First Trimester Pregnancy Pains: When to Call Your Doctor
While I am not a doctor myself, I have carried and birthed four children, and I consider myself qualified to provide advice on the subject of being pregnant. I've also done a lot of research and include the advice of OBGYNs, nurses, and midwives here. Though my goal is to reassure mothers (first-time mothers in particular) that those pains are usually natural and normal, the only way to be sure is to consult your doctor.
Please note that I am not a medical professional. This advice is based on my experience through four pregnancies. Always talk to your doctor about any pain you experience.
How Can I Tell the Difference Between "Normal" Pain and Worrisome Pain?
During pregnancy, you become extraordinarily aware of every twinge, cramp, and kick you may feel. It's so hard to know which pain is normal and which is something to worry about. Mary E Fleming, MD, MPH, OBGYN says, "In the first trimester, I usually tell women if they have mild pulling, stretching, cramping pain that resolves with rest or water, then they don't need to worry. If the pain is sharp, severe, constant, getting worse, making her double over or accompanied by abnormal vaginal discharge or bleeding, then she needs to contact her doctor and arrange to be seen. If a woman is ever worried, she should always call her doctor's office and they can let you know if you need to be seen emergently or can schedule a regular appointment in 2-3 days."
Which Pregnancy Pains Should I Worry About?
In some ways, the first trimester of pregnancy is the "riskiest." Although it is true that the loss of a pregnancy is most likely during the first three months, I'm here to reassure you that most of the aches and pains you experience are natural and normal.
Before I proceed, however, I want to make it clear that miscarriage is a risk of early pregnancy, and so you should contact your doctor if you are concerned about pain that you feel. Any pain which is sharp or which is accompanied by bleeding should prompt a call to your doctor, and possibly a visit to be examined.
Particularly if you're a first-time mother, you should contact your doctor when you experience pain during your pregnancy. In most cases, your doctor is going to reassure you. However, if you are experiencing the following, you should consider seeing a doctor immediately via an urgent care facility or your local women's hospital.
- Cramping with bleeding
- Severe leg pain
- Inability to keep foods down due to nausea
- Pain during urination
If you have additional symptoms accompanying what may otherwise be a normal pain, contact your doctor immediately. Aside from the obvious risk of miscarriage, or chemical or ectopic pregnancy, another risk you need to be warned of is a urinary tract infection. A simple urine test can confirm a UTI and you will be prescribed a pregnancy-safe antibiotic.
Normal vs. Worrisome Pregnancy Pains in First Trimester
See Your Doctor
Severe Abdominal Cramping
Abdominal Cramping + Bleeding
Lower Back Pain
Stabbing Abdominal Pain
Abdominal Cramping + Nausea or Vomiting
Severe or Persistent Headaches
Bleeding With Fever, Pain, or Chills
Breast and Nipple Tenderness
Frequent and Painful Urination
Pain During Urination
Whenever you're worried, to allieve anxiety!
Is Lower Back Pain Normal in Early Pregnancy?
Lower back pain in particular (although upper back pain may also happen) is typical during pregnancy. In fact, it is another possible early indication of pregnancy. Most lower back pain is caused by strain on the back as the uterus expands to accommodate your growing baby, but there may be some other causes. The standard causes are listed below.
- Implantation Bleeding When the embryo first attaches to the wall of the uterus, some women report feeling a brief twinge of pain in their uterus or lower back.
- Poor Posture Your body is working hard to support the added weight of your uterus as it expands (yes, even in early pregnancy!) and this can cause a strain on your lower back until you make adjustments to your posture. Make sure to move about regularly (unless you're on bed rest) and stretch your back whenever possible.
- Constipation In part because of the high iron content in pre-natal vitamins, constipation is a normal part of early pregnancy, and it can cause back pain. Make sure that you are consuming plenty of fluids and that you're eating a diet high in fiber, and you may be able to get some relief.
- Kidney Infection If a urinary tract infection goes untreated for too long, it may spread into your kidneys and cause a kidney infection. This will also cause lower back pain, and so if changing position doesn't help, and your bowels remain "regular," then you should contact your doctor for advice.
Is Breast Pain Normal During Early Pregnancy?
Breast pain may be one of the first signs of pregnancy. During this period, your breasts are beginning to prepare for a big job: Making milk to feed your baby! In addition, the ligaments that support your breasts will begin to relax (along with the ligaments in other parts of your body), and this will account for some of the pain.
In most cases, breast pain is nothing to worry about, but make sure that you contact your doctor if you experience breast pain with a fever, as this may indicate an infection.
Is Hip and Joint Pain Normal During the First Trimester?
As with many pains during pregnancy, these pains are normal.
- Hip pain may be caused by the sciatic nerve, and you may experience this pain throughout your pregnancy, both as a result of sciatica and because your hips are expanding to make room for your uterus and baby. The warm baths and the use of a body pillow may help.
- Joint pain is most common in the second trimester. It generally tapers off during the third trimester (to be replaced by other discomforts), but it may also happen earlier in pregnancy. This pain is generally caused by the ligaments loosening—one of the less desirable effects associated with this remarkable time in your life. Keep up your activity, but go easy on your body. While joint pain is not generally something to contact your doctor about, it may be an indication that it's time for you to slow down a bit and stop pushing your body so far.
- Knees, ankles, and wrists. If you experience pain in your knees or ankles, it's time for you to rest. Pain in your wrists or elbows might mean that it's time to slow down and reduce the amount of time you spend on the computer.
What Kinds of Abdominal Pain Might You Feel in the First Trimester?
