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Uterine Cramps & Pains
Q. I am amazed and happy at age 40 with my first pregnancy two months along. Up to now, I've been very active in sports—running and swimming. My doctors said I can continue exercising as long as I keep my heart rate under 140 and listen to my body for any signs of distress. So far it’s been fine except for side stitches. I am getting a little worried about the side stitches and also a little depressed about not being able to stay fit exercising as long as possible into the pregnancy. I am well aware the body changes, but I don't wish to turn into a total weak blob. So far I can't find any straight answers on exercise's impact on a more mature age pregnancy or any insight about these annoying side stitches. Any thoughts, please?
-Anonymous, New York
A. I did pregnancy both ways: the first time overweight with little exercising, and the second time fit and exercising throughout. I think you have a huge advantage going into pregnancy as fit as you are. You're right, there's no reason to stop (I actually found exercise to be the biggest help battling fatigue and nausea), but you do need to listen to your body and keep your heart rate down a bit. Don't worry about cutting back a bit in your regimen. You will not become a “total weak blob.” Just being pregnant is a workout in itself! Your body requires an extra 300 calories a day. And, while exercising, you burn as many as 200-400 calories an hour.
As far as the side stitches–shocking, isn't it? When I first felt this stabbing pain, I thought something surely must be wrong. I later found out that it is quite normal. It's the stretching of the tendons and ligaments in the abdomen that, when jostled, can contract quickly and cause pain. You may even get the stabbing sensations while doing something as minor as rolling over in bed. These pains will lessen in a few months, but will be replaced by Braxton Hicks contractions. Oh joys!
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Q. I am pregnant for the first time and I am at 18 weeks. I sneezed two times the other day and immediately felt a pain at the top of the place where my buttocks folds—near my lower back. It is quite painful when I sit, stand, bend over and when I press it. Do you have any ideas?
A. You probably experienced a muscle spasm or cramp, which can be associated with the stretching and repositioning of ligaments, tendons, muscles and guts. Sometimes a sudden movement-, such as sneezing-, can trigger a cramp in an area that you never had problems with before. Your body is changing and readjusting on the inside and out. It's bound to feel and function differently.
Q. I am almost nine weeks pregnant. During the first month of my pregnancy I had severe abdominal pain off and on throughout the day and night. If I passed gas or had a bowel movement, the pain usually would go away. I also have changed my diet since I found out I was pregnant. My belly aches have now been gone for a month, but I am so afraid of having an abnormal pregnancy. My doctor doesn't know what caused my severe pain the first month. I was not bleeding at all; I just had the bad belly aches off and on. What do you think?
A. If your abdominal pain was relieved, even a little, by passing gas or feces, then it was probably just painful gas that you experienced. Believe me, this is very normal during pregnancy. I remember having such severe cases of it that I was afraid to eat. Sometimes I felt like I would actually pass out from the gas pain.
The horror-mones of pregnancy can affect a newly-pregnant body in all kinds of ways, including triggering the over- or under-production of stomach acids that can lead to painful gas. I wouldn't worry. I think your prior belly aches will have no adverse effects on you or your baby.
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Q. I had a miscarriage (at eight weeks) last April. I am now four weeks pregnant with my second pregnancy. I have been experiencing intermittent light cramping all over my pelvic area, which is known to be normal during pregnancy. I am concerned, however, about the cramping on my right side, which is always in the same general area but not constant. I am terrified about having a second miscarriage and afraid of the possibility of ectopic pregnancy. Is it normal and common to experience cramping on one side (possibly the side I ovulated from)?
A. It's true that light cramping in early pregnancy is normal. It can sometimes feel like period cramps that come and go.
It's also true that cramping on one side could be an indicator of an ectopic pregnancy. If you have any of the following symptoms—crampy pain with tenderness that starts on one side and then spreads throughout the uterus, pain that worsens when you have a bowel movement or cough, any bleeding or spotting, nausea or vomiting, shoulder pain or rectal pressure—then you should consult your doctor ASAP.
Or, you could be right. You may just be a little sore on the side you ovulated from. This is probably the case if you've ever experienced the same feeling while menstruating.
Q. I had a miscarriage in April at 10 weeks, and I am now pregnant again (four weeks). I'm experiencing the same severe cramping at night as in my first pregnancy. The cramps are menstrual-like and have woken me up twice at night. I am not spotting and did eat a little ice cream, so this may be digestion-related because I have Irritable Bowel Syndrome (IBS). The pains feel more like a uterine contraction, but ease off after 5-10 minutes. Is this a possible sign of miscarriage again?
