Pain in the lower abdomen during pregnancy: how to explain it and when to worry

With Hervé Marsaud, obstetrician and medical gynaecologist

Light or very intense, central or lateral, short or long, progressive or intense… the pains that are felt during pregnancy are varied and most of the time they do not require an alarm. dr Hervé Marsaud helps us sort pain without consequences and pain that should worry us depending on the trimesters of pregnancy.

What abdominal pain can occur during pregnancy?

Various pains in the lower abdomen can occur during pregnancy. Bladder pain associated with a urinary tract infection, bone pain, digestive pain and birth pains.

« Pregnancy itself is not painful », emphasizes Doctor Marsaud. But we must nevertheless pay attention to the pains felt, in order to identify as quickly as possible those that are signs of danger for the child or for the mother.

What pains can we feel in the lower abdomen in early pregnancy?

During the first trimester of pregnancy, the pregnant woman may feel tension and tightness in the lower abdomen. ” This is due to pelvic obstruction early in pregnancy, but it is not serious “, explains Dr. Marsaud.

Contrary to what one might think, the least worrisome is the persistent pain felt. It’s pretty comforting to feel pelvic congestioneven if it means we go to the toilet more often.

This pain, which is normal, is nothing to worry about.

Can you be pregnant and have period pains? The risk of miscarriage

« What is to be feared is pain similar to what is normally felt during menstruation, says dr Herve Marsaud. Pain that increases for 30 seconds to 1 minute and then decreases can raise fears of miscarriage. When a pregnancy ends, it happens abruptly or gradually without being painful. It’s just at the moment of ejection that the uterus contracts and can hurt. »

Knowing: It’s not because we lose a little blood that we miscarry. ” There are the so-called regulate on the anniversary those that should have occurred in the first month of pregnancy, or even the following ones, but with less frequency. It’s absolutely harmless.In case of blackish losses, especially if they are associated with pain, it is necessary to contact your doctor or the maternity ward to exclude the possibility of an ectopic pregnancy. »

Other pain signs of a minor problem

  • L’urinary tract infection : This problem affects 10% of pregnant women. We feel a slight pain in the lower abdomen, more in the middle, a frequent urge to go to the toilet and a burning sensation when urinating. A cytobacteriological examination confirms the infection. The symptoms are therefore quite easy to recognize. A pregnancy-compatible antibiotic treatment is carried out.
  • The digestive problem: If the pain is long-lasting and lateral, it’s probably a passage problem. ” A uterus can’t contract for more than 1.5 minutes, so if the pain lasts 5 minutes, there’s probably a problem constipation. It is the most common cause of pain during pregnancy. To avoid this problem, drink plenty of water..” How can this recurring problem of constipation be explained? Under the influence of the hormone of progesterone, uterine contractions can slow down and this can affect transit, which becomes sluggish. This hormone is one of the reasons why the baby is held in the uterine cavity until birth, as it prevents the uterus from contracting too much before the baby is ready for birth.

Why does the lower abdomen hurt in the second trimester of pregnancy?

« There is generally no pain in the second trimester », says dr Marsaud. Aside from some tightness still associated with the uterus from weight training! ” As a rule, a contraction can be felt from the fourth or fifth month, but it does not hurt, although the pain scale varies from woman to woman.. »

Classic lower abdominal pain in the second trimester

When we can locate the pain, we know more about its origin. ” Uterine pains are symmetrical, forward or backward, or both, explains Hervé Marsaud. While a side pain will have a digestive cause: the right one constipationand on the left another digestive problem, diarrhea, which is looming for example. »

Spontaneous pain and provoked pain: what’s the difference?

It is necessary during this trimester to distinguish pain spontaneously pains provoked B. by walking, driving or sexual activity, or even a harassment, an argument with the spouse, which can lead to contractions of the uterus.

While spontaneous pain are triggered by themselves and can occur when you lie down or sit comfortably on the sofa. ” As in the first trimester, menstrual-like pain is not a good sign. Pay attention to their frequency: if they come back every ten minutes or persist longer, it is better to call the maternity ward. In general, lower abdominal pain rarely requires an emergency consultation unless it is violent, very intense, and persistent after beginning as a “stab.”

It can occur in over 70% of cases in the first two trimesters of pregnancy, more rarely in the third. ovarian torsion refers to the ovary fully or partially rotating around the pedicle, causing sudden, severe, and stabbing pain in the pelvic area, sometimes even accompanied by vomiting. You can feel like one very strong burning or pinching in the lower abdomen. This fairly rare event is not directly related to pregnancy, but is somewhat more common during this period.

In case of severe and severe pain, it is necessary to immediately consult the doctor who will monitor the pregnancy and conduct treatment Endovaginal Ultrasound to confirm the diagnosis. If torsion is confirmed, surgery is required to untwist and rescue the ovary if it has not become necrotic.

Where does pregnancy pain come from?

Osteo-articular pain

« The uterus is a muscle that weighs an average of 80 grams at the beginning of pregnancy and 1.2 kg at the end. explains Dr. Herve Marsaud. In order to grow and eventually expel a baby, it trains and therefore contracts. These contractions are necessary. Called the Braxton Hicks contraction, they’re a dress rehearsal of sorts for the big day.

When the pregnancy is advanced, you can feel bone and joint painat the level of the pelvis, but also at the level of the sacroiliac region, especially standing. The bones are preparing for the passage of the baby. The pelvis expands over the months and the resulting muscle tension can be a source of pain. As the baby’s belly weight increases, the sacroiliac joints become unstable, which can lead to pain. Studies have shown that half of pregnant women experience pain in this area.

Common Pain: What Does Ligament Pain Look Like?

Ligament pain is felt in the pubic bone, groin, perineum, thighs, and sometimes can even descend to the buttocks.

How do you know if it’s ligament pain or a contraction?

With ligament pain, the pulling is constant and does not repeat itself over a few minutes. A good way to distinguish them from contractions.

« We also very often see expectant mothers walking around like ducks in the street at the end of pregnancy; This allows them to relieve pubic pain ” says Dr. Herve Marsaud. Don’t worry, there are other solutions than the duck dance! For example rest, physiotherapy or osteopathy or wearing a belt or pelvic band.

When Should You Worry About Stomach Pain When Pregnant?

Doctor Marsaud lists the cases in which a call to his doctor or to the maternity ward is necessary:

  • Vaginal bleeding accompanied by period-like pain
  • recurring pain regularlyfor example every ten minutes, and which last one or two minutes,
  • Spontaneous pain often and which can therefore be contractions,
  • pains intensive.

« In the first place, when these pains appear at the beginning of pregnancy, it can provoke the extraordinary risk of miscarriage that every woman thinks about, but unfortunately there is nothing to be done at this stage.. On the other hand, if they appear from the 5th month of pregnancy, we can provoke and fear a threatened premature birth. « Do not hesitate to contact the team that follows you and, during the medical examination, describe the pain, its intensity, its frequency and the possible triggering factors. We must pay attention to the signals that the body is sending us and try never to panic, with a good dose of philosophy and objectivity advises doctor Hervé Marsaud.

How to relieve pain in the lower abdomen?

If there is pain in the lower abdomen, the doctor can recommend appropriate therapy or, if necessary, painkillers. Sometimes physical therapy, osteopathy, relaxation or special exercises relieve pelvic pain that is not directly related to the uterus. Always seek advice from a gynecologist or midwife after pregnancy.

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