Note: Nausea during early pregnancy may be perfectly normal. You may find natural remedies for morning sickness useful for helping to make the first trimester more pleasant. Most nausea ends in the thirteenth week of your pregnancy, but be aware that morning sickness can continue through your pregnancy depending on hormones.
There are two main types of abdominal pain that a woman may experience in her first trimester:
- Cramping It is common to experience cramps that feel like period pain, which are caused by the stretching and relaxing of the ligaments that support the abdomen. One of the biggest concerns that new mothers have is cramping during early pregnancy. While cramping may be an indication of miscarriage, in most cases it is caused by other factors.
- Sharp Pains While sharp pains can mean anything, at any phase of pregnancy, I recommend visiting your doctor for a urinalysis in case you have contracted a urinary tract infection (UTI). This can be dangerous for you and for your baby, and your doctor can prescribe a pregnancy-safe antibiotic.
How can you tell the difference between a "normal" abdominal pain and one that signals a problem?
According to Kara Manglani, a certified nurse and midwife in New York, "You really can't tell the difference. If the pain is severe and continues for hours, it is more likely a sign of a problem, but not necessarily. The only way to be sure is to go to your doctor or midwife."
Abdominal pain becomes more common the further into the pregnancy you get. Strain is unusual during the first trimester because there is less weight gain. If you experience abdominal pain, it is recommended that you visit your doctor for more information.
What If I Have Cramps With Bleeding or Spotting?
- About 20% of women experience some bleeding during the first three months of pregnancy. Light spotting (less than a dime-sized amount) is not usually a cause for concern, but moderate or heavy vaginal bleeding, especially if accompanied by fever, chills, cramping, or pain, are all reasons to call your doctor immediately. Your doctor will want to know what your temperature is when you call.
- Any pain which is sharp or which is accompanied by bleeding should prompt a call to your doctor.
- Occasionally, bleeding and mild cramping (in combination) are normal, but it's best to be cautious.
- I also recommend that you read my article on bleeding in early pregnancy, where I go into detail about things to look for in the blood—what color it is, for example, and how much there is.
Is Leg Pain Normal During Early Pregnancy?
Leg Cramps: Although leg cramps are most common in the third trimester, many newly-pregnant women report that their thighs, calves, and feet might feel cramped. An expanding uterus can put pressure on certain nerves and blood vessels, causing poor circulation, cramps, or spasms of pain.
Sciatic Pain: The growing weight of your uterus might push on the sciatic nerve, sending a jolt of pain down the back of your leg.
Other Causes of Leg Pain: Both deep vein thrombosis (DVT) and uterine fibroids also cause leg pain, so it's best to call your doctor or midwife.
Is Pain Normal During the First Trimester of Pregnancy?
The short answer is yes. Mostly, the pain that you may experience during early pregnancy is natural and comes with the territory, although there are certain kinds of pain that may be concerning. The purpose of this article is to address your concerns about any pain you are experiencing and help you know when you need to see a doctor.
This article is a guide to knowing what's normal and what's not, and the best ways to deal with the normal early pregnancy aches and pains. I'll guide you through the most natural types of pain you may experience early on, as well as some which require a doctor's attention.
Are Headaches Normal in the First Trimester?
Headaches are a common complaint during the first trimester, triggered by a surge of hormones and an increase in blood volume. Here's a list of reasons you might have a headache:
- caffeine withdrawal
- low blood sugar
- changes in posture
- lack of sleep
- changes in vision
What medication can I take for a headache if I'm pregnant?
Acetaminophen is safe to take as directed but many other medications (ibuprofen, aspirin, most prescription migraine drugs) aren't, so talk with your doctor first.
Other ways to get relief include making sure you drink lots of water, taking a warm bath, having a nap, and massage.
What If I Experience Pain During Urination?
Urinary tract infections (UTIs) are more common when you're pregnant. Your uterus is located right on top of your bladder, so as your uterus grows, the added weight can block or impede the urine, and this can cause an infection.
How do I know if I have a UTI?
- you have to pee (or mistakenly feel like you have to pee) a lot
- you feel pain or burning during urination
- your urine is cloudy or blood-tinged
- your lower back or pelvic area hurts
- you experience fever, nausea, or vomiting
A UTI might resolve itself within a couple of days, but it can usually be quickly and easily treated with pregnancy-safe antibiotics. When you're pregnant, you are advised not to wait, since UTIs are managed more aggressively during pregnancy to avoid complications. It's best to see your doctor as soon as possible.
Pregnancy Pain Poll
Did You (or Are You) Experience Pains During Your First Trimester of Pregancy?
Anxiety During Pregnancy is Normal and Natural!
Especially if this is your first pregnancy or if you have experienced pregnancy loss in the past, the first trimester can be a frightening time. While many aches and pains are natural during this trimester, some new mothers worry about what each one of these pains means.
In most cases, unless you are bleeding, the pain that you're experiencing is probably natural. But it's always a good idea to consult your doctor if you're feeling anxious.
When asked what she tells women who hesitate to call because they don't want to be a bother, Kara Manglani, a certified nurse and midwife, says "You are never a bother. That is our job. It is better for you to come in to be evaluated that for you to sit home and panic." There's usually no reason to stress, and getting relief for your worry and anxiety by talking to someone is just as important as getting relief for pain.
Any time you are concerned about your pregnancy, you should contact your doctor or midwife. They are the most qualified to determine if you need to make an appointment.
This content is accurate and true to the best of the author’s knowledge and does not substitute for diagnosis, prognosis, treatment, prescription, and/or dietary advice from a licensed health professional. Drugs, supplements, and natural remedies may have dangerous side effects. If pregnant or nursing, consult with a qualified provider on an individual basis. Seek immediate help if you are experiencing a medical emergency.
© 2014 Becki Rizzuti