If you’ve experienced low belly pain when pregnant or pain on your right side, you’re not alone. Whether you’re in your first trimester or getting close to your due date, pregnancy does crazy things to your body. That’s no surprise since you’re growing an entirely new person inside of you! Plus, with the sudden influx of new and intense hormones, pregnancy can be extremely uncomfortable in a wide variety of ways.
But for the first-time mom-to-be, all those new twinges and aches—from low belly pain to right side pain—can be confusing, anxiety-inducing, and often, pretty scary. What’s normal and what’s not? And how can you tell the difference?
Here’s a breakdown of the pregnancy pains that are NBD, and when it’s time to consult your ob/gyn.
These pains are sucky, but normal and nothing to worry about:
Gas or constipation
“Gas and constipation are very common,” Angela Jones, M.D., a New Jersey-based ob/gyn who runs AskDrAngela.com, tells SELF. That’s because pregnancy hormone progesterone causes the smooth muscles in both the esophagus and bowel to relax. Normally, bowels contract to push waste along and out. But with this slowing down, the body has a tougher time ridding itself of waste, blocking everything up and potentially causing low belly pain when pregnant. Jones says the buildup of gas can get so painful that some patients mistake it for something more serious and go to the emergency room. And it can get pretty damn painful. The best way to prevent this is to eat smaller, more frequent meals with plenty of fiber, and to drink loads of water. If you’re experiencing gas or constipation pain, a stool softener can also help.
A pulling or stabbing low belly pain caused by sudden movement
As your pregnancy progresses and you get bigger and bigger, the two ligaments that attach the uterus to the abdominal wall—called round ligaments—begin to stretch and strain, causing pain. “This pain typically starts around 12 to 14 weeks and gets more pronounced during the second trimester,” Shannon M. Clark, M.D., a maternal-fetal medicine specialist at UTMB-Galveston and founder of BabiesAfter35.com, tells SELF. “The pain feels like a pulling or sharp pain in the lower half of the abdomen on either side of the uterus.” Usually, you’ll notice this pain more with sudden movements, such as rolling over in bed or twisting to one side. The good news: Round ligament pain is limited to just one area and once you stop moving, usually subsides.
Contractions that last just one to two minutes
Most pregnant women know that labor is comprised of uterine contractions, but many women don’t know that they can start experiencing contractions as early as the second trimester (that said, they’re most common in the third trimester). These contractions, called Braxton Hicks contractions, are a normal part of pregnancy and while they may be uncomfortable, they usually aren’t painful. “These contractions are just like contractions a woman feels in labor, only they are not as painful and typically do not occur in a pattern or over an extended period of time,” Clark says. “The uterus will get hard and ‘ball up’ in the abdomen and the contraction may last for one or two minutes before the uterus relaxes.” Braxton Hicks are also called “practice contractions” because they prep you for labor and allow you to practice the breathing exercises taught in childbirth classes.
What can trigger Braxton Hicks contractions? Being physically active, a full bladder, sex (you might get the contractions afterwards), and dehydration, according to the American Pregnancy Association. To get rid of them, try the following advice from the American Pregnancy Association:
- Shift positions: If you’ve been standing, try sitting or laying down. If you’ve been sitting, get up and walk around. A walk may be a good idea.
- Draw a warm bath: Sit in the tub for 30 minutes or less.
- Stay hydrated: Drink a few glasses of water (since contractions may be brought on by dehydration).
- Sip something warm: Go for a mug of tea or warm milk.
If none of the above work, call your doctor.
If you feel any of these, you should give your doctor a call:
1. Sudden sharp right side pain during pregnancy
It could be appendicitis (inflammation of the appendix). Surprisingly, appendicitis is the most common reason for emergency surgery during pregnancy, Clark tells SELF. Around 0.1 percent of women will experience appendicitis during pregancy, and it’s most common in the second trimester, according to the Mayo Clinic. “The pain may be sudden and may be sharp or dull and achy,” says Clark. “It is typically associated with fever, inability to eat, nausea, and vomiting.” Since the symptoms of appendicitis are common to being pregnant in general, it can be difficult to diagnose. See your doctor right away if you’re in pain and suspect something is wrong. They can do an ultrasound to see if appendicitis is the culprit.
2. Pain in the upper right abdomen after eating
Slowed down digestion also slows the emptying of the gallbladder, which can lead to gallstones. “If it isn’t too severe a case, gallstones can be managed conservatively with dietary modification including avoiding fatty, fried foods,” Jones says. Occasionally, some patients will need surgery, but in most cases, removal can wait until after delivery, she adds. Gallstones are often associated with pain in the upper right quadrant of the abdomen that occurs after you eat a fatty meal. If cholecystitis occurs, which is inflammation of the gallbladder, the symptoms include fever and increased pain that won’t go away. In this case, surgery may be necessary.
3. Sudden pain in the upper right abdomen, paired with nausea
Preeclampsia is a pregnancy-specific condition that usually involves a sudden increase in blood pressure and some kind of damage to other organs (usually the kidneys and liver), according to the Mayo Clinic. It usually occurs in the third trimester, but some women, such as overweight women and those expecting multiples, are often monitored for it earlier than that. “One common symptom is upper abdominal pain, typically under the ribs on the right side (where the liver is located),” Clark tells SELF. It can also cause nausea, vomiting, unbearable headaches, problems with vision, and shortness of breath, per the Mayo Clinic. “If the pain is constant and new or sudden, she should be evaluated, especially if she has had problems with her blood pressure during the pregnancy,” Clark adds. Preeclampsia can lead to complications for both the mother and baby, including early delivery, so it must be carefully monitored. If you’re experiencing upper abdominal pain at any point in your pregnancy, be sure and mention it to your doctor.
4. Pain paired with vaginal bleeding
Sadly, 15 to 20 percent of all pregnancies end in miscarriage. Sharp, dull, or cramping abdominal or lower back pain paired with bleeding is a red flag. Light spotting is normal during pregnancy, but any vaginal bleeding that is more than a pad per hour is grounds to call your doctor. If bleeding is paired with severe abdominal pain early on in pregnancy, it could also be a sign of an ectopic or tubal pregnancy, which is when the fertilized egg implants in the fallopian tube (or elsewhere in the abdomen) instead of the uterus. “If you have missed your period and have severe right or left lower quadrant pain, spotting, and or vaginal bleeding, dizziness or lightheadedness, this could be a sign of an ectopic pregnancy and an emergency,” Jones adds. It’s urgent you check in with your ob/gyn to handle it ASAP.
There are a few things you can do to minimize the pains of pregnancy.
For both commonplace and serious abdominal pains, lifestyle plays a big role. “Staying hydrated, eating a well balanced diet and avoiding fatty, fried foods is important during pregnancy,” says Jones. “Early detection is also key. If you aren’t feeling quite right and symptoms seem to be getting progressively worse, notify your doctor straight away.” In other words, when in doubt, point it out!