Hcg levels for twins by week

Understanding a Pregnancy with Multiples

The infamous pregnancy hormone, human chorionic gonadotropin (hCG for short), is one of the most important hormones required for a successful pregnancy. In a nutshell, hCG helps the body build a safe and supportive nest for growing a baby.

A woman who is not pregnant will likely have a baseline hCG level of less than 5 MIU/ml. If conception occurs, hCG then rises rapidly during the early phases of pregnancy and peaks sometime around week 10. In women carrying a single child, hCG may reach over 200,000 mIU/ml. However, in women carrying multiples, this number may be much higher.

If you suspect that you may be having multiples, this article will address some of the questions you may have about hCG levels, twins, and what hCG ranges to expect throughout a multiple pregnancy. We’ll also follow up with some guidance on how to test for hCG either at home or at your doctor’s office.

Is hCG always higher with twins?

While there is some research that suggests hCG levels can be higher in twin pregnancies, this is not necessarily always the case. It is still possible to have twins even if your hCG levels are within the “normal” range for a single pregnancy.

However, there is still strong evidence in favor of the idea that hCG levels are typically higher in twin pregnancies. One study in particular found higher than average hCG and estradiol (E2) levels in women carrying twins. Another study also found that peak hCG concentrations were significantly higher and much more prolonged in twin pregnancies. Some in the medical community even estimate that women carrying twins may have approximately 30-50% higher hCG levels compared to women with single pregnancies.

That being said, it’s important to remember that hCG levels can vary widely among women. This is why abnormally high hCG levels alone are not enough to confirm a twin pregnancy. The only way to confirm this is with a standard ultrasound at around five weeks.

What about hCG doubling time with twins?

In a twin pregnancy, hCG will most likely increase at a similar pace to a single pregnancy. The only difference is that the base level for a twin pregnancy will likely be much higher.

This means that in the first four to six weeks after implantation, you can expect hCG to double every two days. Until week 6 of pregnancy, doubling time may slow down to every three to four days. HCG levels then typically peak around week 10, before leveling off and staying constant until delivery.

Understanding hCG and pregnancy

If you’re not quite familiar with the role that hCG plays in pregnancy, here is a brief overview to get you up to speed.

Human chorionic gonadotropin (hCG) is a type of hormone that is produced as soon as implantation begins. Its role specifically is to help the corpus luteum increase the production of progesterone, which is crucial to the growth of the uterus and the uterine lining. If hCG is not being produced, estrogen in turn cannot be produced at an elevated rate and pregnancy is not possible.

HCG is often called the “pregnancy hormone” for this reason, along with the fact that pregnancy tests are designed to test for the presence of hCG in the body.

hCG levels chart for twins by week

There are no standardized hCG ranges for twin or multiple pregnancies. However, it is estimated that the normal hCG levels for twins is 30% to 50% higher than with single pregnancies.

hCG levels during pregnancy

Week	HCG Range (Single)
Week 3	5-50 mIU/ml
Week 4	5-426 mIU/ml
Week 5	18-7,340 mIU/ml
Week 6	1,080-56,500 mIU/ml
Weeks 7-8	7,650-229,000 mIU/ml
Weeks 9-12	25,700-288,000 mIU/ml
Weeks 13-16	13,300-254,000 mIU/ml
Weeks 17-24	4,060-165,400 mIU/ml
Weeks 25-40	3,640-117,000 mIU/ml

Source: American Pregnancy Association

How does hCG testing work?

Testing for the presence of hCG in the body can be done in two different ways:

At home with a urine test
At the doctor’s office with a blood test.

Urine tests are simply the pregnancy tests that you can find at the pharmacy or supermarket. Blood tests, on the other hand, require a visit to the doctor’s office where a sample of blood is taken and sent off to a lab to be analyzed.

The earliest you can take a blood test is 6-8 days after ovulation. A urine test can be taken as early as 12-14 days after your conception date.

What do high hCG levels mean?

Higher than average hCG levels may be an indicator that you are having twins. In rare cases, it can also be a sign of a molar pregnancy or down syndrome. There is also the possibility that you have miscalculated your conception date and are actually further along in your pregnancy than anticipated.

