Pain in upper left abdomen during pregnancy

If you’ve experienced pregnancy pains, you’re not alone. Whether you’re in your first trimester or getting close to your due date, pregnancy does wild things to your body. That’s no surprise since you’re growing an entirely new person inside of you! Plus, with the sudden influx of new and intense hormones, pregnancy can be extremely uncomfortable in a wide variety of ways.

Whether you’re dealing with swollen feet or morning sickness, there are plenty of run-of-the-mill pregnancy aches you might experience. Back pain, for example, might occur when your uterus expands to accommodate your baby, according to the American College of Obstetricians and Gynecologists (ACOG). This throws off your center of gravity and stretches out your abdominal muscles. As you try to adjust to your growing body by shifting your posture, that back pain might show up in response. So while symptoms like these might be a bit uncomfortable, they are probably within the realm of changes you expect now that you’re expecting.

But new twinges and aches happening near your stomach—from low belly pain when pregnant to right-side abdominal pain—can be confusing, anxiety-inducing, and often pretty scary. What’s normal and what’s not? And how can you tell the difference?

Here’s a breakdown of the abdominal pregnancy pains that are NBD, and when it’s time to consult your provider.

These pregnancy pains are typically normal and nothing to worry about:

1. Gas or constipation pain

“Gas and constipation are very common,” Angela Jones, M.D., a New Jersey–based ob-gyn, tells SELF. That’s because the pregnancy hormone progesterone causes the smooth muscles in both the esophagus and bowel to relax. Normally, bowels contract to push waste along and out. But with this slowing down, the body has a tougher time ridding itself of waste, blocking everything up and potentially causing low-belly pain when pregnant. Dr. Jones says the buildup of gas can get so painful that some patients mistake it for something more serious and go to the emergency room. And it can get pretty damn painful. The best way to prevent this is to eat smaller, more frequent meals with plenty of fiber, and to drink loads of water, the National Institute of Kidney Diabetes and Digestive and Kidney Disease explains. If you’re experiencing gas or constipation pain, a stool softener can also help. Even though the products in stool softeners are unlikely to harm your baby, it’s best to check with your provider before taking any over-the-counter medications, the Mayo Clinic suggests.

2. A pulling or stabbing low belly pain caused by sudden movement

As your pregnancy progresses and you get bigger and bigger, the two ligaments that attach the uterus to the abdominal wall, called round ligaments, begin to stretch and strain, causing pain, according to the Mayo Clinic. “This pain typically starts around 12 to 14 weeks and gets more pronounced during the second trimester,” Shannon M. Clark, M.D., a maternal-fetal medicine specialist at UTMB-Galveston and founder of BabiesAfter35.com, tells SELF. “The pain feels like a pulling or sharp pain in the lower half of the abdomen on either side of the uterus.” Usually, you’ll notice this pain more with sudden movements, such as rolling over in bed or twisting to one side, according to the Mayo Clinic. The good news: Round ligament pain is limited to just one area and usually subsides once you stop moving. You can think of them as “growing pains.”

3. Contractions that last just one to two minutes

Most pregnant people know that labor is comprised of uterine contractions, but many don’t know that they can start experiencing contractions as early as the second trimester, according to the Cleveland Clinic. These pains, called Braxton Hicks contractions, are a normal part of pregnancy, and while they may be uncomfortable, they usually aren’t painful. “These contractions are just like contractions a woman feels in labor, only they are not as painful and typically do not occur in a pattern or over an extended period of time,” Dr. Clark says. “The uterus will get hard and ‘ball up’ in the abdomen, and the contraction may last for one or two minutes before the uterus relaxes.” Braxton Hicks are also called “practice contractions” because they prep you for labor and allow you to try out the breathing exercises you may have learned in a childbirth class.

Braxton Hicks contractions are a bit more common in the afternoon or evening, and they can spring up after physical activity (including sex), according to the Mayo Clinic. They also tend to get a little more intense (and more frequent) as you get closer to your due date, the Mayo Clinic explains. There are a few things you might try to get rid of these contractions. If you’ve been standing, try sitting or lying down. If you’ve been sitting, get up and walk around, the ACOG recommends. You might also consider whether or not you’re hydrated. Often, drinking a few glasses of water and resting might alleviate your pain, the ACOG says.

If none of the above techniques work, or if your contractions last for longer than two minutes at a time and seem to get closer together over time, you may be going into labor and should call your doctor, the ACOG explains.

If you feel any of these pregnancy pains, you should give your doctor a call:

1. Sudden sharp, dull or achy pain in your right abdomen

This could signal appendicitis (inflammation of the appendix). Surprisingly, besides pregnancy complications, appendicitis is the most common reason for emergency surgery during pregnancy, Dr. Clark tells SELF. Around 0.1% of pregnant people will experience appendicitis during pregnancy, and it’s most common in the second trimester, according to the Mayo Clinic. “The pain may be sudden and may be sharp or dull and achy,” says Dr. Clark. “It is typically associated with fever, inability to eat, nausea, and vomiting.” See your doctor right away if you’re in pain and suspect something is wrong.

