Tummy Pain in pregnancy 20 weeks and over
Pregnancy causes lots of changes to your body which can be uncomfortable. Recognising what is normal and when to ask for help is important for you and your baby’s health.
It is very common to experience abdominal pain that gets better by itself or improves with simple painkillers such as paracetamol 2x 500mg tablets (1g) 4-6 hourly not exceeding 4g in 24hours. Do not take NSAIDS such as Ibuprofen whilst pregnant. However, if you experience pain and reduced baby movements or vaginal bleeding, you need to call the maternity triage line.
Musculoskeletal
Most abdominal discomfort is caused by the normal changes within your body adjusting to pregnancy. This can be abdominal muscles and uterine ligaments stretching, or aches within your pelvis.
Constipation
The hormonal changes in your body may cause you to become constipated very early on in your pregnancy.
What we mean when we say “severe, moderate or mild pain’’:
Severe pain:
Always there and so bad it's hard to think or talk
You can't sleep
It's very hard to move, get out of bed, go to the bathroom, wash or dress
Moderate pain:
Always there
Makes it hard to concentrate or sleep
You can manage to get up, wash or dress
Mild pain:
Comes and goes (not contractions)
You can manage to sleep
Is annoying but doesn't stop you doing things like going to work or eating a meal
Call 999 immediately if you have:
Contact your maternity unit if you have:
Persistent moderate pain (4-6 hours) that is not eased with paracetamol
Reduced baby movements noticed throughout the day
Epigastric pain (pain under your ribs on the right side) not associated with baby’s position or movements
Vaginal fluid loss
Pain with contractions- see “Am I in labour?” information
Contact your GP surgery (or NHS 111 out of hours) if you have:
Abdominal pain with a temp 38 °C or over (or feel hot to the touch)
Pain when having a wee (passing urine). Or if you notice blood in your wee
Moderate abdominal pain which you do not feel is related to your pregnancy
Stiffness and pain in your pelvis (pelvic girdle pain PGP). Persistent PGP that is not managed with regular paracetamol. For more information click here
Abdominal pain associated with constipation
Mild pain/ discomfort and no uterine tightening (contractions) that goes by itself or is eased with paracetamol
Discomfort associated with physical activity
Braxton Hicks contractions are “practice contractions”. They are usually irregular and either settle by themselves or with paracetamol. They are not a sign of the start of labour and will not cause your cervix to open
Pain relief
Paracetamol 2x 500mg tablets (1g) 4-6hourly, not exceeding 4g in 24hours. Do not take NSAIDS such as Ibuprofen whilst pregnant
Have a warm bath
If pain is made worse by physical activity- rest
Contact your maternity unit if you are still worried
Preventing constipation:
Eat foods that are high in fibre, such as wholemeal breads and cereals, fruit and vegetables, and pulses such as beans and lentils – read more about having a healthy diet in pregnancy
Exercise regularly to keep your muscles toned – read more about exercise in pregnancy Exercise in pregnancy :: Healthier Together (what0-18.nhs.uk)
Drink enough water/ fluids (6-8 medium glasses or 1.6L throughout the day)
Sometime iron supplements can make you constipated – ask your doctor if you can either manage without them or change to a different type
Speak to a pharmacist if diet and lifestyle changes are not helping. They can suggest a laxative suitable during pregnancy. These are medicines that help you poo more regularly. Most laxatives work within 3 days. They should only be used for a short time.
