Why does preterm labour cause severe abdominal pain in pregnancy?

During preterm labour, the uterus contracts in a pattern that may feel like tightening, cramping or strong pain across the lower abdomen. As the cervix softens, shortens and begins to open, pressure can spread into the pelvis, lower back or thighs. Pain may come in waves, become more regular, or occur with pelvic pressure, vaginal discharge or fluid leakage.

Severe pain can have other causes in pregnancy, so its location, timing and associated symptoms matter. A maternity team may assess contractions, the cervix, the baby’s wellbeing and whether the membranes have ruptured.

Contact your maternity unit or obstetric team promptly if you are pregnant and have severe or recurring abdominal pain, especially with tightening, backache, pelvic pressure, bleeding or fluid leakage. Rest on your side while arranging help, note when the pain starts and avoid driving yourself if you feel faint or unwell.

Do not wait for the pain to settle before calling if you are concerned. The assessment may identify labour or another problem and allows the team to decide whether monitoring or treatment is needed.

Seek emergency help for severe pain that is constant or worsening, heavy bleeding, fainting, difficulty breathing, fever, a rigid abdomen, or reduced fetal movement. Fluid leaking from the vagina, regular painful contractions or a strong urge to push also need immediate maternity assessment.

Ask: Could these symptoms be preterm labour? Is my cervix changing? Have my waters broken? How will you monitor my baby and contractions? What symptoms should make me return immediately?