Tummy Pain

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.


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.


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:

  • Severe abdominal pain with vaginal bleeding (fresh bleeding, rather than a blood stained mucous show)
  • Severe constant pain that is not eased with paracetamol

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:

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.

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