During pregnancy, a sore lower abdomen can occur due to muscle pain, gas, constipation, or more serious causes like infection or preterm labor.

From the first day of morning sickness (when you realized you really were pregnant) to the lower back pain you now feel as your baby bump grows, it may seem every single day of your pregnancy comes with some type of discomfort.

You probably expected many common discomforts (especially since you’ve gotten ample warnings about pregnancy pains from friends, family, and even strangers on the street). However, it can still be nerve wracking when something doesn’t feel quite right.

One question you may struggle with is when to notify your doctor. You don’t want to be the pregnant mom who cried wolf, but you also don’t want anything to go wrong for you and your growing baby.

If you’re feeling low belly pain, it can be comforting to know that it’s usually normal and simply a part of the developing pregnancy.

To help you figure out the exact reason for that low belly ache, we’ve included a list of possible causes for the pain (common and more serious) as well as some of the warning signs that mean it’s time to alert your medical provider.

Some common causes of low belly pain in pregnancy include:

Round ligament pain

Ligaments in your pelvis that hold your uterus in place stretch as your belly grows. Because pregnancy puts extra strain on these ligaments, they may become tense and overextended.

Particularly during the second and third trimesters, this can result in sharp pain and discomfort if you move too quickly and your ligaments tighten too quickly, pulling on nerve fibers.

Round ligament pain is usually temporary or intermittent. It is typically experienced as an intense sudden spasm in the abdomen or hip area with the pain most frequently occurring on the right side. That said, some pregnant women experience it on both sides.

If you’re experiencing round ligament pain, slowing down your movements (especially getting up or sitting down), stretching, and practicing yoga can all be beneficial. You may also want to try bracing your pelvic muscles if you feel a sneeze coming on!

Gas

Gas may occur at any point in pregnancy (feel free to blame relaxed intestinal muscles from the high levels of progesterone!). However, you may find yourself with some extra gas as you approach the end of pregnancy, since your enlarged uterus is putting extra pressure on your organs, often slowing digestion.

If you’re experiencing pain from gas, you may want to eat smaller meals more frequently. You can also try exercise to aid digestion and identify (and then avoid) foods that trigger gas. Fried and greasy foods are common culprits!

Constipation

Almost a quarter of pregnant women will experience constipation at some point during their pregnancy. A diet without sufficient fiber/liquids, use of iron supplements, and fluctuating hormones are just some of the factors that may contribute to this unpleasant problem.

If you’re experiencing constipation, you may want to try drinking more water, eating smaller meals more frequently, increasing the amount of fiber in those meals, and exercising. If you’re struggling with constipation frequently during your pregnancy, your doctor may prescribe a stool softener.

Braxton-Hicks contractions

Commonly felt in the third trimester, Braxton-Hicks contractions are also referred to as false labor or warm-up contractions. While they will help to soften the cervix, they won’t cause a baby to actually be born due to their irregular nature.

If you’re experiencing Braxton-Hicks contractions, you can try drinking more water and changing your position. You can also rest assured that these normally don’t stick around for too long!

Pregnancy growth

As you baby grows bigger during the second and third trimesters, you may find that you feel more pain in the lower belly and bladder region. You may feel your skin stretching and more pressure from the added weight.

Supportive maternity belts or belly bands can ease some of this discomfort. A good pair of supportive maternity leggings can also go a long way to help you feel more comfortable. Pregnancy pillows can help ease discomforts while resting.

While it’s most likely that you’re experiencing low belly pain from one of the common causes mentioned above, there are some serious causes of low belly pain to watch out for.

These include:

Illness or infection

Either can occur at any point during your pregnancy and may not even be directly related to your pregnancy. Your chance of experiencing any of these are greatly impacted by your genetics and lifestyle.

Miscarriage

A miscarriage is a pregnancy loss that occurs before 20 weeks of pregnancy. It is most likely to occur in the first trimester and occurs in approximately 10 to 15 percent of known pregnancies.

You should notify your doctor if you experience:

  • heavy spotting
  • vaginal bleeding
  • severe abdominal pain/cramping
  • mild to severe back pain

Ectopic pregnancy

In approximately 1 out of every 50 pregnancies, an ectopic pregnancy occurs. This is when the fertilized egg attaches to a part of the woman’s anatomy outside the uterus. Genetics, hormones, age, and a history of scarring/invasive reproductive system procedures can lead to a higher likelihood of this issue.

Notify your doctor immediately if you experience:

  • sharp waves of pain in the abdomen, shoulders, pelvis, or neck
  • heavy spotting
  • dizziness or fainting
  • rectal pressure

Preterm labor

About one quarter of all preterm labors (those occurring before 37 weeks) are spontaneous. Some reasons for a preterm labor include:

  • a weakened cervix
  • a premature rupture of the membranes
  • hypertension
  • bleeding during pregnancy.

A fetus born before 23 weeks will not survive outside the mother’s body, so it’s important to notify your doctor immediately if you display signs of being in early labor.

Preeclampsia

Around 5 percent of women in the United States will experience preeclampsia. Preeclampsia is a medical condition characterized by high blood pressure. Generally occurring after the 20th week of pregnancy, it is possible to experience it earlier in the pregnancy or even after giving birth.

You may be more likely to experience preeclampsia if you have a history of high blood pressure or diabetes, are obese, and are in your teens or over the age of 35.

You should notify your doctor if you have:

  • persistent headaches
  • abnormal swelling in the hands and face
  • sudden weight gain
  • changes in vision

Placental abruption

According to the March of Dimes, 1 in 100 women will experience a placental abruption, or the detachment of the placenta before it’s time to give birth. The main signal that you are experiencing this problem is vaginal bleeding; however, blood can be blocked by the shifted placenta, so you may not always have this warning sign.

Other signs of a placental abruption include:

  • discomfort
  • sudden stomach and back pain
  • tenderness

Over time these symptoms will only get worse and you should see your doctor as soon as possible to ensure your baby’s safety.

While it’s not always clear cut when you should notify your doctor about lower belly pain, if the pain is accompanied by any of the following, you should notify your doctor right away:

You should notify your doctor if you are feeling extreme levels of pain in the lower belly. Most of the more common causes of low belly pain will cause only mild to moderate levels of pain. Prolonged periods of pain or intense pain are an indicator to slow down and reach out to your doctor.

It’s important to pay attention to your body’s signals during your pregnancy! Aches and pains can be signs that your baby is growing, but they can also be warnings to slow down and seek medical assistance.

When in doubt, it’s always best to reach out to your medical provider. They’ll be able to help you better understand what you are feeling and if needed they can perform tests/scans to check to make sure you and your baby are healthy.