Updated November 2013
I have a pain in my stomach area
Some discomfort in the abdomen/stomach area is normal in pregnancy. It is usually caused by your expanding womb and hormones. It can sometimes feel like a ‘stitch’. You may also feel light period-like dicomfort at the beginning and end of pregnancy. These are nothing to worry about.
However, if you are having persistent abdominal/stomach pain, it should be checked by a doctor or midwife immediately.
Look out for the following:
• severe lower one-sided abdominal pain in early pregnancy (between week 5 and 10) with bleeding or a brown discharge could be the sign of an ectopic pregnancy. The pain is sometimes felt in the shoulder. Contact your midwife, doctor or hospital A&E immediately.
• severe cramps in your lower stomach/abdomen with bleeding that lasts for several hours could be a sign of a miscarriage. Contact your midwife, doctor or hospital.
• regular painful contractions/cramps before 37 weeks could be a sign of premature labour, particularly if accompanied by backache, pelvic pressure and vaginal discharge. Contact your midwife, doctor or hospital.
• severe constant pain in your lower abdomen/stomach, tenderness when you press your stomach and back pain with or without bleeding could be a sign of placental abruption. Contact your midwife, doctor or hospital immediately.
• from 20 weeks, pain in the upper abdomen/stomach with other symptoms such as a very bad headache, nausea, vomiting, flashing lights or seeing spots in front of your eyes could be signs of pre-eclampsia. Contact your midwife, doctor or hospital.
• lower abdominal pain or dull back pain that comes with one or more of the following: pain or discomfort when urinating, pelvic discomfort, need to urinate frequently (although this on its own is common in a normal pregnancy), a raised temperature, cloudy, foul-smelling or bloody urine, nausea and vomiting. These are symptoms of an infection of the urinary tract. It is not an emergency but should be treated as soon as possible, so contact your doctor or midwife.
Towards the end of pregnancy, the following are common:
• ‘Braxton Hicks’ contractions are a sign that the muscles of your womb are tightening. This can happen from as early as 16 weeks, but are more common in later pregnancy. They are infrequent (more than 10 minutes apart) and short-lasting, and uncomfortable more than painful. You do not need to contact your maternity unit or midwife unless contractions become painful and regular (less than 10 minutes apart).
• Contractions/cramps after 37-40 weeks could be the sign of the early stages of labour. This is called latent phase of labour.
NHS Choices, Ectopic pregnancy, London NHS Choices, 2012 (www.nhs.uk/conditions/ectopic-pregnancy)
Trivedi SS, Puri M, Management of High-Risk Pregnancy: A Practical Approach, London Jaypee Brothers Medical Publishers Ltd, 2010
Enkin M, Keirse MJNC et al, A Guide to Effective Care in Pregnancy & Childbirth, Oxford Oxford University Press, 2000
McNabb M (2004) Mayes’ Midwifery A textbook for midwives, Philadelphia Balliere Tindall, p238 (page 238)
National Institute for Health and Care Excellence, Intrapartum care, care of healthy women and their babies during childbirth, Guideline 55, London NICE, 2007