16 Weeks Pregnant Period Like Cramps

You’re halfway through your second trimester now! And more changes – both physical and emotional – are on the way. Once your little one begins to press against your uterus in what’s called the pressure phase (the eighth and ninth months), you may begin to feel some intense period-like cramping in your lower abdomen as early as your fourth month, but usually in your sixth or seventh month. That’s because it’s your uterus tightening into an “innie” (short for “in-ternia,” a Latin word meaning “intestines”) in what are called Braxton-Hicks contractions (named after the doctor who identified them). Be reassured that this is all part of a normal pregnancy and that, luckily, these feelings will pass even if they can be uncomfortable at times.

When you’re pregnant, it’s normal to feel sensations that almost feel like menstrual cramps. These are called Braxton-Hicks contractions. They happen as a result of your uterus tightening. You may have these contractions for several weeks without going into labor.

Week 16, what do you notice? You may have noticed some pretty uncomfortable “cramps” or pains in your uterus and back. If this is the first time you’ve experienced these Braxton-Hicks contractions (or practice contractions), they may have given you a scare, but they’re perfectly normal.

While it feels like mild menstrual cramps (it even causes some discharge), these uterine contractions are just your leading edge of baby’s delivery.

It’s not uncommon to feel a little crampy in the later stages of pregnancy. The cramping you’re experiencing is called Braxton-Hicks contractions. While this kind of “false labor” may be uncomfortable, it’s a good sign that your baby is still growing as he should be and can’t come before he’s ready.

Pregnancy cramps are muscle cramps in your uterus. They can happen any time and will feel a lot like period cramps — mild local pain that you feel on one side. It usually goes away quickly.

Cramping during pregnancy is often scary, but it’s a common symptom throughout all trimesters. Most cramps aren’t dangerous; in fact, they’re simply the uterus’s response to anything that’s happening to it. “The uterus is a muscle, and the only thing a muscle knows how to do is contract, and a contraction feels like a cramp,” says Holly Puritz, M.D., medical director for Sentara Lee Hospital Group for Women in Norfolk, Virginia.

That means whenever your uterus is stimulated—by a full bladder, vigorous exercise, or something more—its natural response is to contract. The important thing, says Dr. Puritz, is to figure out when cramps during pregnancy are normal and when they’re cause for concern. Keep reading for our trimester by trimester guide.

What causes cramps?

Throughout your pregnancy, the most common source of cramps are the ligaments that surround and support your uterus. As your baby grows, these ligaments stretch. When you change positions, you’ll sometimes feel these ligaments cramp up on one or both sides of your abdomen or toward your back.

Ligament cramps can occur any time during your pregnancy, but they’ll be more noticeable between 14 and 20 weeks. During this time your uterus is growing and putting pressure on the ligaments, but it hasn’t grown so large that your pelvic bones help support it. If you have what feels like a ligament cramp, try lying down on your side until it goes away. A hot water bottle may also help, but usually these cramps disappear pretty quickly if you just rest.

Some women experience cramps during sex, both during and after orgasm. This occurs because when you’re pregnant, blood flow to your pelvic area increases; this, combined with the normal increase of blood flow to your genitals that occurs during sex, can result in cramping and a low backache.

If you’re worried that having sex might hurt your baby, you might be tensing up during lovemaking — this can also cause cramping. Talk with your doctor about your fears, and try to relax. If you have a low-risk pregnancy, sex and orgasms won’t hurt your baby. Cramps during sex usually go away pretty quickly. If they don’t, ask your partner to give you a low back rub to help you relax and ease the cramping.

As early as your fourth month, but usually in your sixth or seventh month, you’ll experience what may feel like mild menstrual cramps. This is your uterus tightening in what are called Braxton-Hicks contractions (named after the doctor who identified them). These “practice” contractions are getting your uterus ready for the hard work of pushing your baby out when you’re ready to give birth. They can last anywhere from 30 seconds to two minutes, and will become stronger and more frequent as your due date approaches. If you’re uncomfortable, try lying down, shifting position, or getting up and walking around. Sometimes a change of position is all that it takes to ease the contractions.

As you get closer to your due date and the contractions become stronger, it may be hard to tell whether you’re still having Braxton-Hicks contractions or are heading into labor. If you’re not sure — and especially if you’re at risk for premature labor — call your doctor. You should also call your doctor if you experience any of the following symptoms:

  • more than 4 contractions an hour
  • pain in your back, abdomen, or pelvis
  • unusual vaginal discharge

When to call the doctor

Generally, if your cramps are caused by a serious problem, you’ll know it. They will be acutely painful, and will likely be accompanied by other symptoms such as bleeding or abdominal pain and tenderness.

