Being pregnant with number two (or three. . .) can be an entirely new ballgame. Each pregnancy is different, so you may be experiencing random new symptoms that vary from last time. Likely, you are also feeling much more tired than with your first baby, because now you are chasing around a toddler instead of getting some occasional rest. You are also learning to play defense with your pregnant belly, attempting to keep baby #1 from clobbering it on a regular basis. Despite your best efforts you will occasionally get bumped, pulled on, and likely even body slammed hard enough to take your breath away. This can be scary and painful to the mom, but is extremely unlikely to hurt the baby.
Your baby is protected by many layers:
Bones
Skin
Fat
Muscles
Fascia (strong connective tissue that holds muscles together)
Intestines
Uterus (super thick and strong muscles)
Any blunt force has to pass through all these insulating layers to reach the baby. But even then, the baby is further insulated by the amniotic fluid.
In the first trimester (less than 14 weeks) the uterus is still nestled deep in the pelvis, so the pelvic bones protect the baby from any belly bumps.
After 14 weeks, to injure a baby in the womb, it takes a significant amount of force. Most cases of fetal injury are due to domestic violence (gunshot wounds/stabbing) or car accidents.
What can be concerning is shearing forces, especially in the third trimester. The placenta is made to detach from the uterus after delivery, but strong shearing forces can make it pull away prematurely. Falls onto the abdomen or buttocks, car accidents or severe trauma can cause the placenta to be dislodged from the uterus in a condition called an abruption. An abruption can happen immediately after trauma or may not show up for 24 hours after an accident. Symptoms of an abruption include: contractions, bleeding, and abdominal pain. Anytime you fall during pregnancy after 14 weeks, if it’s hard enough to to take your breath away, you should call your provider. Even if you don’t fall directly on your abdomen it is important to be monitored for signs of an abruption.
Testing for an abruption includes an ultrasound, labs to check for bleeding, and monitoring contractions and baby’s heart beat. Often we will monitor women for up to 8 hours after an accident to make sure that there is no evidence of an abruption.
Many moms often wonder if tight clothes, seat belts, a toddler sitting on her lap, intercourse or pushing on their abdomen might harm the baby. Please rest assured these activities are not going to cause any issues.
The unavoidable day to day bumping and pushing on your pregnant belly is fine. The occasional toddler hop, though painful and stressful for mom is unlikely to injure your baby. The baby will just be sloshed around in his amniotic fluid swimming pool. If you fall or are involved in any type of auto accident, this could be a major issue. Please call your provider to determine if you need further evaluation.
Dr. Heather Rupe 