If you’re pregnant and feeling a hard stomach, you may be wondering if something is wrong. In most cases, a hard belly in the third trimester is normal and is caused by your baby’s position or your body’s changing shape. However, there are some situations where a hard stomach can be a sign of a problem. Keep reading to learn more about what causes a hard stomach during pregnancy and when you should see a doctor.
But first, how do I know all of this? Hi — I’m Hilary — The Pregnancy Nurse 👩⚕️. I have been a nurse since 1997 and I have 20 years of OB nursing experience, I am also the curly head behind Pulling Curls and The Online Prenatal Class for Couples. 🩺 I have talked with hundreds women about why their stomach feels hard and what is normal — so I’m a good resource if it’s a question for you!
Come join me in my free beginning prenatal class to talk more about the third trimester!
What Causes a Hard Stomach During Pregnancy?
Baby’s Growth (and subsequence uterus growth)
In the third trimester, your baby grows rapidly and begins to move into a head-down position in preparation for birth. As your baby drops lower in your abdomen, you may notice that your belly feels harder. This is because your baby is taking up more space and pushing against your abdominal muscles. You may also feel an occasional sharp pain as your baby kicks or stretches.
Your body shape is also changing during pregnancy, which can contribute to a feeling of fullness or heaviness in your abdomen. As your uterus expands, you have some pregnancy weight gain and your stomach muscles stretch, you may notice that your belly feels hard at times.
This is normal on your first baby or even other babies as well.
Pro Tip: As baby moves and grows your stomach may even feel different day to day. It’s crazy to think you’re growing a human inside of you, right?
Contractions can also make your belly feel hard. Often a pregnant woman will wonder what the tightening sensation is.
Early contractions are often not painful — more like just contracting your bicep or glutes (so it can be confusing as they expect all contractions to be painful).
No matter if they are Braxton Hicks contractions or “real contractions” it is still making your uterus contract (and just like when you contract any of your muscles it gets hard).
You may feel these contractions of the uterine muscles just in your lower abdomen, or your back (usually lower back), period cramps, or full abdominal pain — all aren’t unusual.
In fact, most women call the beginning of labor as mild menstrual cramps that extend into more pains.
However, if they are frequent you may be having labor (or preterm labor if you are before 36 weeks). If you’re still in your early pregnancy it’s a good idea to ask your provider at your prenatal visits how many contractions are OK to have before you call them. As you get further into your third trimester of pregnancy (past 36 weeks of pregnancy) these are normal contractions getting your uterus ready for labor.
Contractions come and go — most often you’re not in constant pain with a contraction. So, you’ll have a contraction and then a few minutes will go by, and you’ll feel another one. This is true of real labor and false contractions.
Pro Tip: I felt like my stomach was hard all the time as I was standing up sitting up straight. However, if I laid down on my side and pulled my knees up my stomach would relax and I’d be more easily able to tell if it was a contraction or just my growing baby.
What are Braxton-hicks contractions? Mostly it is just your uterus contracting, often due to growth. But it can be due to fetal movement, your movement or any number of things. They are really normal, but the biggest indicator that it is just Braxton Hicks is that it doesn’t turn into full blown labor where contractions come at regular intervals, get closer together and more painful with time. If the contractions don’t do that it’s normally just a “false alarm” and you just need to keep an eye on it.
Remember true labor contractions are when they are making your cervix open and actively dilate. False labor contractions can still hurt, but aren’t causing your cervix to change or dilate.
Yes, labor can be more confusing than you think it will be. We have a WHOLE CHAPTER in The Online Prenatal Class for Couples that outlines how to know if you’re in labor.
Hard Stomach During Your Second Trimester?
Some people may also feel this during their second trimester. Most often this isn’t an issue unless accompanied by pain or bleeding. However even if it seems benign it might be worth mentioning to your provider at your next appointment.
Is really isn’t unusual to have “practice contractions” throughout your pregnancy, even long before your due date — but you shouldn’t have them frequently. Ask your provider how many are OK to have in an hour.
My Stomach Hurts But It Isn’t Hard
There are a lot of reasons that your stomach may hurt during pregnancy
Growth of your uterus is obviously causing muscles and organs to shift around as you get closer to the end of your pregnancy.