If you are worried about your hCG levels being too high, open up to your doctor about your concerns. They can offer more personalized advice and run additional tests if necessary to further assess the health of your pregnancy.

What do low hCG levels mean?

Lower than average hCG levels in some cases can indicate an ectopic pregnancy or miscarriage. It can also mean that you are not as far along in your pregnancy as you may think. Again, speak with your doctor if you are concerned that your hCG levels are too low. They will be able to offer advice based on your specific situation and medical history.

Testing hCG at home vs with a doctor

Even though you can test for hCG both at home and at the doctor’s, it’s important to make a distinction between these two different types of tests.

At home (urine test)

Testing at home with a urine test is relatively straightforward. This type of hCG testing is known as the standard pregnancy test. There are multiple brands of tests to choose from, and they all may have different methods for collecting and testing urine.

It is important to note that at-home tests can only confirm whether or not your hCG levels are above the threshold for pregnancy. This is typically anywhere over 5-25 MIU/ml. If your levels are above this threshold, you will receive a “yes” or “positive” result, indicating that you are likely pregnant. If they are not above this threshold, you will receive a “no” or a “negative” result, indicating that you are not pregnant (or that it is too soon to tell).

At-home tests are great for confirming that you are in fact pregnant. However, you will not receive a result with your exact numeric hCG concentration level.

Doctor’s office (blood test)

HCG Blood tests, sometimes referred to as “beta hCG tests”, can also confirm pregnancy. However, instead of receiving a “yes” or “no” answer as you would with a urine test, you will instead receive an exact measurement of what your hCG concentration level is. This will be measured in mIU/ml.

Once your result is in, your doctor will be able to confirm whether or not you are pregnant. By monitoring your hCG levels over time, your doctor can continuously monitor the health of your pregnancy and provide further guidance in cases where hCG levels are higher or lower than average.

The hCG Levels That Could Mean You're Having Twins

If you’re concerned about having twins, or if you have been told that your hCG levels indicate there are two little ones on the way, here’s everything you need to know about hCG (human chorionic gonadotropin) and if you might be having twins.

When you get a positive pregnancy test at home, one of the first things you need to do is make an appointment with your obstetrician for your first prenatal visit. At that appointment, your doctor will want to test your hormone levels, specifically your hCG level, to confirm your pregnancy. hCG (human chorionic gonadotropin) is a hormone produced by the body during pregnancy to support fetal growth and development.

Today, we are going to dive into the world of hCG and how and why this is something you should pay attention to during early pregnancy.

What is an hCG Level?

hCG or “the pregnancy hormone” is the most commonly measured hormone during pregnancy. It’s normally produced in the placenta after the egg (or eggs) has been fertilized and traveled to the uterus. hCG is the hormone that alerts your body that you’re pregnant. hCG levels are used as an indicator for the health of your pregnancy. hCG is a useful marker to estimate the gestational age of your pregnancy and to help you determine how far along you are in weeks. hCG levels also assist with determining whether or not you will experience a miscarriage, but hCG testing is not always 100% accurate.

Can a Store-Bought Pregnancy Test Show How High Your HCG level Is?

If you take a home pregnancy test, the results will be based on two main hormones – estrogen and hCG. Levels of these hormones are approximately 1000 times higher during pregnancy than in non-pregnant women. At this time, a store-bought pregnancy test can not give you a specific hCG level; only a woman’s first visit to the doctor can determine the amount of hCG in her system through a simple blood draw.

If you just heard that second heartbeat for the first time, or you know it’s been two for a while, you need to read our twin pregnancy week by week timeline to help you learn what happens week by week with twins. Click here to learn more… and while you’re at it, check out our expecting twins classes and twin parent coaching services.

What Weeks of Pregnancy Does hCG Show Up?

hCG can be detected in the bloodstream about 11 days after conception, with a level of 6 – 40 mIU/ml hCG. The level of hCG doubles every 48-72 hours during early pregnancy. In most normal pregnancies, hCG values increase from the day a fertilized egg implants into the uterine wall, eventually peak around 8-10 weeks after implantation, and plateau as the pregnancy progresses.

