Assessing abdominal pain in pregnancy

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As your uterus grows out of your pelvis your internal organs shift and ligaments and muscles make huge adaptations to accommodate your expanding belly. This can cause some strange and uncomfortable sensations. Here's what you need to know.

Sharp pain in side or groin that lasts less than 2 minutes

Pain felt along the sides of the abdomen is common during pregnancy, usually in the first and third trimester. Often described as a stitch-like pain on the right or left, it can take your breath away when it strikes. A possible cause is spasm of the round ligament holding the uterus in place. These short, thick round ligaments stretch to accommodate your growing uterus. Sometimes they stretch too suddenly, such as when you get out of bed or move awkwardly and go into a brief spasm.

What can you do for this pain?

When pain strikes breathe deeply and slowly and bend towards the pain. Two tablets of mag phos (tissue salt No. 8) under the tongue three times a day may help alleviate this spasm.

Warning signs

If the pain is accompanied by a rigid abdomen, nausea or vomiting, or dizziness or pain lasting more than two minutes, it could indicate an emergency in the placenta or uterus and should be seen to immediately.

Pressure or pulling in your lower abdomen

As your pregnancy progresses it is normal to feel pressure or pulling in your lower abdomen. This uncomfortable sensation is usually caused by the increasing weight of your uterus, the placenta, amniotic fluid and your growing baby. As your abdomen starts to bulge over your pubic bone and gravity takes over, the hipbones that support this added weight start to feel sore and tired. The ligaments supporting the joints of the pelvis start to soften and loosen in response to the pregnancy hormones. This allows laxity and movement in the joints sometimes causing debilitating discomfort and pain. 

How to minimise this pressure

Don’t stand for long periods of time. If your occupation demands extended weight-bearing periods, it may help to wear an abdominal brace or support panties, which may be covered by your medical aid.  Do exercises that strengthen your back and abdominal muscles and adopt positions that take your baby’s weight off your lower abdomen. Strengthening the pelvic floor muscles will alleviate a lot of abdominal discomfort.

Signs to look out for

Should you have a watery, pinkish discharge along with this pressure consult your caregiver; it could mean premature labour.  

Sensitivity in the abdominal wall

You may experience navel discomfort towards the end of your pregnancy, caused by the thinning of the abdominal muscle underneath the skin, making it feel paper-thin and very sensitive. Gentle abdominal massage with a little lotion or oil will soothe and relax the abdominal area. Do appropriate exercises under supervision to strengthen the abdominal muscles and correct your posture. If the separation of your abdominal muscles becomes severe, you could experience extreme backache.

Sharp, burning pain in the pubic bone or groin area

Relaxation and loosening of the pelvic ligaments as a result of pregnancy hormones can cause movement and discomfort at the symphysis pubis joint.

Limit your movements

Do not do anything that makes this pain worse. Take small steps and keep your knees close together. Do not cross them when sitting. Avoid awkward movements, especially when getting in and out of bed. Limit your weight-bearing periods and wear an abdominal support belt. If this pain stops you from walking normally, consult a physiotherapist.

Sensitive ribs

During the second half of pregnancy, your growing baby pushes your abdominal organs up towards your chest, forcing your ribcage to expand more than is normal. This constant tension in the muscles and ligaments in your chest may leave the area just below your ribs feeling sore or even numb in spots.

Exercise can help

Exercises that involve lifting your arms up and out to the sides may help. Make sure your posture is the best it can be and do not “slouch” over your already crowded uterus. Whenever you can, sit up as straight as possible and do focused belly breathing, to relieve some of the tension and discomfort of aching ribs.

Look out for

Any pain felt under the ribs, particularly on the right side, may be cause for concern, especially if you have high blood pressure. Always check with your caregiver if you are worried. 

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