Often, pregnant women experience round ligament pain. The round ligaments are the ligaments that help attach your uterus to your body. As they stretch and grow it can be painful. In general these tend to be sharper longer-lasting pains vs a contraction. Often women experience this pain when they cough or sneeze, or when they stand-up or twist their body in an awkward way.
If it’s near your belly button it could also possibly be a hernia. Sometimes, as those stomach muscles expand with your growing uterus it can cause a gap where a hernia could happen. The good news is that most often this goes back to normal after pregnancy, and no intervention is needed. However if you’re having severe pain around your belly button you’d want to contact your healthcare provider as they can sometimes be an issue that needs help.
Baby’s Movements can also hurt. As baby’s position changes you can have some pain as things shift and move in that area. Often that’s ligament pain but it could also be gastrointestinal tract adjusting to where the baby wants to be right now.
It could also be a bladder infection. If you are having any burning with urination, or frequent urination (more than before, I know this one can be confusing) it COULD be a bladder infection. These happen often during pregnancy and aren’t unusual with hormonal changes. Ask your provider if you can leave a urine sample to see if that’s the issue. My sister site has a good post on bladder infections.
Pro Tip: With all these changes in your body it can be easy to forget about baby’s movements. Make sure you’re still doing your kick counts during this time! The best way to do these is outlined in this podcast.
How do I know if my hard stomach is labor?
Normally if it is just a hard stomach without pain or any other symptoms it is likely just your growing uterus.
However, if you are staring to feel the pain along with some of these other following symptoms of labor you could consider that you’re going into real labor:
- Loss of your mucus plug
- Changes in your vaginal discharge
- You have back pain as well as abdominal pain
- Nausea/Vomiting or Diarrhea
Again, these signs of labor aren’t something we want to see until you’re in the home stretch of pregnancy — full term. If they’re happening before 36 weeks, call your provider. Most often they have someone on for them 24/7 to answer important questions like these.
BTW, if you’re seeing signs of labor, it’s time to pack your hospital bag!
What can I do about my hard stomach?
If your stomach tightening is without pain you can just feel assured it is just due to your growing baby bump and it is a normal part of pregnancy.
However, if it is accompanied by any of the signs below (in the next “problem” section) or it is painful it might be something to contact your health care provider about.
At the very least pain is often a sign that it is time to take it easy. Lay down or at least put your feet up.
Maybe this is a good time to watch your childbirth classes, work on your birth plan and drink some water. Did you know that a lot of “false labor” is caused by dehydration. So making sure you get a LOT of water in you every day is so important.
When Is a Hard Stomach During Pregnancy a Problem?
In most cases, a hard belly during pregnancy is nothing to worry about. However, there are some situations where it can be a sign of a problem. For example, if you suddenly develop severe pain in your abdomen or feel faint or dizzy, this could be a sign of placental abruption, which is when the placenta starts to separate from the uterine wall before delivery.
Placental abruption can be dangerous for both mother and baby, so it’s important to call your doctor right away if you experience any of these symptoms.
Other warning signs that warrant a call to the doctor include
- Vaginal bleeding;
- Contractions (as I’ve said, be sure to know how many contractions are OK for you)
- Severe headaches
- Visual changes such as blurred vision or light sensitivity
- Excessive swelling in the hands, feet or face (especially if it sudden)
- Decreased movement from baby
- Difficulty breathing
- Persistent nausea or vomiting.
- Leaking of amniotic fluid (or if your water breaks)
If you experience any of these symptoms, call your doctor right away or go to the nearest emergency room.
Your growing pregnancy belly is an usual thing and it can be really hard to know what’s going on with you.
Let me walk by you these final months of pregnancy with my expert advice. I can prepare you for your confident birth in just 3 hours in The Online Prenatal Class for Couples The class is quick, fun and meant to be done together to get you BOTH prepared.
And, if you’re not quite sure you’re ready for that whole thing, check out my free prenatal class. It’s your first step toward becoming your own birth boss.
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A nurse since 1997, she has worked in various fields including pediatrics, geriatrics & hospice.
She has 20 years of labor and delivery experience in the San Jose, CA and Phoenix, AZ areas.