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Expert Q&A:
What could be causing my lower abdominal pains?

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Elaine Zwelling
Answered by Elaine Zwelling R.N., Ph.D., L.C.C.E., F.A.C.C.E.
Elaine Zwelling, R.N., Ph.D., has been involved in maternal-newborn health care for 40 years. She has a bachelor's degree in nursing from Capital University and a master's degree in nursing and a Ph.D. in Family Relations and Human Development from Ohio State University. Dr. Zwelling brings to the Pampers Parenting Network her experience of helping expectant parents enjoy their pregnancy, plan and create a positive birth experience, and learn about parenting their newborn baby. She is certified by Lamaze International as a childbirth educator, is a Fellow in the American College of Childbirth Educators, and has taught childbirth classes for 25 years. Dr. Zwelling was the director and faculty for the Lamaze International Childbirth Educator Certification Program of Florida; in that role she prepared many nurses to become childbirth educators.

Dr. Zwelling was a Professor of Maternal-Newborn Nursing for 23 years at both Capital University and Ohio State University in Columbus, Ohio. At these institutions she taught undergraduate and graduate students and conducted research. For eight years she was a Senior Consultant with Phillips &; Fenwick, a women's health consulting firm in Santa Cruz, California, specializing in helping hospitals implement family-centered maternity care. Currently Dr. Zwelling is a Perinatal Nurse Consultant with the Hill-Rom Company. In this position, she provides comprehensive support and consultation to hospital maternity units to create quality care environments equipped with the appropriate equipment for labor and birth and provides clinical education for nursing staff.

Dr. Zwelling is the co-author of a maternal-newborn nursing textbook, Maternal-Newborn Nursing: Theory and Practice, and has published many professional journal articles related to maternal-newborn health care, family-centered maternity care, and childbirth education. Dr. Zwelling is a recognized speaker at professional conferences and teaches continuing education seminars for childbirth educators and perinatal nurses throughout the country.

Dr. Zwelling resides in Sarasota, Florida, and has a grown son, lovely daughter-in-law, and two grandchildren.

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Question


I am concerned because I have had lower abdominal pains during pregnancy. My doctor says that nothing is wrong, that my ligaments are probably stretching. Is my OB right? Read on and see how our experts have answered this question.

Answer


Your physician's diagnosis is a logical one—that the probable cause of the discomfort you're feeling is the stretching of the round ligaments that hold your uterus in place. As your abdomen enlarges during the pregnancy, the uncomfortable sensation you feel is caused by the increasing weight of your uterus, the placenta, the amniotic fluid, and the baby. This weight pulls on those ligaments and causes an ache. The fact that you feel this sensation after sneezing or using the bathroom makes sense, as the contraction of abdominal muscles that occurs with a sneeze or cough would pull on the ligaments.

As long as the pain is occasional and not persistent there is no cause for concern. You are likely to feel these sensations more with a second baby because your previous pregnancy left your muscles weakened and less able to support your enlarging abdomen as well as before. Try doing some gentle abdominal exercises such as pelvic tilts or curl-ups to strengthen abdominal muscles. Avoid doing full sit-ups or exercises that require you to lift both legs at the same time. Also avoid lifting heavy objects. Try splinting your abdomen with your hands when you sneeze or use the bathroom, to see whether that support will decrease the ache. Getting off your feet and resting will usually bring relief.

Preterm labor contractions are another possible cause of abdominal pain, aching, or pressure sensations during pregnancy. Be sure that you discuss this with your physician so that he or she can help you identify whether you are having any other symptoms that might be related to pre-term labor. These would include lower back pain; a watery vaginal discharge, either pink or brown in color; menstrual-like cramps, with or without diarrhea; nausea or indigestion; or leaking of amniotic fluid from the vagina.

The fact that you did not mention any of these symptoms would suggest that this is not what you are experiencing, but it is a good idea to be aware. No two pregnancies are ever the same, even for the same woman, so you are very wise to be observant and to inform your physician about your symptoms.

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Member comments
Feeling Stretching and abdominal Pain
I have currently in the beginning of my 13 weeks. I feel pressure and pulling. This is my second chi..

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