Maternal ligaments in pregnancy

Usually at the beginning of the second trimester of pregnancy, the uterine ligaments have to expand increasingly as the uterus gets larger. This means that there are more tensile forces acting on the uterine ligaments, which are stretched. Stretching pain in the form of a pulling, stabbing pain is the result.

These are located on both sides of the lower abdomen in the direction of the groin. Since there are also numerous ligament connections in the small pelvis, some pregnant women also have pain in the lower back area up to the sacrum. These pains are completely harmless and can often be relieved by resting in a relaxed position (e.g. supine), or in combination with heat.

If the pain becomes very severe or other symptoms such as vomiting or fever are added, a doctor should be consulted immediately to rule out dangerous pregnancy complications. The maternal ligaments are mainly stretched by the growing uterus. If the embryo is growing, the uterus must also stretch.

Therefore, the uterine ligaments usually start to hurt in the second month of pregnancy. This is the time when the embryo and uterus can grow quickly for the first time. However, there are individual differences if, when and how long the uterine ligaments hurt or are noticeable.

Since a pregnancy is often accompanied by pain in the maternal ligaments, this can in principle be an indication of a pregnancy. However, the pain usually begins a few weeks after the beginning of the pregnancy. Often other things therefore indicate a pregnancy at an earlier stage.

These include the absence of menstruation. In the hope of being pregnant, pain in the maternal ligaments should not be confused with different diseases, such as appendicitis.The occurrence of pain during pregnancy, which is caused by the maternal ligaments, can be very individual. In principle, it cannot be ruled out that a few weeks after fertilization, an unpleasant pulling sensation may occur on both sides, the cause of which lies in the mother ligaments.

However, this pain is more likely to be caused by general changes in the uterus and surrounding tissue. A typical symptom of pain in pregnant women often only occurs from the 5th week of pregnancy. Initially, affected women often expect a period when they do not yet know they are pregnant.

This is often characterized by listlessness, tiredness and general malaise. In addition to this, there is a painful pulling, sometimes also described as an unpleasant stinging sensation, which often emanates from the mother’s ligaments. Many women notice from these signs, combined with a lack of menstruation, that they are pregnant.

About 2 weeks later, i.e. from the 7th week of pregnancy, expectant mothers often experience a renewed pulling of the maternal ligaments, this time combined with an urge to urinate, tiredness and insomnia, caused by a hormonal change (by the hormone progesterone). An increase in the traction forces acting on the maternal ligaments increases the stretch pain. This can be expected to increase between the 17th and 24th week of pregnancy, as the growth of the uterus causes the traction force of the maternal ligaments to increase, which can lead to an unpleasant feeling of pressure in the lower abdomen in the direction of the groin.

Pregnant women notice this type of pain when getting up or coughing and sneezing, as these activities can exert a pull on the uterine ligaments to varying degrees. Due to the course of the ligaments in the pelvis, the pulling pain can radiate into the labia and sacrum. Towards the end of the pregnancy, in the third trimester, the maternal ligaments loosen due to hormonal changes, so that the stretching pain can decrease.

This loosening of the ligament structures already serves to prepare for the birth, so that the child can enter the birth canal without damaging all the structures in the mother’s pelvis. Due to the attachment of the uterus to many connective tissue structures and ligaments, as well as the connection to all sides of the pelvic wall and the other organs of the lesser pelvis, it goes without saying that when the uterus is stretched during pregnancy, stretching tensile forces can occur on the maternal ligaments, which can then be quite painful. In addition, movements of the mother (e.g. through sports, rapid movements during the old age or simple changes of position in bed) can lead to stretching of the maternal ligaments and thus to pain in the abdomen/pelvis.

Child movements also contribute to painful maternal ligaments. The pain is usually described as pulling, stabbing or even cramping. The feeling of sore muscles or a pulled ligament is also possible.

These are usually located in the right and left lower abdomen and in the groin region, but can also lead to pain in the lower back, sacrum and labia due to the connection of the uterus with many anatomical structures. In most cases, these pains of the maternal ligaments do not occur until the 2nd trimester (2nd trimenon), since the weight of the unborn child is sufficient to push the uterus downwards from this period onwards. The stretching pain of the maternal ligaments is completely natural (physiological) and harmless for both mother and child.

However, if the pain is very strong or gets stronger and accompanied by fever, vomiting or diarrhoea, it is advisable to consult a doctor, as this could be caused by diseases (such as loosening of the pubic symphysis, appendicitis, kidney stones, placenta detachment) or premature labor. There are a number of possibilities to relieve the pain caused by the tightened maternal ligaments. In most cases, it is sufficient to rest for a short time and relax.

A warm bath or massage is particularly effective in this regard. Magnesium may have a prophylactic effect against tension. Special caution is required when taking pain-relieving medication.

Drugs such as aspirin or ibuprofen can damage the embryo, especially at the end of a pregnancy. As ligament structures, the mother ligaments consist mainly of connective tissue and smooth muscles.These fabrics are able to stretch by several centimeters without tearing. However, the time factor is decisive here: if the mother ligaments were suddenly stretched by several centimeters, they would not be able to withstand the tensile forces.

If the uterine ligaments are stretched by several centimeters over the course of weeks and months, as in the course of a pregnancy, by the growing uterus, they can easily withstand the tension. However, if the uterine ligaments are stretched strongly in the abdomen, e.g. during a growth spurt of the child, stretching pain can result. These are described as pulling and stabbing and are harmless, although sometimes very unpleasant.