The hCG Levels That Mean You’re Having Twins

According to several studies, women pregnant with twins may have a higher level of hCG baseline levels compared to the normal level of hCG in a singleton pregnancy. hCG is the hormone that alerts your body that you’re pregnant. hCG levels are highest during early pregnancy and gradually decline as the pregnancy progresses to term. hCG will be at its highest level when an embryo implants into the uterus.

hCG typically reaches 90,000-100,000 mIU/mL for a singleton pregnancy. Your doctor will be paying closer attention to trends instead of numbers due to the fact that there’s a wide range of normal hCG levels. As long as hCG rises as expected, your doctor will consider your pregnancy as healthy.

Here is a chart of standard hCG levels for a singleton pregnancy. If your levels are on the higher end of the standard hCG range, this could be a clue that you’re having twins.

Week of Pregnancy	Typical hCG Range
3 weeks	5–50 mIU/mL
4 weeks	5–426 mIU/mL
5 weeks	18–7,340 mIU/mL
6 weeks	1,080–56,500 mIU/mL
7-8 weeks	7,650–229,000 mIU/mL
9-12 weeks	25,700–288,000 mIU/mL
13-16 weeks	13,300–254,000 mIU/mL
17-24 weeks	4,060–165,400 mIU/mL
25–40 weeks	3,640–117,000 mIU/mL

What Do High hCG Levels Indicate?

In most pregnancies, the level of hCG normally doubles every 48-72 hours and increases by at least 60% every two days. The higher your levels of hCG are initially, the higher they will be throughout your entire pregnancy. If your HCG levels are higher than average, you could be having twins. An hCG level that is 30%-50% higher than a standard singleton pregnancy could mean a twin pregnancy.

Can hCG Levels Be Found In Urine?

The hormone hCG can be detected in a urine test, but the exact level of hCG can only be measured through a blood test.

Does a High Level of HCG Mean You’re Having Twins?

High levels of hCG do not necessarily mean that you will have twins. You can have high levels of hCG with a singleton pregnancy. The chances of having twins increase with higher levels of hCG, but they cannot be predicted accurately based on this alone. The only way to confirm that you’re having twins is to have an ultrasound, as early as 6 weeks of pregnancy. hCG levels that are higher than normal during pregnancy can sometimes be the result of a problem with the pregnancy, including an hCG-producing tumor (also known as choriocarcinoma), ectopic pregnancies, or a molar pregnancy.

How Common are Twin Pregnancies?

Twin pregnancies occur in three to four out of every 100 pregnancies. Twins account for nearly 80 percent of all multiple births. Triplet and quadruplet births are less frequent but still occur once per 1000 deliveries.

Signs You Are Having Twins

According to research studies, it has been proven that if hCG levels are higher than expected for someone’s week of gestation, then they may be carrying multiple fetuses. Another study revealed that twin pregnancies tend to start out with higher hCG levels than single pregnancies do.

Some studies show that women pregnant with multiples had higher hCG base level counts. Increased hCG levels may indicate a pregnancy that includes twins.

What low hCG levels might mean

Low hCG levels mean that hCG is not being produced in high quantity by the body, which could be the result of testing very early in the pregnancy when the levels are too low. Typically, within a few days, the hCG level will rise much higher. However, in some cases, hCG levels that are too low or not increasing can indicate a miscarriage, also known as a chemical pregnancy. If your hCG levels are not following expected patterns, your doctor may request additional blood draws every few days in order to get a better idea of how the levels are changing.

What high hCG levels might mean

A high hCG level means that hCG is being produced in high quantity by the body, typically due to a strong single pregnancy or a multiple-birth pregnancy. But if your levels aren’t high, that doesn’t automatically mean that there’s something wrong with your pregnancy. It truly depends on what point in time you are in your pregnancy, which can be difficult to determine if you’re not sure of the date of your last period.

High hCG levels alone typically do not indicate that you are having twins, but it may increase your chance of pregnancy with multiples over the normal baseline hCG value for a singleton pregnancy.

Is hCG monitored prior to ultrasound?

Yes, typically, your doctor’s office will check that your blood is showing hCG levels high enough to be considered a healthy pregnancy before scheduling your first ultrasound.

What are the signs of twin pregnancy?

