Abdominal and Pelvic Pain During Pregnancy

If you experience unexpected abdominal and pelvic pain during pregnancy, it's easy to worry. But whilst some pain may need medical attention, sometimes instances of pain are relatively harmless.

Discomfort in the abdominal area is common during early pregnancy. One of the first times when you may experience pain is around the time of your first missed period. For a day or two, some women have a pain that's low down in the abdomen and feels a bit like a dull period pain, as if your period is about to start. It's thought that this is because the embryo is beginning to embed itself in the soft lining of your uterus at this time.

During the third or fourth month of pregnancy, women frequently get a sharp stabbing pain in their groin or to one side. It may come on at sudden intervals, might be worse if you suddenly get up, stretch or move and it might disappear then reappear a few days later. It can be really worrying to suddenly get pains like this, but usually it's due to the ligaments or muscles around your uterus in your pelvis stretch and thicken as they support your growing baby.

Constipation, bloating and wind can also cause aches, pains and abdominal discomfort. Constipation is often caused by the pressure of your growing bump on your rectum, as well as hormones which are said to slow down the movement of food through your digestive system. These factors are also involved in bloating and wind too, with your growing uterus pressing on your intestines and causing wind.

In later pregnancy, Braxton-Hicks contractions may cause some pain. These contractions, which are irregular tightenings of the uterus, can occur from early pregnancy, but most women don't notice them until the latter half. They're generally started of by either you or the baby moving, or if someone touches your stomach. It's a normal part of pregnancy, but can feel very odd. If you're concerned or the contractions become more frequent, talk to your doctor.

Abdominal Pain to Worry About

If you're at all worried about the abdominal pain you're getting, always consult a doctor, midwife or maternity unit immediately. This is particularly so if you experience any of the following symptoms:

• During early pregnancy - severe cramp in your lower abdomen, which lasts for several hours, is accompanied by vaginal bleeding and doesn't ease. This could be the signs of a miscarriage.

• During early pregnancy - severe pain on one side of your lower abdomen, plus bleeding or a brown discharge from your vagina. This could be sign of an ectopic pregnancy.

• At any time - pain or discomfort when urinating, a fever, pelvic discomfort, a frequent urge to urinate, chills, pain in your lower back or side, nausea, vomiting or blood in your urine. This could be a sign of a urinary tract or kidney infection, which being pregnant makes you more susceptible to.

• During later pregnancy - pain in the upper abdomen, along with symptoms such as a very bad headache, nausea, vomiting, flashing lights or seeing spots in front of your eyes. This could be a sign of pre-eclampsia.

• During later pregnancy - severe pain in your lower abdomen, with or without bleeding. This could indicate a separating placenta.

Pelvic Pain

Occasional aches in your pelvic region are common and usually nothing to worry about, but one in 35 women get pelvic joint pain (symphysis publis dysfunction). During pregnancy a hormone called relaxin is released, which softens the joints ready for the birth of your baby. But for women with pelvic joint pain, the hormone goes overboard and causes the ligaments to soften and stretch too much.

The pelvis is made up of four separate bones which are joined at the front by the symphysis pubis and it's normal for there to be a gap of 4-5mm between the two pubic points. During pregnancy, the gap widens by another 2-3mm, but when it stretches too far it results in pain and discomfort. This normally occurs from the second trimester onwards, but it can happen at any stage or even after you've given birth.

The symptoms for SPD include:

• Pain in your pubic area and groin.
• Pain in the inside of your thighs.
• Lower back and hip pain.
• Pain when you walk, move or go up stairs.
• A clicking sound that you can hear.
• A feeling that your bones are grinding together.
• Difficulty and pain when you try and open your legs.

If you experience any of these symptoms, then speak to your doctor or midwife. If they do think it's SPD, you'll be referred to an obstetric physiotherapist, who can offer the best course of treatment. It can make giving birth a bit uncomfortable, but make sure everyone knows what's wrong and that you find a position that is comfortable for you.