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Are first trimester cramps normal?
Q: I’m about three weeks pregnant and am having mild cramping in my sides and lower back. Is this normal or something I should worry about?
A: Congratulations on your new pregnancy. Doctors usually count the weeks of pregnancy from the first day of your last menstrual period. Most women ovulate (release an egg) two weeks after the first day of their last menses. Using the “last menstrual period” method of counting, three weeks would suggest that you conceived only one week ago. At three weeks, a pregnancy test would not yet be positive.

I’m guessing that you mean you conceived three weeks ago. Healthcare professionals would actually count this as five weeks of pregnancy, because they add on the two weeks of your menstrual cycle that occurred before ovulation.

At five weeks of pregnancy, it’s possible to have cramping as a symptom of a healthy pregnancy. In some cases, however, cramping may be an indication of a problem, such as an impending miscarriage or an ectopic pregnancy. It’s impossible to know if your pregnancy is completely fine without a thorough medical exam.

Please make an appointment to see your healthcare provider. After taking a careful history, it’s likely that you will be examined to make sure your pregnancy is fine. If your provider has any concerns, an ultrasound will be ordered to provide a visual picture of your new pregnancy. At five weeks after your last menstrual period an ultrasound will be unable to see if the pregnancy is growing in your uterus. At six weeks, a small embryo can be visualized, and it may be possible to detect a fetal heartbeat. Good luck!
Laura E. Stachel M.D. Obstetrician & Gynecologist