Sharp Abdominal Pain During Pregnancy: Causes at 21’ish weeks?

Are you having sharp abdominal pain during pregnancy?  You may wonder if it’s normal and what the causes of that sharp pain could be.  Today I’m going to share some of the causes and what you should do about it?

But first, how do I know so much about abdominal pain?

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 had THOUSANDS of patients come into the hospital for abdominal pain, so I have seen what is causing it and what can help it.

Note: Abdominal pains can be evidence of a problem during pregnancy.  If the pains are very painful and long-lasting I’d call your provider right away. But if they go away pretty quickly it is still something to mention to them at your next check-up.  Complications could be preterm labor or something wrong in your abdomen and those are emergencies that need looked at ASAP.  Please take the advice over your provider right away over anything in this purely informational article.

21 Weeks Pregnant Sharp Abdominal Pains:

I’m going to focus in on 21 weeks because it gets a bit more complicated later in your pregnancy, but honestly these could always be the culprit no matter when you are in pregnancy.

The main culprits of sharp abdominal pain mid-pregnancy are:

• Round Ligament Pain
• Stomach Cramps
• Pains of a growing Uterus

Note: Prior to seeing baby in your uterus there is a chance that you have an ectopic pregnancy if you are having sharp abdominal pains.  This is something you’d need to contact your provider about ASAP.

Let’s dive a bit deeper into these:

Round Ligament Pain

You uterus attaches to your body with several ligaments called the round ligaments.  As your uterus grows these will stretch.  Around 20 weeks baby will start to get much bigger.  You’ll notice this as you no longer can wear pants that used to fit, etc.

As that uterus stretches those round ligaments get stretched and can get VERY angry and portray that through sharp pains.

Most often these are noticed on the edges of your uterus (not directly over your uterus) — to the sides of your body and pelvic floor.

They also usually sharp and can last a few minutes.  They can also even extend to your groin or cause back pain as your muscles compensate for the changes due to pregnancy.

Ways to help round ligament pain:

Using a heating pad can help your body relax.  I actually recommend a microwavable heating pack and to place it on your sides or over your pelvis, NOT directly over your uterus. You can also try a warm bath to help your muscles relax.

Support your uterus by using things like support straps or maternity bands.  This makes your ligaments feel some support and they won’t be as painful

Watch what is causing this pain.  Often I found it to happen when I got-up really quickly, coughed/sneezed or got out of the car fast.  I learned that by doing these activities differently (rolling to my side and then getting up) or slower it really helped.

Physical therapy can also be helpful if you find them a lot.  They can pinpoint pain movements in your daily life and help you adjust those to live more pain free.

Before we keep going — having tips like this that make it EASY to understand what’s going on is HUGE for pregnancy. If you like simple tips like these, check this out. I needed tips like this that took me from pregnancy through to postpartum, and I love that it’s available to you now.

The Online Prenatal Class for Couples is one you can join right now and then spread it out until your due date so you’ll be totally ready before you know it! Couples love it!

Stomach Cramps

You may just have some good old-fashioned stomach pains.  Maybe you ate something that didn’t agree with you, or you might have caught a stomach bug.  Remember to follow the rules of safe eating during pregnancy (grab my guide here):

When accompanied by nausea, vomiting or diarrhea there is a good chance this is your culprit.

However, if you’re having issues keeping fluids down or are having LOTS of diarrhea it’s best to call your provider to see what they think.

Pains of a growing Uterus

While the round ligaments are usually the most angry as your womb grows, your other abdominal contents can be upset as the uterus grows — especially in the second trimester as this is the first time they will have to adjust.

Sometimes your intestines, bladder or other organs get a little spicy because of the shifting.  Sometimes changing positions or stretching a bit will help them fall into place happily.

Also, it could possibly be a hernia — check out my post on bellybutton pain for more on that issue.

What else could it be?

That’s clearly not EVERYTHING.  Other things that might an issue:

You may think it’s contractions, and it could be — but most people don’t describe contractions as SHARP. Usually they describe them as rhythmic cramps that come and go. If your pains aren’t of that nature we often look to see what else it could be…

Bladder or Urinary Tract Infections: These are more common in pregnancy, if you notice any symptoms of a bladder infection you should call your provider right away as it can be problematic.

Miscarriage: Yes, this pain could be cramps due to a miscarriage, so if you have any questions that this is the problem please call your provider.  In general a miscarriage would be accompanied by vaginal bleeding and a cramping of the uterus as well.

C-Section Scar Issues: I have a whole post on feeling pain over your C-section scar you might find helpful if you have previously had a cesarean section.

Implantation Pain: EARLY in pregnancy (much earlier than 20 weeks) your placenta will be attaching to your uterus and there can be some pain due to implantation.  Most people don’t even know they’re pregnant when this happens and it is normal — but ANY questions call your provider.

Of course, there are a million other pregnancy complications it COULD Be — but these are the most likely.  Remember ANY questions, please call your provider.  They should have someone who answers calls for them 24 hours/day – so call their line if you’re having issues (or you can always go to labor and delivery).

Hopefully the pains have cooled down a bit now. If you’re around 20 weeks it is PRIME time to find your pregnatal class. I hope you’ll check-out The Online Prenatal Class for Couples and decide if it’s the right one for you! I hope I’ll see you inside!

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 getting in the driver’s seat of your birth.