What Are Cramps During Pregnancy?

Cramps during pregnancy may make you anxious and worried, especially if it's your first pregnancy. Rest assured, cramps can be normal as your body goes through changes during pregnancy, especially at the beginning. Mild cramps that go away after you change position, rest, or use the bathroom are generally not a cause for concern.

However, persistent and severe cramps could signal a problem, such as a miscarriage or ectopic pregnancy. Learn how to tell the difference between normal and abnormal cramps and when you should call your healthcare provider.

What Are Cramps?

Your body contains more than 600 muscles, and cramps can occur any time one of those muscles suddenly contracts, or spasms. Muscle cramps are often sudden and involuntary. Most of the time, cramps are just uncomfortable, but sometimes they can be very painful.

They can happen in one muscle or several muscles at a time. The most common areas affected by muscle cramps include the abdomen, arms, hands, feet, thighs, and area around your rib cage.

The most common cause of muscle cramps is straining and overusing a muscle. Other possible causes include:

• Compression of nerves from problems such as a spinal cord injury or a pinched nerve in the neck or back
• Dehydration
• Low levels of electrolytes, such as magnesium, potassium, or calcium
• Pregnancy
• Certain medications
• Dialysis

Menstrual and Pregnancy Cramps

Your uterus is a muscular organ made up of two layers. The outer muscular layer is called the myometrium. The inner layer, or endometrium, is lined with the blood and nutrients you shed during your period each month if you don't become pregnant.

During your period, natural chemicals called prostaglandins build up in the endometrium and signal to the myometrium that it's time to lose a few layers. These chemicals cause the uterus to contract, helping it shed its inner layer if pregnancy did not occur.

Therefore, on the first day of your period, prostaglandin levels are high, and strong cramps can cause a type of pain known as primary dysmenorrhea. This pain usually decreases over the course of your period as prostaglandin levels drop.

Prostaglandins play a role in pregnancy, too. They help the uterus contract when it's time to have your baby. The placenta secretes prostaglandins when it's time for labor to begin, and the cramping, or contracting, of the uterus helps move your baby through the birth canal.

Types

You will experience different types of cramps during your pregnancy. They are usually associated with the changes that your body goes through in the process.

Early Pregnancy Cramps

Your body is going through rapid changes in the beginning of your pregnancy as a fertilized egg implants in your uterus and begins to grow. Implantation alone can cause cramping, as well as issues like bloating and constipation that usually come with pregnancy.

Your uterus will begin to stretch and expand during this time. This can result in mild to moderate cramps in your lower abdomen or back. It may feel like pressure, stretching, or pulling. You may experience cramps throughout your first and second trimesters.

Cramping with small amounts of bleeding can be normal during pregnancy, but you should still talk to your healthcare provider if you experience these symptoms. Bleeding and cramping are the most common symptoms of early pregnancy loss, and could also be a sign of other serious issues like an ectopic pregnancy.

At other times in pregnancy, cramps can be due to other causes:

• Abruption
• Fibroids
• HELLP syndrome (high blood pressure during pregnancy)
• Infections like yeast infections, urinary tract infections, or pelvic inflammatory disease
• Preeclampsia
• Uterine rupture
• Uterine or ovarian torsion

If your healthcare provider is concerned that your cramping may be a sign of another problem, they may perform blood tests and an ultrasound to check on the progress of your pregnancy and overall health.

Late Pregnancy Cramps

Pain and discomfort can become more frequent and intense as you move through your pregnancy. During pregnancy, your uterus grows from less than 3 ounces to around 40 ounces, and can hold more than a gallon of fluid. Cramps can occur as the uterus continues to grow, move, and stretch.

Round ligament pain, also called growing pains, is also common as the muscle that supports your uterus stretches to support your growing bump. It can start in the second trimester, and feels like a sharp or dull pain at your lower abdomen. You may experience sharper pain if you carry more than one baby.

In the late second and third trimester, cramps can also be a sign of preterm labor. Some things to watch for, or call your healthcare provider about, include:

• Contractions or cramps that increase in intensity and frequency
• Bright red blood coming out of your vagina
• A rush of watery fluid from your vagina
• Back pain or aches
• Increased pelvic pressure

Risk Factors

Cramps can affect anyone during pregnancy, but they may strike more often when you:

• Are malnourished
• Have poor nutrition
• Perform strenuous activities
• Are overweight
• Are carrying a large baby
• Have had multiple previous pregnancies

Complications

While some cramps are normal, severe cramps, especially when they come with bleeding, nausea, or vomiting, are not. Call your healthcare provider if you are experiencing severe or worsening cramps during your pregnancy. Your practitioner has to make sure you are not having serious complications. For example, an ectopic pregnancy is the leading cause of maternal death in early pregnancy.

Treatment

Even though cramps are, to some extent, a normal part of pregnancy, that doesn't mean you can't find relief. Your healthcare provider will have frequent visits with you throughout your pregnancy. Based on their findings, they will make suggestions to help with your symptoms.

If your cramps are being caused by the strain of a growing uterus and normal pregnancy changes, there are some things you can do to alleviate the discomfort:

• Avoid foods that increase gas or stomach acid.
• Address constipation or other bowel problems.
• Use relaxation techniques to reduce stress.
• Try a warm, not hot, bath to relax your muscles.
• Exercise gently.

Summary

Mild cramps that go away are usually normal during pregnancy. Call your healthcare provider immediately if you have severe and persistent cramps because they could signal a problem with your pregnancy or an underlying condition.

A Word From Verywell

Pregnancy can be a beautiful time in your journey as a parent, but it can also be quite uncomfortable. Discomfort is sometimes your body's way of telling you that something is wrong, but mild to moderate cramps that resolve after a while are a normal part of pregnancy. Still, it's important to discuss these pains with your healthcare provider. Remember to take time for yourself to rest and relax. It will be good for you and your baby.