Stomach Cramps During Pregnancy

By trimester

Weeks 1–13

1st trimester

Mild cramping early in pregnancy is common and often comes from your uterus adjusting, gas, or constipation. Cramping on one side, spotting, or pain that feels severe is different and deserves a same-day call to your provider.

Weeks 14–27

2nd trimester

As your uterus grows, quick, sharp twinges low on one or both sides of your belly are common, often called round ligament pain, especially when you stand up fast or roll over. Steady, regular cramping or pelvic pressure is different and is worth a call to your provider, since it can be an early sign of preterm labor.

Weeks 28–birth

3rd trimester

Irregular tightening or mild cramps, known as Braxton Hicks, are common as your due date gets closer and usually stop if you change position or rest. Pain high in your belly, cramping that turns regular and doesn't stop, or a headache that won't go away are signs to call your provider or get checked right away.

What does the evidence show for stomach cramps?

• Gas and constipation are common causes of pregnancy cramps, since rising hormones slow digestion and can leave your belly feeling bloated and swollen. 1
• Cramps that come with regular contractions, pelvic pressure, or a constant low backache before 37 weeks can be an early sign of preterm labor, so call your provider the same day. 2
• Mild cramping on just one side low in your pelvis early in pregnancy can be a first sign of an ectopic pregnancy, while sudden, severe belly pain with shoulder pain or dizziness means it's time for the emergency room. 3
• Pain high in your belly or in your shoulder, along with a headache that won't quit or sudden swelling, can point to preeclampsia and is worth a same-day call to your provider. 4
• Cramping along with spotting or bleeding can be an early sign of miscarriage, but bleeding alone doesn't mean a miscarriage is happening, so it's still worth a call to your provider to check. 5
• Preterm labor can start with contractions that feel like menstrual cramps, a low dull backache, pelvic pressure, or a change in vaginal discharge before 37 weeks, and six or more contractions in an hour is not a normal amount to have. 6
• Ectopic pregnancy often causes one-sided lower abdominal pain with vaginal bleeding, and dizziness, fainting, or shoulder pain alongside severe pelvic pain can mean the tube has ruptured, which needs emergency care. 7
• Preeclampsia symptoms can include high blood pressure, protein in the urine, swelling of the hands or face, headache, vision problems, abdominal pain, and nausea or vomiting. 8

When should I call my provider about stomach cramps?

Six or more contractions in an hour, menstrual-like cramps paired with a low backache or pelvic pressure, or a change in vaginal discharge before 37 weeks can be early signs of preterm labor and are worth a same-day call. One-sided lower belly pain with any vaginal bleeding deserves prompt evaluation early in pregnancy, and sudden dizziness, fainting, or shoulder pain alongside severe belly pain is an emergency, since these can mean a ruptured ectopic pregnancy. Pain high in your belly along with a headache that won't quit, vision changes, or new swelling in your face or hands can point to preeclampsia, while cramping with spotting or bleeding can be an early sign of miscarriage. Consult your healthcare provider the same day for any of these patterns rather than waiting to see if they pass. Trust your read on your own body. If something feels off beyond the list above, please consult your healthcare provider rather than waiting it out.