When you are pregnant after a miscarriage, early pregnancy cramps can be a matter of anxiety. Is it just normal uterine stretching and growth, or is it a sign of impending miscarriage? The answer isn't always obvious, but here are some pointers to keep in mind when deciding what to do.
Abnormal Pregnancy Cramps
Always see your doctor if your cramping is persistent or severe. Severe cramping in particular should always be investigated in order to rule out ectopic pregnancy. If you think you have signs of a ruptured ectopic pregnancy, go to the emergency room right away. Also, if your cramping seems to be focused on one side of your lower abdomen, call your doctor to be on the safe side even if the cramping isn't severe; one-sided pain can also be a sign of ectopic pregnancy.
If you are having any kind of vaginal bleeding alongside the cramping in early pregnancy, you should call your doctor -- it's possible that you might be having a miscarriage. These symptoms don't always mean miscarriage, but your doctor should be able to order hCG blood tests or an ultrasound to figure out what's going on.
Normal Early Pregnancy Cramps
Even though cramps can sometimes indicate problems, cramping in pregnancy is probably normal more often than not. As your uterus begins to grow, you can feel mild to moderate cramping in your lower abdomen or your lower back. This cramping may feel like pressure or stretching, or it may feel similar to menstrual cramping, but mild, transient cramping in early pregnancy is usually normal and not a sign of miscarriage. Mention it to your doctor at your next prenatal appointment, but there's probably no immediate cause for concern if the pain isn't severe, isn't one-sided, and is not accompanied by bleeding.
Cramps in Later Pregnancy
Abdominal cramps can occur later in pregnancy also as the uterus grows larger, but be on the lookout for signs of preterm labor, and always let your doctor know right away if you are having severe pain or bleeding alongside the cramping.
Abdominal Pain or Cramping. March of Dimes. Accessed: Oct. 21, 2009. http://www.marchofdimes.com/pnhec/159_15241.asp
Pregnancy FAQ: Early Pregnancy. American Pregnancy Association. Accessed: Oct. 20, 2009. http://www.americanpregnancy.org/gettingpregnant/pregnancyfaq.htm