When Should I Worry About Cramps in the Third Trimester?

Pregnancy symptoms in the third trimester include many different types of discomfort, which include cramping. Cramping in pregnancy is normal and typically shouldn't cause worry, except in the case of a urinary tract infection (UTI), ectopic pregnancy, miscarriage, preeclampsia, preterm labor, or placental abruption.

The third trimester (the last three months of a pregnancy) are often accompanied by a number of uncomfortable symptoms. Cramping during pregnancy is common and normal, and not always a cause for worry. 

However, there are some serious causes cramping during pregnancy, such as: 

• Urinary tract infections (UTIs)
  • Cramping accompanied by painful urination may indicate a UTI
• Ectopic pregnancy 
  • Is usually a problem earlier in pregnancy
  • A fertilized egg implants outside a uterus
  • This causes painful cramps
  • It is a serious condition that must be treated
• Miscarriage
  • Cramping may range in severity from mild to sharp and be accompanied by vaginal spotting
  • Contact your doctor right away if you experience severe cramps and/or heavy bleeding
• Preeclampsia
  • A serious complication of pregnancy in which high blood pressure (hypertension), protein in the urine, and evidence of organ injury develops in a pregnant woman after 20 weeks of pregnancy
  • Can cause pain and cramping in the upper abdomen
• Preterm labor
  • If cramping occurs prior to 37 weeks gestation it may be a sign of preterm labor
• Placental abruption
  • Occurs when the placenta separates from the uterus before the baby is born
  • Cramping is painful and does not go away
  • This is a potentially life-threatening condition
  • Contact your doctor right away if this occurs

Women will also experience cramping toward the end of the third trimester as they go into labor. Labor contractions are at regular intervals of 30 to 70 seconds and get stronger and closer together over time. If you think you are in labor, contact your doctor. 

Contact your doctor if you experience cramping during pregnancy characterized by: 

• Severe pain that does not go away
• Lower abdominal pain accompanied by contractions
• Vaginal cramping
• Heavy bleeding or discharge
• Gastrointestinal symptoms
• Dizziness
• Cramping, along with pain in the shoulder and/or neck
• A sudden increase in thirst, accompanied by a decrease in urination, or no urination for an entire day
• Severe headache that does not go away, sudden swelling, changes in vision, or unexplained weight gain (symptoms of preeclampsia)
• Fever or chills
• Bloody diarrhea
• Pain or burning during urination, difficulty urinating, or blood in the urine
• More than four contractions an hour, which may be a sign of labor