Right lower quadrant pain in pregnancy
Peer reviewed by Dr Surangi Mendis, MRCGPLast updated by Dr Toni Hazell, MRCGPLast updated 29 May 2024
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Your right lower quadrant (RLQ) 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.
At a glance
Right lower quadrant pain in pregnancy has several possible causes.
Common causes include miscarriage, constipation, pelvic ligament pain, and urine infections.
An ectopic pregnancy, where the pregnancy is not in the womb, can also cause pain.
In later pregnancy, placental abruption or going into labour can cause this pain.
Always see a doctor urgently if you are pregnant and have a right lower quadrant pain.
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In this article:
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Even if you are pregnant, you can still have tummy pain caused by all the same conditions seen in non-pregnant women. See our separate leaflet called Right lower quadrant pain.
The rest of this leaflet looks only at common causes specific to pregnancy. Some examples of rarer causes are provided in Further Reading.
Continue reading below
What causes right lower quadrant pain in pregnancy?
Miscarriage
This is very common in the first twelve weeks of pregnancy (first trimester) - about 1 in 4 recognised pregnancies end in miscarriage.
It can happen later in pregnancy (second trimester) but this is less common.
Miscarriage usually causes cramping pain, like period pain, over both sides of the lower tummy.
It is often accompanied by bleeding, which can range from a small amount of dark blood to larger amounts of bright red blood with clots.
You can find out more in the separate leaflet called Miscarriage and bleeding in early pregnancy.
Constipation
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).
You can read more about this in the separate leaflet called Constipation.
Pelvic ligament pain
Typically this starts at 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.
It 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.
You can read more about this in the separate leaflet called Common problems in pregnancy.
Urine infection
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).
See the separate leaflet called Urine infection in pregnancy.
Ectopic pregnancy
You should always see a doctor urgently if you think you might be pregnant and are experiencing right lower quadrant (RLQ) pain. You could have an ectopic pregnancy.
An ectopic pregnancy is a pregnancy that is not in the womb (uterus).
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.
See the separate leaflet called Ectopic pregnancy.
What causes right lower quadrant pain in later pregnancy?
Back to contentsPelvic 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 RLQ.
Find out more in the separate leaflet called Common problems in pregnancy.
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.
See the separate leaflets called Premature labour and Pelvic pain in women for more information.
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Your left lower quadrant is the bottom left side of your tummy (abdomen) from the tummy button down. There are many causes of left 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.
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Sign up for our free 8-week Healthy Pregnancy course!
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Frequently asked questions
What is meant by 'later pregnancy' in the context of right lower quadrant pain?
The article references 'later pregnancy' in relation to conditions like pelvic girdle pain, placental abruption, or premature labour. While not precisely defined, it implies the period after the first trimester, when specific conditions like pelvic ligament pain typically start (around 14 weeks) and onwards.
Can I have pelvic ligament pain in my hips or genital area?
Yes, pelvic ligament pain, which is caused by the growing womb pulling on its supporting structures, can extend beyond just the abdomen. It can cause a stabbing pain down one or both sides of the tummy and sometimes radiate into the hips and the genital area.
If I experience shoulder tip pain, should I be concerned?
Yes, if you experience pain over the tip of your shoulder, especially in conjunction with missed periods or other symptoms, it can occasionally be a sign of an ectopic pregnancy. You should always seek urgent medical attention if you suspect an ectopic pregnancy.
Is it normal for a urine infection to cause pain only on one side of my tummy?
While a urine infection typically causes pain across the lower tummy, it can manifest on one side. If the pain is specifically on one side, it might indicate that the infection is developing into a kidney infection (pyelonephritis).
How can I tell the difference between cramping from constipation and cramping from a miscarriage?
Cramping from constipation is associated with opening your bowels less often and passing hard, pellet-like stools. Miscarriage cramping, while also like period pain, usually occurs over both sides of the lower tummy and is often accompanied by vaginal bleeding, which can range from dark blood to larger amounts of bright red blood with clots.
Continue reading below
About the authorView full bio

Dr Toni Hazell, MRCGP
MBBS, BSc, MRCGP, DFSRH, Dip GU med, DRCOG, DCH (London, UK, 2000)
Dr. Toni Hazell qualified from St. Mary’s Hospital Medical School and did her VTS at Northwick Park Hospital.
About the reviewerView full bio

Dr Surangi Mendis, MRCGP
Consultant and Medical Author
MBBS, BSc (1st), MRCGP (2014), DFSRH, PGcert otology and audiology
Surangi Mendis is a consultant in Audiovestibular Medicine and Neuro-otology at The Royal National ENT and Eastman Dental Hospitals, UCLH.
Article history
The information on this page is written and peer reviewed by qualified clinicians.
Next review due: 28 May 2027
29 May 2024 | Latest version

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