In early pregnancy, cramps usually accompanied by bleeding may signal a miscarriage. Miscarriage is most likely in the first 13 weeks and is usually caused by the fetus not developing properly. If you have severe pain or bleeding that soaks through several sanitary pads in an hour, or if you pass blood clots or grayish material, go to the emergency room immediately. Otherwise, call your doctor right away if you have any of the following symptoms:

  • bleeding with pain or cramps in the lower abdomen
  • continuous, severe pain for more than a day, even if it is not accompanied by bleeding
  • bleeding that is similar to a heavy menstrual period, or light bleeding that lasts for more than three days

Rarely, early cramping and lower abdominal pain can signal an ectopic (or tubal) pregnancy. This means the fertilized egg has been implanted in the Fallopian tubes or elsewhere outside the uterus. Most ectopic pregnancies are diagnosed before you even suspect you’re pregnant — symptoms usually show up within a week of the egg being fertilized — but it’s still a good idea to know what to watch for. Seek immediate medical attention if you have any of the following symptoms of ectopic pregnancy:

  • pain in the lower abdomen that becomes more severe and localized, usually to the side that the ectopic pregnancy is on (similar to appendicitis pain)
  • sudden, severe, stabbing pain in the lower abdomen, which may indicate a rupture of the Fallopian tube
  • bleeding that precedes or accompanies pain
  • nausea, vomiting, dizziness, or faintness with increased pain and bleeding
  • mild to severe tenderness over the area of your Fallopian tube

Though miscarriages typically occur during the first trimester, it is possible to have a miscarriage between the 12th and 20th weeks of pregnancy — called a “late miscarriage.” (Delivery after the 20th week is usually considered a premature birth.)

Late miscarriages are usually due to problems with the placenta, health problems of the mother, a cervix that opens prematurely, or other problems. If you have a pink or brown discharge, call your doctor to have it checked out. It could be an early sign of a miscarriage or it could be a minor problem. However, if you begin to bleed heavily, seek immediate medical attention at your doctor’s office or the emergency room. While you wait to be seen, sit or lie down with your feet up, and relax as much as possible.

Cramps late in pregnancy may signal preterm labor. This means labor contractions — at least every 10 or 15 minutes — that begin between the 20th and 38th week. If you suspect you may be in preterm labor, call your doctor. She may want to examine you or have you go to the hospital, where you may be given medication that can stop the contractions. Call if you experience any of the following symptoms:

  • bleeding or a change in vaginal discharge
  • feeling your baby push down on your pelvis
  • a low, dull backache that may travel around to your abdomen
  • what feels like menstrual cramps
  • abdominal cramping with or without diarrhea

References

William Sears, MD and Martha Sears, RN. The Pregnancy Book. Little, Brown and Company.

Arlene Eisenberg, et al. What to Expect When You’re Expecting. New York. Workman Publishing.

March of Dimes. What you need to know. Pregnancy and Newborn Health Education Center. January 2010 http://www.marchofdimes.com/pnhec/159_513.asp

National Women’s Health Information Center. Pregnancy Complications: Symptoms, Diagnosis, and Treatment. http://www.4woman.gov/Pregnancy/complications.cfm

American College of Obstetricians and Gynecologists. Early Pregnancy Loss: Miscarriage and Molar Pregnancy. http://www.acog.org/publications/patient_education/bp090.cfm

Cramps During Pregnancy Second Trimester

Pregnancy puts a major strain on your body, and nowhere is this more evident than in your expanding belly. As your baby grows, the added pressure on muscles, joints, ligaments, and surrounding organs can lead to cramping and discomfort. Knowing when and why cramps are likely to occur can help you recognize which ones are a normal part of pregnancy, and which ones may need your doctor’s attention.

Cramps During Early Pregnancy
“The majority of pregnancies will have some mild (light) cramping intermittently during the first 16 weeks,” says Chad Klauser, M.D., Clinical Assistant Professor of Obstetrics and Gynecology at the Mount Sinai School of Medicine in New York City. Here are some common causes of first trimester cramping.

Implantation Cramping: For some women, cramping is the first sign of pregnancy, as it sometimes happens when a fertilized egg burrows in the uterine wall. This is called implantation cramping, and it can feel like your period is about to start, says Dr. Puritz.

Uterine Growth: Rapid uterine growth in the first two trimesters of pregnancy can also lead to a pulling sensation within the stomach, says Dr. Klauser. Your uterus must stretch and expand to accommodate your growing baby.

Gastrointestinal Issues. Changing hormone levels might cause increased gas, bloating, and constipation during the first trimester. All of these gastrointestinal issues can cause cramping sensations.

Ectopic Pregnancy: In rare cases, first trimester cramping could be caused by ectopic pregnancy (when the embryo implants outside of the uterus—usually in the fallopian tube). Ectopic pregnancy often comes with one-sided cramping, bleeding, lightheadedness, or shoulder pain. Contact your doctor immediately if you have symptoms of ectopic pregnancy.

Miscarriage: Miscarriages often happen because of abnormal development in an egg or embryo (usually caused by chromosomal abnormalities). The cramping associated with miscarriage actually happens when blood and tissue leave the uterus, causing it to contract. Aside from cramping, the most telltale sign of miscarriage is heavy bleeding that doesn’t let up. Contact your doctor right away if you suspect miscarriage.

