Mild cramps are common in pregnancy, and most of the time they are harmless. Your womb is growing, the ligaments that support it are stretching and your digestion slows down. What matters is the pattern. Cramps that are mild and ease when you rest, change position, pass wind or go to the toilet are usually nothing to worry about. Cramps that are severe, come at regular intervals, or arrive with bleeding or other symptoms need to be checked straight away.
Is it normal to have cramps during pregnancy?
Yes. Most pregnant women feel some cramping or stomach pain at some point, and in most cases there is a simple explanation:
- Ligament pain. A sharp cramp on one side of the lower tummy as the ligaments stretch to support your growing bump. It is often called round ligament pain.
- Constipation, which is very common in pregnancy.
- Trapped wind.
- Braxton Hicks contractions, the practice tightenings of later pregnancy.
| Usually normal | Get checked straight away |
|---|---|
| Mild, and eases with rest or a change of position | Severe, or not gone after 30 to 60 minutes of rest |
| Eases after passing wind or going to the toilet | Comes with bleeding, spotting or leaking fluid |
| Short, sharp twinge on one side when you move | Regular cramps or tightenings, especially before 37 weeks |
| Irregular tightenings that do not build up | Comes with burning when you urinate, a bad headache, or your baby moving less |
Cramps in the first trimester (weeks 1 to 12)
What is normal: mild, period-like cramps and twinges as the womb starts to grow, as well as cramps from wind and constipation.
What is not:
- Cramping with vaginal bleeding. This can be a sign of a miscarriage or a threatened miscarriage and should always be checked.
- Tummy pain with bleeding, pain in the tip of your shoulder, or discomfort when you urinate or pass a stool. Between weeks 4 and 12 these can be signs of an ectopic pregnancy, where the pregnancy grows outside the womb. This is an emergency.
Cramps in the second trimester (weeks 13 to 27)
What is normal: ligament pain is at its most noticeable now. It is sharp and brief, usually on one side, and often comes when you stand up, cough or turn over in bed. It is a common explanation for cramps around 20 weeks when there is no bleeding and the pain settles with rest.
What is not:
- Cramping with bleeding.
- Regular cramps or tightenings, which can be a sign of premature labour.
- From 20 weeks, pain just under the ribs, especially on the right, together with a severe headache, problems with your vision or sudden swelling of the hands, feet or face. These can be signs of pre-eclampsia, which needs hospital monitoring.
Cramps in the third trimester (week 28 to birth)
What is normal: Braxton Hicks contractions. Your bump tightens and feels hard for a short while. They are uncomfortable but usually not painful, they do not last long, they come irregularly and they do not build up.
What is not:
- Period-like cramps or tightenings that become regular, longer and stronger. This is how labour starts. Before 37 weeks, call immediately.
- Any contraction that lasts longer than two minutes, or six or more contractions in ten minutes.
- Your waters breaking, any vaginal bleeding, or your baby moving less than usual.
- Severe pain that does not ease, with or without bleeding. This can be a sign that the placenta is separating from the wall of the womb, which is an emergency.
Could it be a urinary infection?
Urinary infections are common in pregnancy. They can cause tummy pain, sometimes with burning when you urinate, needing to go more often, or cloudy urine. They are usually easy to treat, but they need treatment promptly because an infection can spread to the kidneys. Our article on kidney pain describes what a kidney infection feels like.
What helps with normal pregnancy cramps
- Sit or lie down and rest, or change position.
- Move slowly when you stand up or turn over, to ease ligament pain.
- Drink plenty of water and eat high-fibre foods to prevent constipation.
- Stay gently active, for example with walking.
- Check with your doctor, midwife or pharmacist before taking any medicine, including painkillers.
When to call your doctor, midwife or clinic straight away
Call if you have stomach pain or cramps together with any of these:
- bleeding or spotting
- regular cramping or tightenings
- lower back pain
- unusual vaginal discharge or leaking fluid
- pain or burning when you urinate, or needing to go much more often
- cloudy, pink, red or brown urine
- severe pain that has not gone after 30 to 60 minutes of rest
- your baby moving less than usual
Call 10177, or 112 from a cellphone, or go straight to the nearest emergency or maternity unit if the pain is severe, the bleeding is heavy, you have pain in the tip of your shoulder, or you feel faint.
Do not wait until the next day or your next appointment, even if it is the middle of the night. Maternity staff would rather check you and find that all is well.
This article is for general information and does not replace advice from your doctor or midwife.
Medically reviewed by the ASAIPA clinical team.
