Your right lower quadrant is the bottom right side of your tummy (abdomen) from the tummy button down. There are many causes of right lower quadrant pain in pregnancy. Most are of no concern, but it is important to seek medical help if your pain is severe, doesn't settle, or is associated with other symptoms.
Even if you are pregnant, you can still have tummy pain caused by all the same conditions seen in non-pregnant women. You can find out more about these in our leaflet on right lower quadrant pain. The rest of this leaflet looks only at causes specific to pregnancy.
What are the most common causes of right lower quadrant pain in pregnancy?
- Very common in first twelve weeks of pregnancy (first trimetster) - about 1 in 4 recognised pregnancies ends in miscarriage
- Can happen later in pregnancy (second trimester) but less common
- Usually causes cramping pain, like period pain, over both sides of the lower tummy.
- Often accompanied by bleeding, which can range from a small amount of dark blood to alrger amounts of bright red blood with clots
- Constipation is very common in pregnancy.
- It gives you crampy lower tummy (lower abdominal) pains.
- You will open your bowels less often than you usually do and typically you pass hard, pellet-like stools (faeces).
Pelvic ligament pain
- Typically this starts around 14 weeks and goes on into late pregnancy.
- It is due to the growing womb (uterus) pulling on the structures (round ligaments and broad ligament) which hold it in place.
- Usually causes a stabbing pain down one or both sides of the tummy (abdomen) and sometimes down into the hips and genital area.
- Pain can be quite marked.
- Urine infection is more common in pregnancy.
- Usual symptoms are of pain when you pass urine and passing urine more often.
- You may also get tummy pain and a high temperature (fever) and notice blood in your pee.
- If you do get pain, it's usually across the lower tummy but can be on one side if you are developing a kidney infection (pyelonephritis).
- An ectopic pregnancy is a pregnancy that is not in the normal place.
- Pain is often sudden and can be severe, but it can come on over a few days.
- You may have missed your period but you can still have an ectopic pregnancy even if you think you have had a period.
- Vaginal bleeding often happens but not always.
- Occasionally you can get pain over the tip of your shoulder.
Right lower quadrant pain in later pregnancy
Pelvic girdle pain affects the joint connecting the two bones at the front of your pelvis, called the symphysis pubis. This joint becomes loosened during pregnancy, often as early as 14 weeks into pregnancy. The pain can be severe and is usually felt over the symphysis pubis, but can spread to the right lower quadrant.
In later pregnancy, RLQ pain can be caused by a placental abruption or by going into labour. Placental abruption happens when there is bleeding between the afterbirth (placenta) and the lining of the womb. Labour is too soon (premature labour) if it happens before 37 weeks.
Further reading and references
Manterola C, Vial M, Moraga J, et al; Analgesia in patients with acute abdominal pain. Cochrane Database Syst Rev. 2011 Jan 19(1):CD005660. doi: 10.1002/14651858.CD005660.pub3.
Cartwright SL, Knudson MP; Evaluation of acute abdominal pain in adults. Am Fam Physician. 2008 Apr 177(7):971-8.
Kim JS; Acute Abdominal Pain in Children. Pediatr Gastroenterol Hepatol Nutr. 2013 Dec16(4):219-224. Epub 2013 Dec 31.
Cartwright SL, Knudson MP; Diagnostic imaging of acute abdominal pain in adults. Am Fam Physician. 2015 Apr 191(7):452-9.