Expert: Lawrence Jay Rappaport <B>M.D.</B> - 3/28/2004
Question This question is for my 29 year old daughter who has a 22 month old son and is due July 31 with a girl. She has had abdominal pain upon walking. She walks and pushes a stroller with her son in it. He is 28 pounds. Their walk is about an hour on sidewalk downtown streets. She walks slowly and calmly. She has gotten cramp-like symptoms, feeling like she has to have a bowel movement or is having contractions. They bring her to tears, but stop after she stops walking and sits down for a few minutes. She also got these symptoms a few days ago while putting mulch outside around her trees. She was using a shovel. This has happened about five times in the last 2 weeks. She is a very thin woman, 5'7" tall.She did not have this with her last pregnancy, but her son's head got stuck during birth (for three hours) and he had to be delivered by forceps. She had bladder problems after the birth. Should she stop walking? Is this a medical problem that needs to be addressed by her midwife?
Answer At 22 weeks gestation, it is common to complain of cramps in the groin (or lower abdomen) due to Round Ligament Syndrome. The round ligaments are the ligaments that anchor the uterus to the sidewalls of the abdomen. At around 5 months pregnancy, any sudden stretch on these ligaments will cause a cramping pain in the abdomen or groin. It often occurs when walking if one turns suddenly or while getting up out of a chair or a bed. If your daughter is having these cramps only when she walks the baby or does gardening, she can try taking Tylenol every three hours to alleviate the pain, or she can use a heating pad or warm shower afterwards. Other than that, if the pain persists, she will have to curtail the activities that trigger the pain. I doubt that anything else is going on or it would continue when she is not walking or engaging in strenuous activity. What were the bladder problems that she had after the birth of her son? If she notices difficulty in urinating or has constant pressure on her bladder, it must be investigated.
