Congratulations, you’re pregnant! As you grow a tiny human inside you, rapid changes are happening in your body. While some are amazing (that pregnancy glow), some are… not so amazing.

Who knew pregnancy kinda hurt? We’re talking about cramping and twinges in your pelvis, lower abdomen, and back. You may feel discomfort as your uterus expands and affects the muscles and organs nearby.

Though it’s unpleasant, this kind of pain isn’t usually a cause for concern. Read on for more about common reasons for pelvic pain during pregnancy and how you can find relief.

Your pelvic floor spans the bottom of your pelvis, or the area between your abdomen and legs. It’s covered with a layer of muscle and supports the organs in your pelvis, like your bladder and ovaries.

Both men and women have pelvic floors. Women’s are wider, since we may need to accommodate an expanding uterus. Early pregnancy pelvic pain can include discomfort in your pelvic floor, bladder, vagina, back, or abdomen.

Lots of women have weak pelvic floor muscles, which can become even weaker after giving birth. There’s an exercise to strengthen this area called Kegels. (You might have heard Samantha Jones talk about them on “Sex and the City.”)

When done correctly, Kegels are the gold standard for strengthening your pelvic floor and keeping you from dribbling pee down there.

You know what period cramps feel like? During pregnancy, you may also feel cramping as your uterus stretches to make room for the fetus.

Stretching pains may include spasms or mild discomfort in your uterine or lower abdominal area. Most cramps go away with time and are not a sign of a larger problem.

To ease your cramps, try:

  • resting
  • taking a warm shower or bath
  • drinking plenty of water and other fluids
  • lying on your back and shifting your knees toward your chest to take pressure off your uterus

Try not to worry — light cramping is actually a sign your pregnancy is going well.

More severe cramps

Some bleeding or cramping is common during pregnancy, but it can also be a sign of a miscarriage. Miscarriage is most common early in a pregnancy — 80 percent of miscarriages happen in the first 12 weeks.

Vaginal spotting or bleeding, mild to severe back spasms, contractions, and tissue discharge from the vagina are also symptoms of miscarriage. If you experience any of these, call your healthcare provider immediately.

The round ligaments are muscles located in your pelvis that hold your uterus in place. As your womb grows, especially during your second trimester, they stretch and can feel achy.

The pain may feel sharp or like a pulling sensation and is usually on only one side of the abdomen. The pain should last only a few seconds or minutes, though it may return when you laugh, stand, or bend down.

You can find some relief from round ligament pain by:

  • resting
  • avoiding sudden movements
  • using warm compresses
  • doing light stretching or prenatal yoga
  • getting a prenatal massage

Definitely contact your healthcare provider if the pain is frequent or if you also have other symptoms.

Other types of pelvic pain during pregnancy can come from your bladder, kidneys, gastrointestinal tract, or liver.

Gas or, worse, constipation

Gas and bloating are common during your first trimester, thanks to the hormone progesterone, which increases during pregnancy. Progesterone causes your muscles to relax, so your digestion slows and gas builds up.

Here are some ways to get relief from gas and bloating:

  • Drink 8 to 10 glasses of water a day.
  • Cut out foods that make you gassy.
  • Exercise.

Up to 38 percent of pregnant women experience constipation.

Once again, you can thank progesterone for relaxing your bowel muscles and slowing digestion. If you’re taking iron supplements (like prenatal vitamins), they could also be the culprit.

To fight constipation, try:

  • exercising
  • eating more fiber-rich foods like raspberries, peas, and broccoli
  • consuming probiotics, like yogurt
  • taking a pregnancy-safe stool softener (after getting the OK from your doctor)

UTIs (aka painful peeing)

You probably already know that pregnant women pee approximately every 5 minutes, since the uterus sits directly on top of the bladder.

Another not-so-fun side effect is urinary tract infections (UTIs). As your uterus grows, the increased weight can prevent urine from completely draining out of your bladder. This creates a perfect environment for bacteria to grow.

Symptoms of a UTI can include:

  • cramping in the lower abdomen
  • burning or discomfort when peeing
  • a sense of urgency when peeing
  • cloudy or foul-smelling pee

The good news: If caught early, a UTI should be easy to treat with antibiotics that are safe for both you and your baby.

To prevent UTIs:

  • Drink 8 to 10 glasses of water each day.
  • Cut back on refined foods, fruit juices, caffeine, alcohol, and sugar.
  • Pee as soon as you feel the need.
  • After peeing, blot dry (wiping from front to back, of course).
  • Pee before and after sex.
  • Don’t soak in the tub for longer than 30 minutes.
  • Avoid strong soaps, douches, antiseptic creams, feminine hygiene sprays, and powders.

Ouch! Welcome the kidneys

Kidney issues can show up during pregnancy. The two most frequent issues are kidney infections and kidney stones.

A kidney infection starts as a UTI and travels up to one or both kidneys. Normally, urine drains down from your kidneys into your bladder and then out through your urethra (the tube you pee out of).