A. If you are not spotting or bleeding, then you are probably experiencing gas pains. Combined with IBS, the horror-mones of pregnancy can really tie your stomach in knots. I remember having such bad gas pains during my second pregnancy that I thought I would pass out. See the other "gas" questions for more details.
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Q. I am a little over seven weeks pregnant and last year I had a miscarriage at six weeks. When my husband and I have sex and I have an orgasm, I get these horrible cramps. It really scares me. Do you know what may be causing the cramps?
A. During pregnancy, uterine cramping after orgasm is quite common. It is more painful for some women than others. I, personally, didn't find it painful, just uncomfortable and weird. When I started to show, I suddenly noticed a strange transformation of my belly after sex. During and after an orgasm, the uterus contracts and stays contracted for several minutes. The large, loose, bowl-of-jelly stomach transforms into a tight, hard, football-like mass. It usually squashes downward and off to one side. Don't worry; this momentary pregnancy deformity doesn't harm the baby, although you may initially freak out over the appearance and feeling.
Q. I am 31 years old and I had two miscarriages about four years ago. I recently got pregnant again (about four weeks along) and I am having painful lower abdominal cramps, but no bleeding. I am really scared of this being the sign of another miscarriage. How do you know when painful lower abdominal cramps become a problem?
A. In early pregnancy, lower abdominal cramping, similar to period cramps, is common. This usually only lasts for a week or two. The cramping can be caused by implantation of the ovum into the uterine wall or your body adjusting to a different flux of hormones.
These cramps can be problematic if they are accompanied by bleeding, are contraction-like (coming and going every on regular time intervals) and encompass the abdomen and lower back, or if they are so intense you feel like you cannot breathe. If you experience any of these symptoms, then you should contact your doctor ASAP to check it out.
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Q. I am 34 weeks pregnant with my second child. When I was 30 weeks, I started feeling period-like cramps, so I went to the hospital. I went into premature labor, which they had to stop. They also gave me steroid shots to help develop the baby's lungs. At the time, I was told the baby had dropped. I still feel these cramps and every time the baby moves I feel it in my vagina. I've also had leaking of fluids when this happens and feel lots of dull pain in my lower back. When I have a contraction, half the pain is in my back and half is in my stomach. Should I go to the hospital if I keep getting these symptoms?
A. Since you have had leakage of fluids accompanied by labor-like cramping, I think you should go to the hospital now. It sounds as if you are in labor. The fluids could be from the amniotic sac. If this is the case, then you should deliver within the next 48 hours or so to avoid possible infection.
At your stage of pregnancy, the baby has an excellent chance of survival. Normally, in the eighth month there is a small chance that the baby's lungs may not be fully developed, but since you had the steroid shots, your baby's breathing capacity should be very good.
The worst-case scenario is that you are not in active labor, the leakage of fluids is just urinary incontinence and the doctors will send you home to wait for real labor.
Q. The right side of my lower abdomen has been very tender to touch. I can also feel something hard behind it when I touch it. What is this? Do I need to be worried?
-Tracey, United Kingdom
A. What you are experiencing is normal, and yes, I've had it too. I called it "the sore spot syndrome." These tender spots on the uterus are usually localized to one area and remain for a few days at a time before moving on to another spot. When I had a Braxton Hicks contraction, the sore spot was the most painful. Sometimes the baby puts a lot of pressure on a certain area of the uterus, making it tender and sensitive, like a bruise, or the baby can push on certain nerve endings that have the same effect. The hardness you felt is probably the baby's back, head or behind pushing on that tender area.
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Q. I am around seven weeks pregnant with my first pregnancy. I have been having more severe cramping the past couple of days (I originally was having mild cramps for quite a while when I first found out I was pregnant). Also, just this morning there was some light spotting. It was light pink in color, and there was very little. It looked about the same as what you would see at the very end of a period, except it was pink. Also, I've been having some pain in my shoulder, but it mainly feels like my shoulder is out-of-joint. I've been concerned about an ectopic pregnancy. Is the pain I'm feeling in my shoulder typical of ectopic pregnancies? I realize the pain in my shoulder could simply be a coincidence and I'm really hoping that's the case.
-Anonymous, New York
A. All of the symptoms you've described could indicate an ectopic pregnancy. The most common signs are: extreme crampy pain with tenderness that starts on one side and then spreads throughout the uterus, possibly worsening with movement, coughing or having a bowel movement; spotting or bleeding; nausea or vomiting; shoulder pain (yes, this is a symptom); and rectal pressure.
Since you are experiencing quite a few of these symptoms, you should report them to your OB/GYN just in case. If the pain becomes sharp and severe, get yourself to your doctor's office or an emergency room ASAP.
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