A woman’s body goes through dramatic changes during pregnancy. Ligaments and muscles stretch, blood volume doubles, and hormone production spikes. Symptoms like mood changes and morning sickness are par for the course, but what about cramping in the second and third trimesters?
Pregnancy Cramping Is Common
“Muscle cramps are a common symptom during pregnancy, with the majority occurring in the legs,” explains Sarah Abel, ND, CNS, founder and CEO of Wella Clinic in Roseville, California. “Cramps are typically in the calf muscles but can also occur in the thighs and feet.”
An estimated 30% to 50% of pregnant women in the third trimester experience leg cramps twice a week, sometimes causing severe pain and sleep disturbance.1Liu J, Song G, Zhao G, Meng T. Effect of oral magnesium supplementation for relieving leg cramps during pregnancy: a meta-analysis of randomized controlled trials. TJOG. 2021;60(4):609-614. https://doi.org/10.1016/j.tjog.2021.05.006 Broken sleep leads to fatigue, which can make the strenuous process of carrying a child even more exhausting.
“Pregnant women may also have cramps in other areas, such as the back and hands,” says Dr. Abel. “While some women experience muscle cramps in the first trimester, these issues are more common in the second and third trimesters.”
Causes of Pregnancy Cramps
Many factors contribute to cramping, especially in the legs:2Fiat F, Merghes PE, Scurtu AD, et al. The main changes in pregnancy-therapeutic approach to musculoskeletal pain. Medicina (Kaunas). 2022;58(8):1115. Published Aug 17, 2022. https://doi.org/10.3390/medicina58081115

- Circulation changes. As blood volume increases, circulation can decrease, leading to swelling and cramping.
- Dehydration. Lack of hydration and resulting electrolyte imbalance may cause cramps.
- Added weight. Weight gain can contribute to muscle fatigue. Extra pressure on blood vessels from the enlarged uterus may lead to sore muscles and cramping in legs and feet.
- Low vitamin or mineral levels. A pregnant woman needs certain vitamins and minerals and specific amounts of these nutrients. Without enough magnesium, calcium, and B vitamins, cramps are a risk.
“Pregnant women should take a prenatal vitamin that provides a wide range of nutrients, including ample amounts of active B vitamins, which can help reduce muscle cramps,” says Dr. Abel.
According to the American Pregnancy Association, pregnant women are also at increased risk for urinary tract infections (UTIs) from weeks six through 24.3Urinary Tract Infection — UTI During Pregnancy. American Pregnancy Association. https://americanpregnancy.org/healthy-pregnancy/pregnancy-complications/urinary-tract-infections-during-pregnancy/#:~:text=Pregnant%20women%20are%20at%20increased,urinary%20tract%20infection%20during%20pregnancy UTIs can cause cramping and pain in the lower abdomen. Talk to your doctor if you suspect a UTI.

Preventing Pregnancy Cramps: Diet, Hydration, and Exercise
Multiple strategies can reduce the risk of pregnancy cramps and alleviate pain and discomfort when they occur. A healthy diet fuels your changing body while giving your baby nutrients to develop and grow. Physical activity and hydration are also vital.
“It’s important to ensure that foundational healthy habits are in place, such as adequate hydration, a balanced diet, and consistent exercise with stretching,” explains Dr. Abel. “If any of these areas is lacking, there is an increased risk of cramping.” To stay hydrated, drink at least eight cups of water per day and eat water-rich foods, such as melon, strawberries, oranges, celery, and cucumbers.
Electrolytes and trace minerals are drained more easily during pregnancy. “While increased hydration is important during pregnancy, plain water may not provide the minerals required to reduce muscle cramps,” notes Dr. Abel. “In many cases, incorporating electrolytes or trace minerals as part of a daily routine will help keep muscles functioning optimally.”
Dr. Abel advises patients to look for natural sources of electrolytes with no added sugar or color.
Gentle exercise before bed can increase blood flow and reduce the risk of nighttime cramps. If a cramp strikes at night, gently massage the affected area while slowly flexing your foot to reduce spasms.2Fiat F, Merghes PE, Scurtu AD, et al. The main changes in pregnancy-therapeutic approach to musculoskeletal pain. Medicina (Kaunas). 2022;58(8):1115. Published Aug 17, 2022. https://doi.org/10.3390/medicina58081115
Consider Cramp-Fighting Supplements

In addition to eating healthy and taking a prenatal vitamin, pregnant women may benefit from certain supplements. Magnesium, for example, is one of Dr. Abel’s go-to natural remedies for cramps.
“Oral magnesium, preferably magnesium glycinate, citrate, malate, or a combination thereof taken before bedtime may improve sleep, which is always a nice bonus during pregnancy,” she says. “A topical magnesium cream can work well for women with leg, foot, or hand cramps but should not be applied to the abdomen.”
In a 2015 randomized controlled trial of 86 healthy pregnant women who were experiencing leg cramps at least twice a week, 300 mg of magnesium bisglycinate daily improved symptom frequency and intensity.4Supakatisant C, Phupong V. Oral magnesium for relief in pregnancy-induced leg cramps: a randomized controlled trial. Matern Child Nutr. 2015;11(2):139-145. https://doi.org/10.1111/j.1740-8709.2012.00440.x Similarly, a 2013 analysis of randomized clinical trials found magnesium effective in treating pregnancy leg cramps compared to a placebo.5Sebo P, Cerutti B, Haller DM. Effect of magnesium therapy on nocturnal leg cramps: a systematic review of randomized controlled trials with meta-analysis using simulations. Fam. Pract. 2014;31(1):7-19. https://doi.org/10.1093/fampra/cmt065
Dark chocolate, sunflower seeds, avocados, and pulses such as beans, soybeans, peas, and chickpeas are all rich in magnesium.6Vormann J. Magnesium: nutrition and homoeostasis. AIMS Public Health. 2016;3(2):329-340. Published May 23, 2016. https://doi.org/10.3934/publichealth.2016.2.329
Homeopathic cell salts, which restore mineral balance and support the body’s healing process, may also replenish deficiencies and reduce the risk of skeletal muscle cramps.
Other Strategies for Relieving Cramps: Massage, Yoga, and Pillow Support

