Abdominal tightening can be a sign of the uterus stretching, gas, or pregnancy loss, depending on the stage of pregnancy. In the third trimester, Braxton Hicks contractions or labor can cause feelings of tightness in the stomach.

There are many reasons for the stomach or abdomen to tighten during pregnancy, and these may vary, depending on the trimester.

In this article, we look at the causes, as well as when to speak to a doctor.

Woman holding her belly due to stomach tightening during pregnancyShare on Pinterest
As the uterus grows in the first trimester, the stomach may feel tight.

There are many reasons why a woman may feel her stomach is tightening during the first trimester of pregnancy, including:

Stretching

During the first trimester, the uterus is growing and stretching rapidly to accommodate the growing fetus.

This can cause abdominal cramping or sharp, stabbing, or shooting pains along the side of the abdomen, as the ligaments and other tissues stretch.

Gas or constipation

Gas pain is a very common problem throughout pregnancy. It can cause cramping or shooting pain in the abdomen, and it can be very painful.

Constipation is also a common complaint in early pregnancy. The changing pregnancy hormones can slow down the gastrointestinal tract.

Also, the iron in some prenatal vitamins can harden stool and make it difficult to go to the bathroom. Both gas and constipation can sometimes make it feel as if the stomach is tightening.

Miscarriage

Rarely, tightening of the abdomen can signal a miscarriage, which is the loss of a pregnancy before 20 weeks.

However, a miscarriage is most common before the 12th week of pregnancy. Other signs of a miscarriage include:

  • mild to severe back pain
  • bright red or brown vaginal bleeding
  • cramping
  • vaginal discharge of tissue or clots
  • decrease in the symptoms or signs of pregnancy, such as morning sickness or breast tenderness

The signs of a miscarriage vary between individuals and, in some situations, a woman may not have any signs at all. It is important for a woman to get regular prenatal care during early pregnancy so that her doctor can monitor the baby’s development.

In early pregnancy, a woman should call the doctor’s office with any vaginal bleeding, especially if it is red and resembles a period.

Stretching, cramping, and stabbing pain along the sides of the uterus often continues into the second trimester, and is known as round ligament pain. The round ligaments are located on either side of the uterus and connect the uterus to the groin.

During pregnancy, the ligaments stretch as the uterus grows, which can cause the sharp pain. This pain commonly occurs with changes in position, such as sitting to standing or bending down.

Most women start to feel their uterus contract and periodically tighten some time during the second trimester, the point in their pregnancy between 14 to 28 weeks. These are known as Braxton-Hicks contractions, false labor, or practice contractions.

The purpose of Braxton-Hicks contractions is for the uterus to prepare for the hard work of labor and delivery. It is thought that they help to tone the muscle in the uterus and promote blood flow to the placenta.

Braxton-Hicks contractions are normal and very common. They typically last for around 30 to 60 seconds but can be as long as 2 minutes. They are not as painful as regular contractions, but can still cause considerable pain and discomfort.

Some things may trigger or worsen Braxton-Hicks contractions:

  • sex or orgasm
  • dehydration
  • a full bladder
  • sharp kicking by the baby

Even though Braxton-Hicks contractions are common during pregnancy, it is important to mention them to the doctor at prenatal visits. The doctor can help determine whether they are Braxton-Hicks, or if they could be a sign of preterm labor.

It is important to call the doctor if:

  • contractions get stronger or closer together
  • contractions are not relieved by rest or drinking water
  • there is fluid leaking from the vagina
  • there is vaginal bleeding

A doctor should evaluate these symptoms to make sure that a woman is not experiencing complications or preterm labor.

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During the third trimester, Braxton-Hicks contractions may increase in strength.

Stomach-tightening associated with Braxton-Hicks contractions increases in strength and frequency during the third trimester. These contractions are especially common during the last few weeks of pregnancy as the uterus prepares for birth.

However, it is still important to notice and keep track of them. If a woman has more than a few in an hour, she should speak to her doctor.

Things a person can do to relieve the pain and stretching feeling include:

  • Drinking a glass of water: Dehydration is a common trigger for Braxton-Hicks contractions. Try having a big glass of water and lying down for a few minutes.
  • Using the bathroom: Having a full bladder is associated with increased Braxton-Hicks contractions. Sometimes, just using the bathroom and emptying the bladder can stop the contractions.
  • Changing positions: Sometimes body position can put pressure on the uterus, triggering Braxton-Hicks contractions. Try shifting positions or lying down.
  • Taking a warm bath or shower: Sitting in a warm tub can relax tired or achy muscles, including the uterus.
  • Drinking a cup of tea or warm milk: Warm milk or herbal tea can be both relaxing and hydrating.

It is important to call a doctor if home remedies do not relieve stomach tightening or if there are more than four contractions in an hour.

Many women have called their doctor or gone to the hospital if they experience Braxton-Hicks contractions, especially near the end of their pregnancy. As Braxton-Hicks contractions get stronger and more frequent, it often feels as if labor is beginning for real.

There are a couple of differences, however:

Braxton-Hicks contractionsTrue labor
Irregular in intensity and frequencyGet closer together and progressively stronger
UncomfortablePainful
May be relieved with home measures, including drinking water or lying downHome measures do not relieve them
No other signs of laborMay have other signs of labor

Other signs of labor can include:

  • back pain or cramping
  • leaking of fluid from the vagina
  • bloody vaginal discharge

As always, it is essential to contact the doctor or make a trip to the hospital with any questions or concerns.