You're pregnant, yet those familiar lower abdominal cramps are back. The same pain you feel during your period, except this time, your period won't come. And then you panic: Is this normal? Is something wrong? Should you call the midwife immediately?
Yes, you can definitely be pregnant and experience pain similar to menstrual cramps. It's even one of the most common symptoms of pregnancy, affecting up to 80% of pregnant women at one point or another. These pains are often simply a sign that your body is adapting, that the uterus is transforming to accommodate the baby. But not all pains are the same. This article helps you understand what's really going on in your belly. Without dramatizing, without minimizing. Just the facts, the biological mechanisms, and above all, how to distinguish normal pain from pain that should alert you.
What you need to understand from the outset
Why Does It Hurt When You're Pregnant?
To understand these pains, you must first grasp the magnitude of the transformations taking place. From the first days of pregnancy, your body begins a silent but intense metamorphosis.
The Expanding Uterus
Your uterus, normally taille of a pear, multiplies its weight by 15 to reach more than a kilo in the long term. This rapid growth stretches the muscles and ligaments, causing these pulling sensations in the lower abdomen.
As the baby grows, the uterus moves up into the abdominal cavity. This displacement compresses the surrounding organs and explains the cramps or pulling sensations felt during certain movements.
Round Ligaments Under Tension
These two fibrous cords hold the uterus in place. From the beginning of pregnancy, a hormone, relaxin, softens them to allow expansion, which can cause sharp but brief pain, especially after sudden movement.
These ligament pains affect nearly 80% of pregnant women, especially from the second trimester onwards. They generally occur on one side of the lower abdomen and often occur after a sudden movement.
How to recognize them: Sudden pain on one side, disappearing within seconds or minutes, without progressive intensification.
Pelvic Congestion
Blood volume increases by about 50% during pregnancy, dilating the vessels in the pelvic region. In some women, this congestion (accumulation of blood in the vessels) causes a dull discomfort, comparable to menstrual cramps, especially at the end of the day.
Resting and lying on your left side often helps relieve pressure and get circulation going.
Hormonal and Digestive Changes
Progesterone, the star hormone of pregnancy, slows down intestinal transit, leading to constipation, bloating, and abdominal cramps. These sensations are often confused with uterine pain, but they are digestive.
About one in two pregnant women suffer from constipation, especially in the third trimester. Proper hydration and a diet rich in fiber can really help.
Timeline: Pains by Trimester
Pain isn't the same at 1 week of pregnancy as it is at 8 months. It evolves with your body and your baby. Here's what happens at each stage.
Very Early Pregnancy (1-4 Weeks)
What is happening
About a week after fertilization, the embryo implants in the uterine wall. This process, called implantation, can cause mild cramping and sometimes spotting (very light bleeding). These implantation cramps are usually milder than regular period pain and last only a few hours to a day or two.
Typical feeling
- Mild tingling or pulling in the lower abdomen
- A pricking or pinching sensation, sometimes described as "electric"
- Pain less intense and shorter than usual periods
- May be accompanied by a few drops of pink or brown blood
At this stage: Many women don't even realize they're pregnant. They attribute these cramps to the imminent arrival of their period. It's only a few days later, when their period is late, that they realize it.
First Trimester (1-12 Weeks)
What is happening
Your uterus begins its rapid expansion. It goes from the taille from a pear to a grapefruit in just a few weeks. This rapid growth stretches the ligaments and muscles in your lower abdomen. At the same time, pregnancy hormones (especially progesterone) slow down your digestive system, causing bloating and constipation.
Typical feeling
- Diffuse cramps in the lower abdomen, similar to premenstrual pain
- Feeling of pelvic tightness or heaviness
- Pain that comes and goes, without regularity
- Bloating and gas which can increase discomfort
- Pain often more pronounced in the evening or after an active day
Important nuance: These pains are generally bearable. If they become intense, are accompanied by heavy bleeding, or a fever, seek medical help promptly. The first trimester is also the time when the risks of miscarriage and ectopic pregnancy are highest.