A calf massage can ease lower leg pain by stimulating blood flow and loosening stiff muscles. It’s important to avoid deep-tissue and shiatsu massage, which apply strong pressure to the legs and may increase the risk of blood clots during pregnancy.7Mueller SM, Grunwald M. Effects, Side effects and contraindications of relaxation massage during pregnancy: a systematic review of randomized controlled trials. J Clin Med. 2021;10(16):3485. Published Aug 6, 2021. https://doi.org/10.3390/jcm10163485 Use slow, gentle strokes to relieve tension.
Research shows prenatal yoga can alleviate many common discomforts of pregnancy.8Sun Y, Hung Y, Chang Y, Kuo S. Effects of a prenatal yoga programme on the discomforts of pregnancy and maternal childbirth self-efficacy in Taiwan. Midwifery. 2010;26(6). https://doi.org/10.1016/j.midw.2009.01.005A 2023 study found yoga significantly reduced pregnancy-related symptoms and helped support overall wellness.9Sahin E, Gurkan O. The effect of prenatal yoga on pregnancy-related symptoms: a pilot quasi-experimental study. Complement. Med. Res. 2023;30(3). https://doi.org/10.1159/000528801
Because leg cramps often occur at night, creating a consistent, tranquil sleep routine is important. A warm shower or bath before bedtime relaxes sore muscles and relieves stress.
If you sleep on your side, place a pillow between your knees to help facilitate blood flow. Nighttime cramps often strike without warning. When a cramp wakes you, try placing a hot water bottle or compress on the affected area to ease pain.
When to See Your Healthcare Provider
Cramps are a normal part of pregnancy for many women, but remember to talk with your doctor or midwife if you experience one or more of these symptoms, as leg cramps may be a sign of deep vein thrombosis:2Fiat F, Merghes PE, Scurtu AD, et al. The main changes in pregnancy-therapeutic approach to musculoskeletal pain. Medicina (Kaunas). 2022;58(8):1115. Published Aug 17, 2022. https://doi.org/10.3390/medicina58081115
- Cramps consistently keep you up at night, and natural remedies don’t help.
- You feel extreme pain upon standing.
- Cramps worsen, become severe, or persistent.
- Your legs are very swollen.
- Red spots appear on skin and are warm to the touch.
- The veins in your legs become enlarged.
“Pregnant women are 50% more likely to experience blood clots than other women, so if the leg pain is severe, stops you from standing, persists, or worsens, it’s time to call your doctor,” says Dr. Abel. “For most women, muscle cramps go away after pregnancy.”
Footnotes
- 1Liu J, Song G, Zhao G, Meng T. Effect of oral magnesium supplementation for relieving leg cramps during pregnancy: a meta-analysis of randomized controlled trials. TJOG. 2021;60(4):609-614. https://doi.org/10.1016/j.tjog.2021.05.006
- 2Fiat F, Merghes PE, Scurtu AD, et al. The main changes in pregnancy-therapeutic approach to musculoskeletal pain. Medicina (Kaunas). 2022;58(8):1115. Published Aug 17, 2022. https://doi.org/10.3390/medicina58081115
- 3Urinary Tract Infection — UTI During Pregnancy. American Pregnancy Association. https://americanpregnancy.org/healthy-pregnancy/pregnancy-complications/urinary-tract-infections-during-pregnancy/#:~:text=Pregnant%20women%20are%20at%20increased,urinary%20tract%20infection%20during%20pregnancy
- 4Supakatisant C, Phupong V. Oral magnesium for relief in pregnancy-induced leg cramps: a randomized controlled trial. Matern Child Nutr. 2015;11(2):139-145. https://doi.org/10.1111/j.1740-8709.2012.00440.x
- 5Sebo P, Cerutti B, Haller DM. Effect of magnesium therapy on nocturnal leg cramps: a systematic review of randomized controlled trials with meta-analysis using simulations. Fam. Pract. 2014;31(1):7-19. https://doi.org/10.1093/fampra/cmt065
- 6Vormann J. Magnesium: nutrition and homoeostasis. AIMS Public Health. 2016;3(2):329-340. Published May 23, 2016. https://doi.org/10.3934/publichealth.2016.2.329
- 7Mueller SM, Grunwald M. Effects, Side effects and contraindications of relaxation massage during pregnancy: a systematic review of randomized controlled trials. J Clin Med. 2021;10(16):3485. Published Aug 6, 2021. https://doi.org/10.3390/jcm10163485
- 8Sun Y, Hung Y, Chang Y, Kuo S. Effects of a prenatal yoga programme on the discomforts of pregnancy and maternal childbirth self-efficacy in Taiwan. Midwifery. 2010;26(6). https://doi.org/10.1016/j.midw.2009.01.005
- 9Sahin E, Gurkan O. The effect of prenatal yoga on pregnancy-related symptoms: a pilot quasi-experimental study. Complement. Med. Res. 2023;30(3). https://doi.org/10.1159/000528801