Health & safety

Cramps during Pregnancy: What Could They Mean?

Cramps during pregnancy, especially in the first few weeks, can be worrisome. Are they a sign of implantation, or could they be signs of miscarriage?

While there is no evidence proving implantation cramps happen, it’s perfectly normal to experience cramps during early pregnancy. But, cramping can also be a red flag that warrants further medical attention. To help you tell the difference, this post will cover:

  • What causes cramps during pregnancy?
  • Are cramps an early sign of pregnancy?
  • When are cramps during pregnancy normal versus cause for concern?
  • What are ways to manage painful cramps during pregnancy?

What causes cramps during pregnancy?

While researchers are still trying to figure out exactly why cramps happen with such a broad range of severity, there are few reasons that explain why they occur:

  • Progesterone: This hormone can relax the digestive muscles, leading to constipation, indigestion, and stomach cramps.
  • Prostaglandins: These are chemicals that are similar to hormones and can increase inflammation and pain.

Are cramps an early pregnancy sign?

No, cramps are not early pregnancy signs. It can be tempting in the early weeks of pregnancy, especially during the two-week wait, to scan your body for possible early pregnancy symptoms, such as cramps. However, as in the case of premenstrual cramps, cramping during pregnancy can simply mean that progesterone levels are changing. Because progesterone levels are high before your period and in the early weeks of pregnancy, it’s impossible to distinguish those possibilities to explain cramps during the two-week wait.

When are cramps during pregnancy normal?

It’s normal to experience minor cramps—mild strength and infrequent occurrence—during the first and second trimester given the numerous changes the body undergoes during pregnancy.

Cramps during pregnancy can continue in the second trimester as the the round ligament, which is the muscle that supports the uterus, stretches. When this ligament stretches, it can lead to cramping as well as pain in the abdomen. This pain can feel like a sharp pain or a dull ache in the lower abdomen.

Also, pregnancy hormones can impact digestion, gas, and constipation, which can lead to cramping. Finally, having sex can lead to uncomfortable cramps and even Braxton Hicks contractions.

Bottom line? If you experience mild cramps every once in a while, that can be expected during pregnancy. But, to know what more intense cramps can mean, check out the following sections.

Are cramps a sign of miscarriage?

Not necessarily. Cramping alone usually is not associated with miscarriage, but cramping along with bleeding, brown discharge, or spotting could be an indication of miscarriage.

But, it’s important to know that cramping or bloody discharge are not definitive signs of miscarriage, and it’s certainly possible to experience these symptoms and have a healthy pregnancy.

The main takeaway: There are many miscarriage myths which muddy the symptom spotting waters. Approximately 25 percent of pregnancies end in miscarriage, which means that the odds favor not having a miscarriage than having one. So, if you got a positive pregnancy test and have cramps, keep an eye out for worsening symptoms and bleeding to know whether you need to see a doctor.

Could cramps be a sign of preterm labor?

If you experience intense or constant cramping before week 37 of pregnancy along with the following symptoms, then it’s important to contact your health care provider about possibly experiencing premature labor:

  • Uterine contractions
  • Watery fluid (amniotic fluid) leakage
  • Low, dull backache
  • Pelvic pressure
  • Changes in pregnancy discharge

When do I need to see a doctor about pregnancy cramps?

If you’re pregnant and experience strong and/or frequent cramps that don’t subside along with pain as well as intense abdominal or back pain changes, then it’s important to see a medical profession to determine whether one of the following serious complications are present:

  • Ectopic pregnancy: Intense pain or cramping on one side of the abdomen can be a sign of ectopic pregnancy, which is a serious medical complication which requires immediate treatment intervention.
  • Urinary tract infection: Mild cramps along with painful urination and lower abdominal pain can be a sign of an infection, which can require antibiotics.
  • Placenta abruption: Painful cramps that do not subside can be a sign of placenta abruption, or when the placenta is torn from the uterus. This can be a life-threatening condition for you and the baby, so it is important to seek medical attention right away if you experience this form of cramps.
  • Preeclampsia: Cramps or pain in the upper abdomen can be a sign of preeclampsia. This condition is also characterized by high blood pressure and urine protein levels, and it requires prompt medical attention.

How can I alleviate pain related to cramps?

If you’re trying to conceive and experience cramps before you can take a pregnancy test, it is recommended that women avoid using NSAIDs during implantation and use acetaminophen for painful cramps instead because anti-inflammatory medication can disrupt implantation.

These are alternative methods for alleviating pain associated with cramps:

  • Warm bath
  • Hot water bottle
  • Drink plenty of fluids
  • Stretching
  • Regular exercise and pregnancy workouts

Aarthi Gobinath, PhD

Aarthi Gobinath earned her PhD in neuroscience from the University of British Columbia. Her research covers the ways that stress affects the male and female brain differently.

She tackled the issue of sex bias in research by looking at why standard treatments for depression don't always work in the case of postpartum depression. Her work has been covered by Vice and Massive Science.

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