Yes, cramping during pregnancy is very common. Cramps can occur due to the normal changes that happen in the body during pregnancy. While cramping is usually not a cause for concern, severe or persistent cramps can sometimes be a sign of a problem.
What causes cramps during pregnancy?
There are several common causes of cramps during pregnancy:
- The ligaments stretching – As the uterus grows, the ligaments stretch to accommodate its increasing size. This stretching can cause mild cramping or pulling sensations.
- Changing hormone levels – Rising levels of hormones like progesterone and relaxin cause the smooth muscles to relax. This relaxation can lead to cramping in the uterus.
- Constipation – Constipation is very common during pregnancy due to hormones slowing down digestion. Straining with constipation can cause abdominal cramping.
- Gas or bloating – Hormonal changes can also slow down digestion and increase gas production, leading to cramps and bloating.
- Increased blood flow – More blood flows to the uterus during pregnancy. This can cause a feeling of fullness or slight cramping.
- Braxton Hicks contractions – These practice contractions prepare the uterus for true labor. They cause the uterus to periodically contract, which can feel like cramping.
- Sexual intercourse – Orgasm and prostaglandins in semen can trigger mild uterine contractions that feel like cramps.
- Urinary tract infections – UTIs are more common during pregnancy and can cause cramping in the lower abdomen.
When do cramps typically occur during pregnancy?
Cramps can occur throughout pregnancy, but are more common at certain times:
- First trimester – Mild cramping often occurs during the first 12 weeks as the uterus grows rapidly in size.
- Second trimester – Round ligament pain from stretching ligaments is most common around weeks 16-28.
- Third trimester – Braxton Hicks contractions, constipation, gas pains and urinary tract infections cause late pregnancy cramping.
- Any trimester – Cramping may occur after exercise, sex, bowel movements, or if dehydrated. These cramps are generally short-lived.
What do normal pregnancy cramps feel like?
Normal cramping or achiness during pregnancy will have these characteristics:
- Mild intensity – More like twinges, pulling, pressure or tingling than acute pain
- Intermittent – Comes and goes, not constant
- Only on one side of the abdomen – Not generalized pain
- Not severe or worsening over time
- Relieved by changing positions or stretching
The specific feeling can vary depending on the cause. Round ligament pain feels like a short sharp pain when moving. Braxton Hicks feel like tightening. Gas, bloating and constipation cause dull, achy cramps.
Are cramps a sign of a problem?
Mild, occasional cramps are perfectly normal in pregnancy and not a concern. However, severe or persistent abdominal cramps can be a sign of a problem that should be evaluated. Contact your doctor right away if you have:
- Intense cramping that comes in waves
- Cramps with bleeding or spotting
- Cramps that don’t go away with stretching or changing positions
- Cramps along with fever, chills, vomiting or foul-smelling discharge
- Cramps that begin suddenly and feel unfamiliar
These types of cramps can indicate an issue like:
- Preterm labor
- Placental abruption – when the placenta separates from the uterus
- Urinary tract infection
- Kidney stones
Contact your provider immediately if you have any signs of these conditions. If you have mild cramping along with nausea, vomiting, diarrhea or decreased fetal movement, call your doctor as well.
How can I manage normal pregnancy cramps?
To manage mild, harmless cramps during pregnancy:
- Drink plenty of water and stay hydrated
- Get regular mild exercise like walking
- Practice relaxation techniques like yoga, meditation or deep breathing
- Take a warm bath to soothe the uterus
- Use a heated pad on the abdomen briefly
- Wear loose, comfortable clothing
- Empty your bladder frequently
- Change positions, stretch, or massage the area
- Get more rest and avoid overexertion
Your doctor may also recommend:
- A fiber supplement like Metamucil for constipation
- Magnesium or calcium supplements for muscle cramps
- Acetaminophen for generalized discomfort
Let your doctor know if cramps persist for more than a couple days or start severely interfering with your daily activities.
When should I contact my doctor about cramps?
In general, call your doctor if you have:
- Severe pain that comes and goes in waves
- Cramps accompanied by bleeding or spotting
- Persistent or worsening cramping lasting over 2 days
- Cramps that are not relieved by stretching, changing positions or other self-care measures
- Cramps along with fever, chills, vomiting or foul discharge
- Cramps that begin suddenly and feel different than previous cramps
You should also let your doctor know if cramps are interfering with your ability to do normal daily tasks. Early evaluation is recommended whenever there are any concerns.
How will my doctor evaluate pregnancy cramps?
If you contact your doctor about cramping, they may recommend:
- Physical exam – To check for uterine tenderness, contractions, fetal heart rate.
- Pelvic exam – To check for cervical changes or bleeding.
- Urine test – To check for a urinary tract infection.
- Ultrasound – To evaluate the fetus, placenta, amniotic fluid and uterine wall.
- Blood tests – To check for infection or issues with blood counts or clotting.
Based on the exam and test results, your doctor can determine if the cramps are normal or require treatment for a complication. They can also provide advice on managing troublesome cramps.
What home remedies are safe for pregnancy cramps?
These self-care measures can safely relieve many pregnancy cramps at home:
- Resting in a comfortable position
- Apply a warm compress to the abdomen
- Take a warm bath
- Drink plenty of water
- Eat small, frequent meals
- Try yoga poses like cat-cow and child’s pose
- Get a pregnancy massage
- Wear loose clothes
- Change positions frequently
Some other remedies that may help but should be discussed with your doctor first include:
- Heating pads – Use only for short periods to avoid overheating
- Prenatal yoga or meditation apps
- Epsom salt baths
- Prenatal massage
- Magnesium or calcium supplements
- Fiber supplements for constipation
Avoid herbal or medicinal remedies without medical approval as they may not be safe during pregnancy.
What medications can I take for pregnancy cramps?
Always check with your doctor before taking any medication while pregnant, even over-the-counter drugs. Some options they may approve include:
- Acetaminophen (Tylenol) – For relief of generalized discomfort. Avoid ibuprofen.
- Stool softeners – For constipation cramps. These help avoid straining during bowel movements.
- Antacids – For gas, bloating or indigestion. Examples are TUMS or Mylanta.
- Antihistamines – If cramps are associated with round ligament pain. These can calm the uterine ligaments.
- Antibiotics – If cramps are caused by a urinary tract infection.
- Anti-nausea medication – If cramping comes along with nausea and vomiting.
Some types of medications should always be avoided during pregnancy unless directly prescribed by your OB provider. These include:
- Ibuprofen (Advil, Motrin)
- Naproxen (Aleve)
When should I go to the ER for pregnancy cramps?
Seek emergency care right away if you have:
- Severe cramping that comes and goes every 5-20 minutes
- Cramps with persistent vomiting
- Cramps with heavy bleeding or bleeding with clots
- Sudden, severe abdominal pain
- Cramps with fever over 100.4F (38C)
- Cramps with foul smelling vaginal discharge
- Cramps with weakness, dizziness or feeling faint
Going to the ER is especially important if you are less than 20 weeks pregnant, as severe cramps can be a sign of miscarriage or ectopic pregnancy. Later in pregnancy, they may signal preterm labor or placental abruption.
Trust your instincts and do not wait if your cramps feel different or more painful than what you have previously experienced in this pregnancy.
- Mild cramping is very common during pregnancy and usually not concerning.
- Severe, persistent or worsening cramps need prompt medical evaluation.
- Call your doctor for cramps with bleeding, fever or other unusual symptoms.
- Normal cramps can be relieved with rest, heating pads, massage, hydration and OTC medication if approved.
- Contact your OB provider or go to the ER if cramps seem abnormal or you have severe pain.