RELATED: 22 Weird Pregnancy Symptoms You Might Not Expect
Cramps During the Second Trimester
Women are less likely to experience cramping or other uncomfortable pregnancy symptoms during the second trimester. One exception is for women who are pregnant with multiples, since the uterus grows more rapidly and will reach third-trimester proportions in the second trimester. Here are some other causes of second trimester pregnancy cramping.

Round Ligament Pain: This benign pain occurs around week 13 when the ligaments that support the uterus stretch as the uterus grows upward. Round ligament pain is usually quick, sharp, and one-sided.

Urinary Tract Infections. Mild UTIs can also cause cramps during pregnancy in the second trimester. Other symptoms include painful urination, the frequent need to pee, and lower abdominal discomfort. Contact your doctor if you think you have a UTI.

Uterine Fibroids: A more serious, but rare, cause is uterine fibroids. These harmless overgrowths of tissue can start breaking down in the second trimester (usually between 15 and 18 weeks of pregnancy) because there’s not enough blood to sustain their growth. The pain is pretty severe. Any woman who has a history of uterine fibroids should watch for pregnancy cramps at this point, because she may need hospitalization to manage the pain effectively until it passes.

RELATED: What Are the Different Types of Contractions, and What Do They Mean?
Cramps During the Third Trimester
It’s very common for women to experience cramping in the third trimester—often in the form of Braxton Hicks contractions. These “false contractions” don’t actually progress into labor, but they help prepare your body for delivery. While Braxton Hicks contractions only last between 30 seconds and two minutes, you can relieve symptoms by drinking some water and resting.

Of course, if third trimester cramping doesn’t quickly subside, you could be experiencing preterm labor. Call your doctor right away and express your concerns; they might want to evaluate you right away.

Other serious causes of cramps during the third trimester include placental abruption (when placenta separates from the uterine wall) and preeclampsia (a condition characterized by sudden high blood pressure). Call your doctor for cramping accompanied by bleeding, severe headaches, shortness or breath, swelling, or vision changes.

RELATED: Signs of Preterm Labor and What Your Doctor Will Do
Is My Cramping Normal During Pregnancy?
Sometimes cramping is normal during pregnancy. According to experts, you shouldn’t worry about cramping after sex. “Intercourse is one of the most common causes of cramping,” says Dr. Puritz. That’s because semen contains prostaglandins that stimulate the uterus. She adds that it’s completely fine to have sex, and if you have cramps afterwards, try getting off your feet and hydrating.

It’s also a good sign if changing position makes cramps better or worse. This generally means you’re experiencing cramps related to stretching of the uterus or its supporting ligaments, which is completely normal during pregnancy. Finally, if you feel better after passing gas, the pain is likely related to a gastrointestinal problem instead of the uterus, says Dr. Klauser.

On the other hand, certain scenarios indicate that something more serious could be happening. Watch out for the following red flags and inform your doctor ASAP if you notice them.

You have six or more contractions in an hour, which could be a sign of preterm labor. Also watch for other symptoms of preterm labor, including changes in vaginal discharge, pelvic pressure, and dull backaches.

Cramping comes with dizziness, lightheadedness, or bleeding—especially if you haven’t yet confirmed your pregnancy with an ultrasound. This can be a sign of an ectopic pregnancy. Bleeding can also be a symptom of miscarriage or placenta previa, a condition in which the placenta covers the cervix.

You have persistent cramping when you are pregnant with multiples (which increases your risk of preterm labor), have a history of preterm labor or ectopic pregnancy, or have been diagnosed with a shortened cervix.

RELATED: Signs of Approaching Labor: How to Tell Your Baby is Coming Soon
You have intense back or abdominal pain that’s associated with nausea, vomiting, and/or fever. Back cramping and/or pain in your abdomen area could be symptoms of appendicitis, kidney stones, or gallbladder disease.

Your cramping isn’t improving over time. It’s also important to get checked out if changes in physical position don’t alleviate the cramping sensation.

You have signs of preeclampsia, which include pain in the upper-right side of the stomach, headaches, swelling, vision changes, and sudden weight gain. These usually show up in the third trimester.

How to Relieve Cramps During Pregnancy
If you have pregnancy cramps that don’t seem worrisome, Dr. Puritz advises getting off your feet, resting, drinking fluids, and taking acetaminophen (Tylenol) if needed for pain relief. Don’t use a heating pad on your abdomen because raising your core temperature is dangerous during pregnancy, especially in the first trimester. (Using one on your extremities is fine, Dr. Puritz says.)

Dr. Klauser recommends that his patients try a warm shower. They might also benefit from stretching and sitting breaks throughout the day, particularly if their cramping is worse after long periods of being in one position.

Most importantly, always contact your doctor for unusual cramps or ones that don’t go away. “I always tell my patients that I love a false alarm,” says Dr. Puritz. “I’m happy to see you and say you’re fine rather than miss something where I could have intervened.”

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