The third trimester is notoriously difficult. From breathing through Braxton–Hicks contractions and wondering whether they are the real thing to stretching skin and crowded organs, people may feel exhausted and ready to give birth by the end of the third trimester.
Stomach pain is a common pregnancy complaint. Some people report pain in the upper stomach or upper abdomen during their third trimester. This pain may be sharp and shooting or a dull ache.
Many of the causes of upper abdominal pain are harmless, but feeling intense pain here can signal a serious problem. Talk to a doctor or midwife about any unusual or very painful sensations.
In this article, we look at the possible causes of upper abdominal pain during pregnancy, how to ease the symptoms, and when to see a doctor about it.
Is this pain normal?
Abdominal pain can occur in the third trimester, as the uterus begins to crowd the organs.
Stomach or abdomen pain is more common during early pregnancy, when hormonal shifts can trigger the nausea and vomiting of morning sickness. In the middle of the second trimester, at around 20 weeks, stomach pain usually goes away.
In the third trimester, abdominal pain can reappear as the uterus begins to crowd the organs. Some women experience heartburn or a sensation that the skin of the stomach is stretching.
Having stomach pain in the third trimester may indicate a more serious problem if it:
- occurs with other symptoms, such as itching
- feels sudden or intense
- is constant
- is in a specific location
- appears alongside a fever, nausea, or vomiting
- appears alongside vaginal bleeding
What can cause it?
Many causes of upper abdominal pain in the third trimester are harmless. However, because premature labor, placenta issues, and other concerns can endanger the woman and the baby, it is important to be cautious and tell a doctor or midwife about any unusual symptoms.
Possible causes of upper abdomen pain during the third trimester include:
Constipation and gas
Constipation is one of the most common pregnancy complaints.
During the first trimester, hormonal shifts may trigger constipation. By the third trimester, the uterus is putting significant pressure on the intestines and making it more difficult for a person to have a bowel movement.
Having a vague feeling of fullness in the upper stomach or abdomen is sometimes a symptom of severe constipation. Other symptoms might include gas, straining to have a bowel movement, and having very hard or small bowel movements.
Eating fiber-rich foods may help. Taking laxatives can also provide relief, but it is important to talk to a doctor or midwife before taking any medication when pregnant.
Taking over-the-counter medication may ease heartburn during pregnancy.
Heartburn is a common symptom, affecting an estimated 17–45 percent of women during pregnancy. A pregnancy hormone called progesterone can cause acid reflux and heartburn.
As the uterus grows, pressure on the digestive tract can make this problem more severe. Many pregnant women experience acid reflux when lying down.
Pain in the upper abdomen may be from acid reflux if the pain extends up the chest and into the throat or includes a burning sensation. Some women belch or experience gas.
Taking over-the-counter heartburn medications, eating smaller meals, and opting for a less acidic diet may help.
Some pregnant people report feeling an intense sensation of stretching skin. As the uterus expands, this sensation can extend to the upper abdomen. If the skin itches and feels tight, and the pain is on the outside of the stomach rather than deep in the abdomen, stretching skin could be the culprit.
Gently massaging the area, applying lotion to it, and taking warm showers can sometimes help relieve the discomfort.
Muscle pain and strain
The abdominal muscles must stretch to accommodate the growing fetus. The pressure of the uterus on the lower body can also change the way a person walks or moves, increasing the likelihood of sustaining an injury.
Feeling pain when bending or lifting may mean an injury to the stomach or chest muscles. Resting and stretching can help with minor injuries. People can see a doctor about injuries that do not go away on their own.
Pain in the upper right part of the abdomen, under or near the ribs, may mean that there is a problem with the liver or gallbladder.
If there is nausea or vomiting, or if the pain comes in waves or attacks, it may be a sign of gallstones. Left untreated, gallstones can block the bile duct and cause liver problems.
If the gallstones do not pass on their own, a doctor might recommend removing the gallbladder.
Pregnancy-related hormone changes can cause a condition called intrahepatic cholestasis of pregnancy (IHP), or cholestasis. For most women, the first symptom is itching. Some also experience pain in the upper abdomen, nausea, vomiting, or yellowing eyes or skin.
A doctor must carefully monitor liver health in a person with IHP. In some cases, they will need to deliver the baby early to prevent serious complications, including liver failure and injuries to the developing baby.
Pancreatitis is inflammation in the pancreas. Infections, injuries, and problems with other organs, including the liver and gallbladder, can cause pancreatitis.
Pancreatitis may cause upper abdomen pain, exhaustion, nausea, or changes in the color of stool.
Depending on the cause of pancreatitis, a woman may need to stay at the hospital. In some cases, a doctor may recommend antibiotics or fluids.
Pain in the upper abdomen, especially the left side, may mean that there is a problem with the spleen.
A blow to the stomach can bruise or injure the spleen. Infections can cause the spleen to rupture. Rarely, a person’s spleen may rupture for no clear reason.
Spleen injuries cause intense, sudden pain. A woman may feel dizzy or lightheaded, and they must seek emergency treatment. A surgeon may need to remove the spleen.
True labor contractions typically start at the top of the uterus, causing an intense tightening sensation that becomes progressively more painful. A woman who feels contractions beginning in the top of the abdomen may be going into labor.
Call a medical professional straight away. If there is vaginal bleeding, go to the emergency room.
Treatment and home remedies
The risk of missing a serious problem far outweighs any benefits of trying home remedies. If the cause of the problem is unclear, call a doctor or midwife first.
If they feel that the pain is not dangerous or does not need medical treatment, some home remedies that may help ease upper abdomen pain during pregnancy include:
- stretching to ease muscle pain and tension
- eating fewer acidic foods
- with a doctor or midwife’s permission, using an antacid to deal with heartburn
- eating smaller, more frequent meals to reduce the pain of a full stomach and heartburn
- massaging the area to ease muscle tension and stress
When to see a doctor
It is important to see a doctor or midwife if experiencing any unusual pain in the stomach or abdomen.
Call a doctor or midwife within a day for any unusual pain in the stomach or abdomen. At each visit with a provider, talk about any recent symptoms, as well as any symptoms that have changed in severity.
Go to the emergency room or immediately call a medical professional for:
- intense upper abdominal pain, especially if it is on the right side or if the pain is unbearable
- abdominal pain accompanied by vaginal bleeding
- contractions that come at regular intervals
- abdominal pain and a fever
- symptoms of high blood pressure, such as dizziness, difficulty breathing, a bad headache, or intense fatigue
- itching, yellowing skin or eyes, or vomiting
Most causes of stomach or abdominal pain in the third trimester are not fully preventable. As the fetus grows, the organs must shift. This can cause some aches and pains.
For some women, hormonal shifts trigger serious complications, such as IHP.
The best strategy to prevent serious pregnancy complications is to get regular prenatal care. Talk to a provider about any concerns, and ask about lifestyle strategies to ensure a healthy pregnancy.
For most women, eating a healthful and balanced diet, getting regular exercise, and devising healthful strategies for managing stress can all help with the aches and pains of pregnancy.
Abdominal pain is one of the most common pregnancy complaints. This does not mean that a woman should ignore it. Only a doctor or midwife can diagnose the problem, so do not hesitate to call them.
They can either reassure a person that there is nothing to worry about or offer medical care to prevent an emerging condition from becoming more serious.