Second Trimester (13-26 Weeks)
What is happening
The uterus moves out of the pelvis and becomes an abdominal organ starting around the 12th week. This gradual rise stretches the round ligaments that support the uterus. This is the period of the famous "ligament pain," which affects 80% of pregnant women. Toward the end of the second trimester, Braxton Hicks contractions (practice contractions) may also appear.
Typical feeling
- Sudden, sharp pain on one side of the lower abdomen, triggered by movement
- Pulling pain that radiates to the groin or upper thigh
- Last a few seconds to a few minutes, then disappear
- Braxton Hicks contractions: hardening of the stomach without pain or with slight discomfort, irregular
- Feeling of heaviness due to the baby's increasing weight
Tip: To relieve ligament pain, change positions slowly. Avoid sudden movements. Lie on your side with a pillow between your legs to relieve tension.
Third Trimester (27-40 Weeks)
What is happening
Your uterus reaches its taille maximum and now weighs more than a kilo. It compresses all your organs: stomach, intestines, bladder, diaphragm. Braxton Hicks contractions become more frequent and sometimes more intense as labor approaches. Your baby moves a lot and its kicks can be painful. The pressure on the pelvis and cervix increases.
Typical feeling
- More frequent Braxton Hicks contractions (10-12 per day maximum if not regular)
- Lower abdominal pain due to the baby's pressure on the cervix
- Sensation of intense pelvic heaviness, especially at the end of the day
- Rib pain when baby pushes up
- Cramps in the legs and pelvis due to weight and nerve compression
- Small electric shocks to the cervix or vagina (baby movements)
Differentiating between Braxton Hicks and real contractions: Braxton Hicks contractions are irregular, spaced apart, and do not intensify. True labor contractions gradually become more frequent, longer, and more intense, and do not stop if you change positions.
Normal Pain vs. Warning Signs
The line between "normal pregnancy pain" and "a sign of a complication" can be blurry. The challenge is to distinguish between the two without becoming distressed or, conversely, minimizing a real problem.
Situations That Require Prompt Consultation
Don't play guessing games with your health and that of your baby. Certain situations warrant an immediate call to your midwife or the maternity ward. Here are the warning signs that should alert you:
⚠️ First trimester (weeks 1-12)
- Severe pain localized on one side (risk of ectopic pregnancy)
- Heavy bleeding with strong cramps (risk of miscarriage)
- Dizziness, lightheadedness, fainting accompanying pain
- Right shoulder pain (may indicate internal bleeding)
- Fever above 38°C with abdominal pain
⚠️ Second and third trimesters (weeks 13-40)
- Regular contractions before 37 weeks (every 10 minutes or more frequently)
- Severe, continuous abdominal pain that does not subside
- Heavy vaginal bleeding
- Severe pain in the upper abdomen or under the ribs (risk of pre-eclampsia)
- Loss of amniotic fluid (feeling of water leaking)
- Decreased or absent baby movements
- Severe headaches with visual disturbances (bright spots, blurred vision)
⚠️ At any time during pregnancy
- High fever (over 38,5°C) with pain
- Repeated vomiting that prevents hydration
- Burning or pain when urinating (urinary tract infection)
- Feeling of general malaise, sudden extreme fatigue accompanied by pain
If in doubt, always contact your midwife or gynecologist. No one will judge you for calling "for nothing." Healthcare professionals would much rather reassure you unnecessarily than miss a complication. You know your body better than anyone. If something doesn't seem right, trust your instincts.
Complications That Cause Pain
Certain serious medical conditions can manifest as abdominal pain during pregnancy. These complications are rare, but early recognition can make all the difference.
Ectopic Pregnancy
The embryo implants outside the uterus, usually in a fallopian tube. This situation represents a medical emergency because the tube can rupture, causing potentially fatal internal bleeding.