But progesterone can slow the contraction of the ureters (ducts on your kidneys that connect to your bladder) so that the urine doesn’t drain completely. As your uterus swells, it weighs down on the ureters, and they don’t fully drain.

Signs of a kidney infection can include:

  • the need to pee often
  • pain in your back, abdomen, or groin
  • pain or burning while peeing
  • blood in your urine

Don’t wait to see your healthcare provider. An untreated infection can permanently damage your kidneys or spread to your bloodstream and cause sepsis, a life threatening infection. Kidney infections are treatable with antibiotics, but sometimes hospitalization is required.

Kidney stones are collections of calcium or uric acid that build up in the kidneys. Sometimes they’re NBD, but they can get stuck in your ureter and block your pee from coming out. This is very painful.

While kidney stones can happen to anyone (pregnant or not), they tend to happen in the second or third trimester of pregnancy. Pain from kidney stones may show up in your abdomen, back, sides, and groin.

Symptoms include:

  • nausea
  • vomiting
  • a sense of urgency when peeing
  • blood in your pee

Treatment for kidney stones can include:

  • bed rest
  • pain relievers
  • a medication called Flomax (tamsulosin), which relaxes the ureter
  • drinking more fluids
  • surgery

Liver pain

Your liver is responsible for many crucial functions, including sorting nutrients and creating bile, which helps with digestion. Several types of liver disease can occur during pregnancy. See your healthcare provider to get the correct diagnosis.

Your liver is connected to your gallbladder, which produces the digestive enzyme your liver uses. Gallstones and other liver-related problems can cause an ache in your upper right abdomen, just below your ribs.

Usually it’s a dull, vague pain and may come along with a backache and darker urine. You might also experience intense itching, which can be a sign of gallbladder problems.

Some conditions that cause pelvic pain require immediate medical treatment.

Ovarian torsion

Ovarian torsion is when the ovary, and possibly the fallopian tube, twists inside the body. This causes sudden, sharp, overwhelming lower abdominal pain — so intense that some women vomit or faint.

Usually it happens on only one side of the body — more often the right side. Ovarian torsion can be triggered by an ovarian cyst but can also appear without previous symptoms. In pregnant women, it most often happens in weeks 6 to 14.

Sometimes the ovary can twist back to its normal position on its own, but that doesn’t always happen. If ovarian torsion cuts off the blood supply to your ovary, it can permanently damage your fertility. You might need surgery to untwist your ovary and fallopian tube.

Ovarian torsion can be fatal to a fetus in some cases, though it generally isn’t. But it can be extremely painful, and surgery to correct it could affect your pregnancy. If you feel sharp, overwhelming pain on one side, head to the ER immediately.

Ectopic pregnancy

An ectopic pregnancy (also called tubal pregnancy) is when a fertilized egg attaches someplace other than your uterus, like in your fallopian tube. This occurs in 1 to 2 percent of pregnancies (it’s slightly more common in women who have had fertility treatments).

If you experience sudden, sharp, or stabbing pain on one or both sides of your uterus or abdomen; vaginal bleeding; weakness; dizziness; or fainting, immediately head to the ER.

Risk factors for an ectopic pregnancy include:

  • being over 35
  • smoking
  • fertility treatments
  • previous fallopian tube, pelvic, or abdominal surgery
  • previous ectopic pregnancy
  • endometriosis
  • certain STIs

In an ectopic pregnancy, the fetus can’t survive. And if it continues to grow, it may damage your organs or cause life threatening bleeding.

Treatment for ectopic pregnancy involves a medication called methotrexate or surgery (typically laparoscopy), either of which will end the pregnancy.

Consider asking your healthcare provider for a referral to a grief counselor after an ectopic pregnancy. You aren’t alone in this experience, and support is available. It’s also important to take care of yourself after a loss. Eat nutritious foods, keep moving with gentle exercise, and give yourself time to grieve.

How you treat pregnancy pain depends on its cause. But in general, women who experience early pregnancy throbs and aches may find relief if they:

  • rest
  • take a warm bath or shower
  • massage the affected area or surrounding muscles
  • try to avoid quick movements and sharp turns at the waist
  • exercise
  • get a prenatal massage
  • wear low-heeled shoes with good arch support
  • use over-the-counter pain relievers (with the permission of a healthcare provider)
  • wear a pelvic support garment, which can keep the uterus from pushing down on the pelvis

Your healthcare provider may recommend other treatments for you.

See your healthcare provider immediately if you experience sharp pain, especially if you also have any of these symptoms:

  • vaginal bleeding
  • dizziness
  • shortness of breath
  • blood in your pee
  • high fever
  • chills

If your pain goes away on its own, it may not be a concern. But you should still let your doctor know about it.

Mild uterine pain during early pregnancy is normal. Resting and adding more water and fiber to your diet will usually help.

There are a few more serious conditions that cause pelvic pain, but these are rare. Cramping accompanied by spotting or bleeding may indicate a miscarriage, and you should call your healthcare provider immediately.

Otherwise, welcome to 9 months of pregnancy, where aches and pains are part of your body’s normal response to the fetus cooking inside you. You’ve got this.