in particular, anything like water or mucus — or a decrease in fetal movement should be evaluated by your physician," she explains.
"Also, if the pain is so severe that you are unable to perform your daily activities, or can't breathe, walk or speak, you should get immediate attention," she adds. "If you are uncertain, or something still doesn't feel quite right, it is always a good idea to call your doctor."
- American College of Obstetricians and Gynecologists: "Ovarian Cysts"
- Preeclampsia Foundation
- Fact, Views, & Vision in ObGyn: "Management of Ovarian Cysts and Cancer in Pregnancy"
- Hepatobiliary & Pancreatic Diseases International: “Pancreatitis in Pregnancy: Etiology, Diagnosis, Treatment, and Outcomes”
- US National Library of Medicine: "Placental Abruption"