Experiencing abdominal pain during pregnancy can be unsettling, even in the 2nd trimester, when many women otherwise feel more energetic and have fewer discomforts. Abdominal pain can be caused by perfectly normal changes such as the growth of the uterus and stretching of ligaments, but it can also be associated with conditions that should be assessed by a doctor or midwife. The key is to look at the nature and duration of the pain, and whether other symptoms accompany it.

Below, you will find practical guidance on understanding what is typically normal, how to find relief, and when you should contact healthcare professionals. The information is based on general knowledge, which is also reflected in Danish patient guidelines such as Regionshospital Randers’ information on the 2nd trimester, Baby.dk’s descriptions of round ligament pain, and Sundhed.dk’s patient handbook on abdominal pain.

Round ligament pain (also called ligament pain) typically occurs because the uterus grows, and the ligaments that hold it in place become stretched. This is often seen in the 2nd trimester, when the uterus significantly increases in size.

Many describe round ligament pain as:

• Stabbing or sharp pains on one or both sides of the lower abdomen
• Pulling or soreness, especially when getting up, coughing, sneezing, or turning over in bed
• Short-lived jabs of pain that occur with movement and subside with rest

If the pain is mild to moderate, occurs with movement, and is not accompanied by other alarming symptoms, it may be consistent with normal pregnancy changes. If in doubt, it is still perfectly reasonable to discuss it with your midwife or doctor.

Not all abdominal pain is due to ligaments. In the 2nd trimester, the abdomen can also react to changes in digestion, bladder, and pelvis.

• Constipation and gas: Can cause dull aches, cramps, and pressure.
• Bladder irritation or urinary tract infection: Can cause pain above the pubic bone, burning during urination, or frequent urination.
• Pelvic-related discomfort: Can be felt as soreness/heaviness in the front and down towards the groin, especially with exertion.
• Braxton Hicks contractions: Some may experience periodic tightening in the abdomen. If it becomes regular, intensifies, or is accompanied by other symptoms, it should be assessed.

The point is not to self-diagnose, but to use the symptom pattern to determine whether you can wait and apply self-care, or if you should seek professional medical help.

It is always better to contact your midwife, general practitioner, or maternity ward one time too many than one time too few, especially if the pain changes in character.

• Vaginal bleeding or watery discharge you are unsure about
• Fever, chills, or a generally unwell feeling
• Pain that is severe, persistent, or worsening over time
• Pain accompanied by burning during urination or foul-smelling urine
• Severe abdominal pain with vomiting or signs of dehydration
• Regular pain/tightening resembling contractions

If you have acute severe pain or feel very unwell, you should seek emergency help.

If you have already been assessed, or the symptoms resemble mild, movement-induced round ligament pain, you can often try gentle relief.

• Change position slowly: Get up gently and roll onto your side in bed instead of "twisting".
• Rest during exertion: Take short breaks, especially if the pain occurs after activity.
• Gentle movement: Calm walks or pregnancy-adapted exercises can help some if it feels comfortable.
• Local heat: A warm hot pack can provide relief for some (without overheating the body).
• Focus on stomach/bowel: Drink enough fluids and get fiber in your diet if you tend to be constipated.

If a piece of advice clearly worsens the pain, stop and choose a more gentle solution.

If your pain is related to a feeling of heaviness or a need for relief in everyday life, a support product can be a practical supplement to the other advice. An adjustable support belt can provide some with a sense of greater stability, especially during periods of walking and standing activities. You can see an example of a support belt here: Maternity Support Belt.

Choose a solution that can be adjusted as your body changes, and use it as support when needed - not as a substitute for assessment if you have red flags or persistent pain.