- frequency: About 2% of pregnancies
- Symptoms: Severe, localized pain on one side, vaginal bleeding, dizziness, shoulder pain
- timing: Usually detected between 6 and 10 weeks of pregnancy
Miscarriage
Spontaneous termination of pregnancy before 22 weeks. Miscarriages affect 15 to 20% of known pregnancies, the majority occurring before 10 weeks.
- Symptoms: Severe cramps (worse than usual period pain), heavy bleeding with clots, sudden disappearance of pregnancy symptoms
- Nuance: Not all bleeding indicates a miscarriage. "Anniversary bleeding" (light bleeding around the time of the expected period) affects some women in the first or second month without jeopardizing the pregnancy.
Placental Abruption (Retroplacental Hematoma)
The placenta detaches prematurely from the uterine wall before delivery. This is a serious situation that endangers both mother and baby.
- frequency: 0,5 to 1% of pregnancies
- Symptoms: Sudden and severe abdominal pain, bleeding, uterus that is hard and tender to the touch, decreased fetal movement
- timing: Mainly in the third quarter
Pre-eclampsia / HELLP Syndrome
Hypertensive disorder of pregnancy that can cause severe pain in the upper abdomen (below the ribs, especially on the right). HELLP syndrome is a severe form that combines hemolysis, liver abnormalities, and low platelets.
- Symptoms: Severe epigastric (upper abdomen) pain, severe headache, visual disturbances, sudden significant swelling, high blood pressure
- timing: Usually after 20 weeks, more common in the third trimester
Appendicitis
The most common non-obstetric surgical emergency during pregnancy. The appendix can be pushed upward by the uterus, making diagnosis more difficult.
- frequency: 1 in 1000 to 2000 pregnancies
- Symptoms: Pain that starts around the navel and then moves to the right side (or higher if advanced pregnancy), fever, nausea, loss of appetite
- timing: Can occur in any trimester, more common in the second
How to Relieve Normal Pain
Once you're reassured that your pain is normal, you just want it to ease. Several approaches can help, without medication and without risk to your baby.
Gentle Warmth
Heat relaxes muscles and relieves cramps. Use a warm (not hot) hot water bottle or heating pad on your lower abdomen for 15-20 minutes. Be careful not to apply excessive heat or directly to your abdomen during the third trimester.
Alternate: A lukewarm bath (37°C maximum) can also work wonders. Avoid baths that are too hot, which can raise your body temperature.
Position & Rest
Lying on your left side is magical. It improves blood flow to the placenta, relieves pressure on the inferior vena cava, and reduces cramps.
Technical
- Lie on your left side
- Place a pillow or cushion between your knees
- Place another pillow under your belly to support it
- Use a C- or U-shaped pregnancy pillow for optimal comfort
This position is particularly effective in relieving ligament pain and pelvic congestion.
Gentle Movement
Paradoxically, gentle movement can relieve cramps. Light walking, prenatal yoga, or swimming improve circulation and relax muscles.
Movements to favor
- Gentle walk of 15-30 minutes
- Gentle stretches of the hips and pelvis
- Cat position (on all fours, back rounded then hollowed)
- Pelvic tilt standing or lying down
Hydration & Nutrition
Dehydration can trigger Braxton Hicks contractions and worsen cramps. Drink 1,5 to 2 liters of water per day, more if you sweat a lot.
For cramps related to constipation or bloating:
- Increase fiber (fruits, vegetables, whole grains)
- Consume prunes or prune juice
- Split up your meals (5 to 6 small meals rather than 3 large ones)
- Limit foods that ferment (cabbage, legumes, carbonated drinks)
Pregnancy Belt
From the second trimester onwards, a support belt can really relieve ligament pain and the feeling of heaviness. It distributes the weight of the belly and reduces pressure on the pelvis.
To wear: During activities, especially standing or prolonged walking. Remove it in the evening to allow your muscles to relax naturally.
Authorized Medicines
Paracetamol remains the only recommended painkiller during pregnancy. It effectively relieves mild to moderate pain without risk to the baby.
Dosage: 500 mg to 1 g, up to 3 times a day, with an interval of 4 to 6 hours between each dose.
