CWC Article - Exercise In Pregnancy

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Pain In Pregnancy

By: Bradley G. Goldberg, M.D.

I am sure that most of the mothers out there are aware that pregnancy comes with not only its joys but also with its aches and pains. While some of these discomforts are part of the normal progress of a healthy pregnancy, others may indicate trouble.

During the first trimester of pregnancy (the first 13 weeks), many women will experience some mild pelvic cramping. Most of the time this is a normal sensation possibly related to the growth of your uterus. However, there is the potential that this could be an indication of more serious conditions such as ectopic (tubal) pregnancy or miscarriage.

With the widespread use of ultrasound in modern Obstetrics, we are usually aware of an ectopic pregnancy long before the pregnant woman becomes symptomatic. Because of this, the chances of serious complications from an ectopic pregnancy are lower today than they have been in the past. This is not to say that the risk has been totally eliminated, since ectopic pregnancies are responsible for approximately 40 maternal deaths per year in the U.S. Therefore significant pain in the early part of pregnancy should be evaluated with an exam and ultrasound.

In the second and third trimesters, it is common to experience “round ligament pain”, also sometimes referred to as “ligamentalgia”. This pain is usually located towards the groin at the base of the enlarged pregnant uterus or in the upper, inner thigh on either side. It is usually a sharp pain that comes and goes quickly.

This round ligament pain should not be associated with bleeding, leakage of fluid, or urinary symptoms. If these other symptoms are present, immediate consultation with your physician is warranted. Otherwise, the best course of action is get off your feet and find a comfortable position, after which this pain usually will resolve quickly. If not you should contact your doctor to rule out conditions such as premature labor, infection or even placental abruption (a topic I will save for a future article).

My final word of advice goes out to all of the potential mothers to be out there. I do not want you to go away from this discussion believing that pregnancy will be filled with pain, because for the most part it is not. The vast majority of pregnancies will proceed normally with minimal discomfort. The minor aches and pains that we have discussed above should not dissuade you from the endless joys you will experience with parenthood.