Cramps in early pregnancy are relatively common. In the majority of women light cramping is nothing to be concerned about, and tends to improve without any specific management or care. Occasionally, however, uterine cramping can be a sign of pregnancy complications, so it is always worthwhile to be checked by a health care practitioner such as your GP, midwife or obstetrician.
Women who have had problems getting pregnant can be particularly anxious. Having a history of previous miscarriage or a complicated pregnancy means that every little niggle can be alarming. It’s worth remembering though, that every pregnancy is its own unique event. Aiming to stay healthy, reducing your stress, keeping regular obstetric appointments and maintaining good supports will all help in making your pregnancy as enjoyable as possible.
It is not unusual for women to have slight spotting only, which is not associated with any cramping. Commonly, this is due to the embryo burrowing into the wall of the uterus. This is why spotting at around the same time when a period would normally be due is known as an implantation bleed. Unless the bleeding becomes heavy, continuous and is accompanied by pain, then generally it settles after a day or so.
In some women, the uterus is not positioned in exactly the right position in their pelvis. Instead of tilting forwards and sitting almost on top of the bladder, it is retroverted-or tilting backwards. As the uterus enlarges it may need to tilt more in one direction than the other and this places additional pressure on the ligaments and nerves.
Light cramping is similar to period pain, when the uterus is contracting and there is a heavy, dragging feeling in the pelvis. Sometimes this is felt more on one side than the other. Cramps can be experienced more after standing for long periods or at the end of the day. When the pressure in the abdomen rises suddenly, which is what happens during sneezing, coughing or laughing, the cramps may be more noticeable.
Women describe the cramps in a variety of ways. For example sharp, stabbing, dull, heavy or “just annoying” can all be used as ways of expressing the sensation.
Some health care practitioners use the analogy of cramps in early pregnancy as being a form of growing pains of the uterus. Although the growth of the baby in the first trimester is relatively slow, the blood supply and hormonal changes within a mother’s pelvic organs are significant.
There are a lot of changes going on; not just because they’re necessary now, but to prepare for the months ahead. The uterus, when non-pregnant, is a relatively small organ. It is made up of muscular fibres which have the capacity to expand and stretch many times greater than their original size. Some degree of discomfort and cramping is an almost inevitable part of all that growth.
Although this doesn’t make it any easier to tolerate, understanding the cause and knowing it will ease can make the cramping more manageable.
Although cramping can be completely normal, it can also be an early sign of miscarriage. Unfortunately, there is little which can be done to stop miscarriage from occurring if it is inevitable. It is estimated that around one in four pregnancies end in miscarriage; due, in many cases to chromosomal abnormalities or a problem with the embryo embedding itself into the lining of the uterus.
Occasionally, cramping can be a sign that the fertilised egg has not embedded in the uterus but instead, is nestling down somewhere else in the pelvis. Most commonly, this is in one of the fallopian tubes. This is known as an ectopic pregnancy. Because the fallopian tubes are minute and only wide enough for the microscopic egg to migrate along, they cannot expand in the same way as the uterus can. The uterus is made of muscle which is designed to enlarge.
An ectopic pregnancy constitutes a medical emergency and can potentially be fatal. The embryo cannot be saved and needs to be removed along with all, or a portion of the fallopian tube. Occasionally, the tube ruptures before surgery is possible. This leads to added complications of shock, bleeding and infection. Women who have had surgery on one or both of their fallopian tubes can have subsequent problems with conceiving. Retaining as much healthy and patent fallopian tube as possible, whilst not compromising the health of the mother are the two primary goals of surgery. This is why early, expert care and attention is important if ectopic pregnancy is suspected.
Generally there is improvement as the uterus enlarges and is better supported by the bones in the pelvis. Until then, the ligaments and muscles need to bear the weight of the uterus and like any muscles they can ache and become fatigued.
It may be useful to determine when your due date is and compare this with when the cramps started. This can help to explain some of the reasons for cramping in early pregnancy.
Remember – it’s always worth getting checked by your health care professional if you are having cramps in early pregnancy.