It can be difficult to diagnose appendicitis (signs like nausea and vomiting aren’t that different from pregnancy symptoms), but if your doctor understands your history and conducts a thorough examination, it’s a very treatable condition, the Mayo Clinic says. First, doctors will perform a series of tests and scans to confirm that you have appendicitis, SELF previously reported. From there, they might determine whether surgery is the best option. In cases where your provider decides that surgery isn’t right for you, they might prescribe antibiotics to treat infection and remove your appendix at a later time.

2. Sharp and intense pain in the upper right abdomen

Slowed-down digestion also slows the emptying of the gallbladder, which can lead to gallstones. Gallstones are often associated with pain in the upper right quadrant of the abdomen, the Mayo Clinic explains. In addition to upper right abdomen pain, you might experience pain in the center of your abdomen, back pain between your shoulder blades, pain in your right shoulder, nausea, and vomiting, the Mayo Clinic says.

“If it isn’t too severe a case, gallstones can be managed conservatively with dietary modification including avoiding fatty, fried foods,” Dr. Jones says. Occasionally, some patients will need surgery, but in most cases, removal can wait until after delivery, she adds. In some cases, the gallstone can cause cholecystitis, which is inflammation of the gallbladder, the Mayo Clinic says. The symptoms of cholecystitis include fever and increased pain that won’t go away. In this case, surgery may be necessary.

3. Sudden pain in the upper right abdomen, paired with nausea

Preeclampsia is a pregnancy-specific condition that involves a sudden increase in blood pressure and some kind of damage to other organs (usually the kidneys and liver), according to the Mayo Clinic. It usually occurs in the third trimester, but some pregnant people with certain risk factors are monitored for it earlier than that. More specifically, risk factors include having a family history of preeclampsia, chronic hypertension, as well as factors like age and race (Black women have higher rates of the condition than women of other races), the Mayo Clinic explains.

“One common symptom is upper abdominal pain, typically under the ribs on the right side (where the liver is located),” Dr. Clark tells SELF. It can also cause nausea, vomiting, unbearable headaches, problems with vision, and shortness of breath, per the Mayo Clinic. You may also notice that you’re peeing less frequently, or your doctor might flag kidney problems like excess protein in your urine, the Mayo Clinic explains.

If the pain is new and not going away, then you should be evaluated, especially if you’ve had problems with your blood pressure during the pregnancy, Dr. Clark adds. Preeclampsia can lead to serious complications for both the pregnant person and baby, including early delivery, so it must be carefully monitored and diagnosed as early as possible. If you’re experiencing upper abdominal pain on the right side at any point in your pregnancy, be sure and mention it to your doctor.

4. Abdominal pain paired with vaginal bleeding

There are multiple potential reasons why you might experience this combination of symptoms. They could be a sign of an ectopic or tubal pregnancy, according to the Mayo Clinic. This happens when the fertilized egg implants in the fallopian tube (or elsewhere in the abdomen) instead of the uterus. It’s possible to have an ectopic pregnancy before or after missing a period, the Mayo Clinic says. In addition to abdominal pain and vaginal spotting, you might also experience extreme lightheadedness, shoulder pain, and fainting, the Mayo Clinic notes.

Another possible cause is miscarriage, which means losing a pregnancy before the 20th week (typically within the first 12 weeks). Sadly, 10 to 20% of known pregnancies end in miscarriage, according to the Mayo Clinic, but the actual numbers might be higher because many people might have a miscarriage without knowing they’re pregnant. Sharp, dull, or cramping abdominal or lower back pain paired with bleeding is a red flag.

Beyond that, if you’re earlier than 37 weeks along but feeling abdominal pain and seeing bloody discharge (or other discharge changes like very watery or mucous-filled secretions), it could be a sign of preterm labor, the ACOG says.

The thing that can make it tough to figure out when bleeding might be a problem during pregnancy is that light spotting can be normal when you’re expecting. With that said, any bleeding during pregnancy at any time is a solid reason to contact your provider—especially if you’re also experiencing pain.

There are a few things you can do to minimize pregnancy pains.

Even if you haven’t experienced major pregnancy pain yet, prioritizing your health and well-being can go a long way toward helping you minimize the aches and pains you might encounter. Dr. Jones recommends staying hydrated and eating a well-balanced diet to support your overall health during pregnancy. Additionally, a little exercise can help with minor abdominal pains from constipation and gas, along with benefitting your mood and possibly even leading to better overall pregnancy outcomes like postpartum recovery time, the ACOG explains. (Just make sure to clear it with your doctor first.)

If you are dealing with major abdominal pain during pregnancy, it can be hard to figure out how best to minimize it because there are so many potential causes. What is clear is that you should talk to your doctor about any discomfort you have before setting out to treat it yourself, especially if your self-treatment plans include over-the-counter medications. More importantly, it’s difficult to determine serious symptoms from minor signs—and time is a factor when it comes to more serious conditions like preeclampsia and preterm labor. “Early detection is also key. If you aren’t feeling quite right and symptoms seem to be getting progressively worse, notify your doctor straight away,” Dr. Jones says.

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