Many women find pregnancy a time of immense joy, filled with the new surprises of a mother's expanding role. Along with this joy, however, pregnancy can be a time for discomfort, particularly in the beginning and at the end of the pregnancy. A chief complaint among pregnant women is abdominal pain, which can range from extreme, contraction-like waves to a niggling, dull ache. Often, this pain is mitigated by lying on the side, but sometimes the pain continues when reclining or is exacerbated by a side-lie. Understanding common reasons why abdominal pain occurs and when to seek care can sometimes relieve a pregnant woman's anxiety about abdominal pain.
Nature of the abdominal pain
While all pain signals that something in the body undergoing change, some types of pain are considered typical in pregnancy and are not a reason for concern. The location of the pain sensations is often a clue to the cause of the pain. Pain can be located in the upper half of the abdomen (above the navel) or the lower half of the abdomen (below the navel). In addition, the pain can be central or off to one side or the other. Be sure to note the location of your abdominal pain when both lying on your side and standing. In addition to the location of the pain, the type of pain can also help you identify the cause of the pain. Note whether or not the pain is stabbing or dull, and whether or not it is intermittent or constant.
Causes of pain
Abdominal pain during pregnancy can be caused by a number of conditions. In early pregnancy, pain when lying on the side might be caused by round ligament stretching, which happens when the uterus begins to grow with the pregnancy. Women describe round ligament pain as a cramping feeling, much like menstrual cramps. Abdominal pain might also be caused by a urinary tract infection. A UTI will cause other symptoms such as frequency of urination and burning during urination.
In middle to late pregnancy, abdominal pain can be caused by uterine contractions -- either benign "warm-up" contractions or labour contractions. Uterine contractions will usually be accompanied by tightening of the uterus and perhaps a backache as well. Appendicitis can also happen during pregnancy; pain from appendicitis will be located in the lower right abdomen. In all stages of pregnancy, abdominal cramps can be caused by constipation or gastrointestinal upset. Immediately report any abdominal pain that is accompanied by vaginal bleeding.
While most abdominal pain is not reason for alarm, your body can give you warning signs that you should not ignore. Some signs can indicate a medical emergency. If you experience any of the following, report it immediately to your doctor or midwife: uterine contractions before 37 weeks, unrelenting or incapacitating abdominal pain, abdominal pain with burning or pain with urination, abdominal pain accompanied by fever, diarrhoea that lasts more than 24 hours or abdominal pain with vaginal bleeding.
If your doctor or midwife has told you that your abdominal pain is not dangerous, then you may need some suggestions for how to cope with the pain. Adjust your coping techniques based upon the type and cause of your pain. Ligament and muscular pains respond quite well to temperature therapy. Place a hot compress or a cold compress on the area; you can also alternate between them. A warm bath also can help your body recover from the strain, and it will relax your muscles enough to give you some relief. Allow your body to rest as comfortably as possible until the abdominal pain passes. Using breathing techniques to cope can also be helpful in relieving pain. Talk to your doctor or midwife before resorting to any over-the-counter medications. Be sure to clear any treatment options with your care provider.
When to call your doctor or midwife
Call your doctor or midwife immediately if you experience any of the signs listed in the "Warning signs" section. If you have conferred with your doctor or midwife and your condition has become worse, call again to update them on your situation. Your doctor, midwife or backup care provider should be available to you day and night. If you aren't sure if what you are experiencing constitutes an emergency, it's best just to inform your care provider about your symptoms.