⚠️ To avoid: Ibuprofen, aspirin, and nonsteroidal anti-inflammatory drugs. These medications can cause fetal complications, especially after 24 weeks. Always seek medical advice before taking any medication.
Testimonies: Their Pains, Their Stories
Because reading about other women's experiences can help you feel less alone in the face of these pains.
"At 7 weeks, I had cramps so similar to my period that I was convinced my test was a false positive. I even bought some protection, certain that my period would arrive any minute. My ob-gyn reassured me: it was just my uterus starting to grow. These cramps lasted about 3 weeks and then disappeared. My son is now 2 years old."
— Sophie, 29 years old
"In the second trimester, I had shooting pains on my right side every time I stood up too quickly. The first time, I panicked and called my midwife in the middle of the night. She explained that it was the round ligaments stretching. She advised me to move slowly and put a pillow between my legs at night. It made a huge difference."
— Léa, 32 years old
"At 8 months pregnant, I had cramps almost every night. My stomach would harden completely, like a ball. They were Braxton Hicks contractions. At first, I was afraid it was the beginning of labor, but they remained irregular and stopped when I lay on my side. I learned to recognize them and stop stressing about them every time."
— Camille, 27 years old
Protect Yourself with Peace of Mind
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Learning to Trust Your Body
Yes, it's possible to be pregnant and experience pain similar to period cramps; it's even very common. They often reflect normal changes in the body, such as uterine growth, ligament stretching, and hormonal changes that also affect the digestive system. These sensations evolve with pregnancy, from tightness at first, to ligament pain in the second trimester, and then Braxton Hicks contractions later.
In most cases, these pains are not serious and subside with rest, a little warmth, or paracetamol. But if they become intense, accompanied by bleeding, fever, or regular contractions, consult a doctor immediately. Trust your feelings: a precautionary call is better than a worry left unaddressed.
Sources & References
This article is based on recent scientific studies and international medical recommendations regarding abdominal pain during pregnancy.
Abdominal pain during pregnancy
- Cartwright SL, Knudson MP. (2015). Evaluation of acute abdominal pain in adults. American Family Physician. PMID: 25955624
- Krispin E, Aviram A. (2018). Management of acute abdomen in pregnancy. International Journal of Surgery. DOI: 10.1016/j.ijsu.2018.01.026
- Spalluto LB, Woodfield CA, DeBenedectis CM, Lazarus E. (2012). MR imaging evaluation of abdominal pain during pregnancy: appendicitis and other nonobstetric causes. radiographics. DOI: 10.1148/rg.322115057
Obstetric complications
- Barnhart KT. (2009). Ectopic pregnancy. New England Journal of Medicine. DOI: 10.1056/NEJMcp0810384
- Wilcox AJ, Baird DD, Weinberg CR. (1999). Time of implantation of the conceptus and loss of pregnancy. New England Journal of Medicine. DOI: 10.1056/NEJM199906103402304
- Ananth CV, Kinzler WL. (2007). Placental abruption: Clinical features and diagnosis. UpToDate.
Ligament and physiological pain
- Sabharwal A, Usha MG. (2021). Acute abdomen in pregnancy: a comprehensive review of diagnosis and management. Cureus. DOI: 10.7759/cureus.16596
- Young BC, Levine RJ, Karumanchi SA. (2010). Pathogenesis of preeclampsia. Annual Review of Pathology. DOI: 10.1146/annurev-pathol-121808-102149
French recommendations and resources
- National Institute of Public Health of Quebec. Warning signs during pregnancy. INSPQ link
- High Authority of Health (HAS). Monitoring and guidance of pregnant women based on identified risk situations. 2016.
Note: DOIs allow direct access to original scientific publications. This article was written in accordance with current medical knowledge.
Medical Warning: This article is for informational purposes only and is not a substitute for professional medical advice. If you experience pain during your pregnancy, always consult your midwife, gynecologist, or primary care physician for a diagnosis and treatment tailored to your situation.
