Is Cramping in Early Pregnancy a Sign of Miscarriage?

Learn How to Decode Your Abdominal Pain

Young woman in bed with PMS suffering
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If you're pregnant, you're likely paying extra close attention to your body. This tends to be especially true in the first trimester when experiencing a miscarriage is the most common, occurring in 10 percent to 25 percent of pregnancies, according to the American Pregnancy Association.

Every time you feel something inside your abdomen, you might wonder: What was that? Is something going wrong with my pregnancy? Is my baby OK? 

A little bit of anxiety is totally normal. After all, your life is about to change with the addition of this tiny bundle of joy. Your instinct is to protect your little one and make sure that he or she is as healthy and as safe as possible. 

If you happen to feel a cramp at some point during your pregnancy, what exactly does that mean? Does it signal what you're dreading—that you're having a miscarriage? It depends on when it occurs, the severity of the cramping, and whether you're experiencing other symptoms alongside it. Find out more, below. 

Cramping in Early Pregnancy

Having cramps in your lower abdominal area or lower back in early pregnancy (the first trimester) most likely signals one of three things:

  • Normal pains: The good news is that cramping without bleeding is usually not a sign of miscarriage. Cramps or short-lived pains in your lower abdomen can happen early in a normal pregnancy as your uterus adjusts to the implanted baby. These pains are likely mild and brief. If you feel anything severe and/or prolonged, always call your doctor to be safe.
  • Miscarriage: There are times when cramping can, indeed, be a sign of miscarriage—when the cramping is accompanied by spotting or other vaginal bleeding. You should call your doctor for advice and possibly to schedule some testing to determine whether you are having a miscarriage. A miscarriage can occur within the first 20 weeks of gestation, but chances are higher that it will occur in the first trimester.
  • Ectopic pregnancy: If you are feeling faint and/or if your abdominal cramping is severe, your cramping may be a symptom of ectopic pregnancy. An ectopic pregnancy is a pregnancy that implants outside the uterus, usually in a fallopian tube. This happens in only one out of every 100 pregnancies. This type of pregnancy is, unfortunately, not viable. In fact, it can put the mother's life in danger if the fallopian tube ruptures, causing severe bleeding, and she doesn't undergo emergency surgery immediately. Go to the emergency room to be evaluated.

Signs of a Miscarriage—What to Look Out For

According to the American Pregnancy Association, these are the signs and symptoms of miscarriage to look out for:

  • Bleeding: Brown or bright red, with or without cramps.
  • Clots of tissue passing from the vagina
  • Mild to severe back pain that's worse than normal menstrual cramps
  • Weight loss
  • White-pink mucus
  • Very painful contractions every 5 to 20 minutes
  • A sudden decrease in the signs of pregnancy, such as breast tenderness or morning sickness

Contact your doctor if you notice any of these symptoms. Miscarriage is the most common cause of early bleeding in pregnancy. However, it's important to note that the statistics include something called threatened miscarriage.

This is diagnosed when there's uterine bleeding but the cervix is closed and an ultrasound shows that the baby's heart is beating. Fortunately, threatened miscarriages don't always result in pregnancy loss, even when there's a lot of blood and more than one incident. If you experience spotting or bleeding that's concerning, your doctor may perform an ultrasound to check on the baby's status.

Cramping in Late Pregnancy

Cramping in the second or third trimester could be harmless or concerning—it depends on the situation.

  • Round ligament pain: You may experience shooting pains in the lower abdomen or around your hips due to a phenomenon called round ligament pain, which occurs as your body accommodates your growing uterus. These types of pains are normal and will pass.
  • Preterm labor: If cramps are occurring at regular intervals (try timing them), it's important that you know the signs of preterm labor. Signs of preterm labor include having more than five cramps or contractions in one hour, vaginal bleeding that's bright red, a sudden gush of clear, watery fluid from your vagina, a low, dull backache, and intense pelvic pressure. If you experience any of these symptoms, call your doctor immediately.

A Word From Verywell

Talk to your doctor whenever you are concerned about any level of cramping during pregnancy. It can be a stressful time, and talking to your doctor about your symptoms can be very reassuring.

Sources:

Miscarriage: Signs, Symptoms, Treatment and Prevention. American Pregnancy Association. http://americanpregnancy.org/pregnancy-complications/miscarriage/.

Norwitz ER, Park JS. Overview of the etiology and evaluation of vaginal bleeding in pregnant women. UpToDate. https://www.uptodate.com/contents/overview-of-the-etiology-and-evaluation-of-vaginal-bleeding-in-pregnant-women.

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