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General Practice 2023

What can be a stomachache in pregnancy (and what to do)

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What can be a stomachache in pregnancy (and what to do)
What can be a stomachache in pregnancy (and what to do)

Tummy pain in pregnancy can be caused by the growth of the uterus, constipation or gas, and can be relieved through a balanced diet, exercise or teas.

However, it can also indicate more serious situations, such as ectopic pregnancy, placental abruption, preeclampsia or even miscarriage. In these cases, the pain is usually accompanied by vaginal bleeding, swelling or discharge.

Regardless of the cause, when the pain is very intense, does not improve or is accompanied by other symptoms, it is advisable to go to the hospital or consult an obstetrician, in order to identify the correct cause and initiate the most appropriate treatment.


1st trimester of pregnancy

The main causes of abdominal pain in the first trimester of pregnancy, which corresponds to the period from 1 to 12 weeks of pregnancy, include:

Urinary tract infection

Urinary infection is a very common problem of pregnancy and it is more frequent to happen in the beginning of the pregnancy, being able to be noticed through the appearance of pain in the bottom of the abdomen, burning and difficulty to urinate, urgent desire to urinate even with little urine, fever and nausea.

What to do: It is recommended to go to the doctor for a urinalysis to confirm the urinary tract infection and to start treatment with antibiotics, rest and fluid intake.

Ectopic pregnancy

Ectopic pregnancy happens due to the growth of the fetus outside the uterus, being more common in the fallopian tubes and, therefore, it can appear up to 10 weeks of gestation. Ectopic pregnancy is usually accompanied by other symptoms, such as severe abdominal pain on only one side of the belly that worsens with movement, vaginal bleeding, pain during intimate contact, dizziness, nausea or vomiting.

What to do: In case of suspected ectopic pregnancy, you should immediately go to the emergency room to confirm the diagnosis and start the appropriate treatment, which is usually done at from surgery to remove the embryo. Understand more about how to treat an ectopic pregnancy.

Spontaneous abortion

Abortion is an emergency situation and it happens most often before 20 weeks and can be noticed through abdominal pain in the bottom of the belly, vaginal bleeding or loss of fluids from the vagina, clots or tissue leakage, and headache. See full list of miscarriage symptoms.

What to do: It is recommended to go to the hospital immediately for an ultrasound to check the baby's heartbeat and confirm the diagnosis. When the baby is dead, a curettage or surgery must be performed to remove it, but when the baby is still alive, treatments can be performed to save the baby.

2nd trimester of pregnancy

Pain in the 2nd trimester of pregnancy, which corresponds to the period from 13 to 24 weeks, is usually caused by problems such as:


Preeclampsia is a sudden increase in blood pressure during pregnancy, which is difficult to treat and which can pose a risk to both the woman and the baby. The main signs and symptoms of preeclampsia are pain in the upper right part of the abdomen, nausea, headache, swelling of the hands, legs and face, and blurred vision.

What to do: It is recommended to go to the obstetrician as soon as possible to check blood pressure and start inpatient treatment because this is a serious situation that puts the life of mother and baby. See what treatment for preeclampsia should look like.

Detachment of the placenta

Detachment of the placenta is a serious problem of pregnancy that can develop after 20 weeks and that can cause premature birth or miscarriage depending on the weeks of pregnancy. This situation generates symptoms such as severe abdominal pain, vaginal bleeding, contractions and lower back pain.

What to do: Go to the hospital immediately to check the baby's heartbeat and perform treatment, which can be done with medication to prevent uterine contraction and rest. In the most serious cases, delivery can be done before the expected date, if necessary. Find out what you can do to treat placental abruption.

Training Contracts

Braxton Hicks contractions are training contractions that typically come after 20 weeks and last less than 60 seconds, although they can happen several times a day and cause little abdominal pain. At this point, the belly is momentarily hard, which does not always cause abdominal pain. But in some cases there may be pain in the vagina or in the lower part of the belly, which lasts for a few seconds and then disappears.

What to do: It is important at this moment to try to keep calm, rest and change position, lying on your side and placing a pillow under your belly or between your legs to feel more comfortable.

3rd trimester of pregnancy

The main causes of abdominal pain in the 3rd trimester of pregnancy, which corresponds to the period from 25 to 41 weeks, are:

Constipation and gas

Constipation is more common at the end of pregnancy due to the effect of hormones and the pressure of the uterus on the intestine, which decreases its functioning, facilitating the development of constipation and gas. Both constipation and gas lead to discomfort or abdominal pain on the left side and cramps, in addition to the belly may be more hardened in this place of pain. Find out about other causes of colic in pregnancy.

What to do: Eat foods rich in fiber, such as wheat germ, vegetables, cereals, watermelon, papaya, lettuce and oats, drink about 2 liters of water per day and engage in light physical exercise, such as 30-minute walks, at least 3 times a week. It is recommended to consult the doctor if the pain does not improve on the same day, if you have not pooped for 2 days in a row or if other symptoms such as fever or increased pain appear.

Round ligament pain

Round ligament pain arises due to overstretching of the ligament that connects the uterus to the pelvic region, due to the growth of the belly, leading to the onset of pain in the lower abdomen that extends to the groin and lasts just a few seconds.

What to do: Sit down, try to relax and, if it helps, change your position to relieve pressure on the round ligament. Other options are bending your knees under your abdomen or lying on your side placing a pillow under your belly and another between your legs.


Labor is the leading cause of abdominal pain in late pregnancy and is characterized by abdominal pain, cramping, increased vaginal discharge, jelly-like discharge, vaginal bleeding, and uterine contractions at regular intervals. Know the 3 main signs of labor

What to do: Go to the hospital to assess whether you are really in labor, as these pains may become regular for a few hours, but may disappear completely during all night, for example, and reappear the next day, with the same characteristics. If possible, it is recommended to call the doctor to confirm if it is labor and when to go to the hospital.

When to go to the hospital

Persistent abdominal pain on the right side, close to the hip and low-grade fever that can appear at any stage of pregnancy may indicate appendicitis, a situation that can be serious and therefore should be ruled out as soon as possible, being recommended go to the hospital immediately. In addition, you should also go to the hospital immediately or consult the obstetrician who follows the pregnancy when you present:

  • Abdominal pain before 12 weeks of pregnancy, with or without vaginal bleeding;
  • Vaginal bleeding and severe cramping;
  • Severe headache;
  • More than 4 contractions in 1 hour for 2 hours;
  • Accentuated swelling of hands, legs and face;
  • Pain when urinating, difficulty urinating, or bloody urine;
  • Fever and chills;
  • Vaginal discharge.

The presence of these symptoms may indicate a serious complication, such as preeclampsia or ectopic pregnancy, and therefore it is important for the woman to consult her obstetrician or go to the hospital immediately to receive appropriate treatment as soon as possible. possible.

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