Signs of a twin pregnancy are cramping, bleeding, spotting, nausea or vomiting, and fatigue — the same symptoms as for singleton pregnancies, but when you’re having twins, these symptoms are typically a LOT stronger. Read this article about signs of twin pregnancy to learn more about the signs that you might be having twins.

It is understandable that pregnant women will be curious about the possibility of having multiples. If your doctor has requested additional blood draws in order to get a better idea of how hCG levels are changing, it could mean they suspect you may have twins on board. Keep an eye out for any other symptoms and contact your physician if anything seems off or unusual. And hang in there until you can get that ultrasound done and know for sure if you’re having twins!

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90,000 hCG with twins - a table by day and week.

The hCG table with twins by day and week is a way to make sure that the expectant mother is expecting two babies. Doctors also use such data when managing multiple pregnancies.

Human chorionic gonadotropin (hCG) is one of the most reliable ways to diagnose pregnancy.

Significance of the hormone and its features

Chorionic gonadotropin ensures the functioning of the corpus luteum, the production of progesterone, which protects the pregnancy, and provides nutrition to the fetus. Pregnancy is determined by the concentration of this hormone in the blood: the hormone is abundantly produced by the shell of the embryo after it has attached to the uterine wall and prepared for further development.

Rapid pregnancy tests are based on the determination of a high concentration of hCG in the urine. The hormone is unique in its own way. It is produced in a small amount by the pituitary gland, so it is found in the blood of women of climatic age, with certain diseases (for example, oncology of the appendages or ovaries), and even in men.

How hCG levels change

For each pregnancy, the growth of human chorionic gonadotropin is unique, and a slight deviation of the indicators from the standard norms is allowed. But tabular data help to understand the dynamics, to track how the pregnancy is progressing in the early stages.

Indicative hCG table for twins by week compared to singleton pregnancy.

Pregnancy (weeks)	Concentration of hCG during multiple pregnancy (in mU/ml)	HCG concentration in singleton pregnancy (in mU/ml)
1-2	50-340	25-156
2-3	208-9740	101-4870
3-4	2220-63 000	1110-31 500
4-5	5120-164 600	2560-82 300
5-6	46 200-302 000	23 100-151 000
6-7	54 600-466 000	27 300-233 000
7-11	41 800-582 000	209 00-291 000
11-16	12 280-206 000	6140-103 000
16-21	9440-160 200	4720-80 100
21-39	5400-156 200	2700-78 100

Until the 11th week, the hormone rapidly increases, after the 11th week its concentration decreases. The table clearly shows that the level of hCG with twins is twice as high as with a singleton pregnancy.

Methods for determining the level of hCG

The level of hCG is determined in three ways. The hormone concentration is checked:

rapid pregnancy test;
laboratory blood test;
laboratory analysis of urine.

Pregnancy tests intended for home use. do not show the amount of human chorionic gonadotropin in numbers. They only determine the sufficiency of the hormone, provide initial information about whether a woman has become pregnant or not.

After a home test, a woman goes to the doctors to confirm her pregnancy. Professional studies of urine and blood in laboratories show the exact amount of the hormone.

How to pass tests correctly

No special preparation is required for taking a blood test for hCG. The analysis is taken in the morning, on an empty stomach. Blood is taken from a vein, the analysis will be recognized after a couple of hours or the next day (depending on the workload of the laboratory).

To pass urine for analysis, it is collected at home in a sealed container for analysis. Urine is collected in the morning and handed over to the laboratory in the morning.

Features of twin pregnancy during IVF

During in vitro fertilization (IVF), several embryos are implanted into the uterine cavity at once. This is done to increase the chance of getting pregnant. The replanting of several embryos often leads to the fact that a woman develops a multiple pregnancy. According to statistics, twins are born more often with in vitro fertilization than with natural conception.

After the embryo transfer, the woman's hCG level is already positive. With IVF, a pregnant woman takes tests every five days, starting from the day of embryo replanting. Such careful monitoring is important because early pregnancy with artificial insemination is especially difficult.

A pregnant woman is closely monitored at the time when hCG is actively increasing: these are 10, 11, 12, 13, 14, 15, 16 weeks. At this time, it is important to keep track of the numbers, comparing them with previous readings. If hCG decreases rather than increases, this indicates serious fetal pathologies.

HCG table for twins after IVF

Compared to a singleton pregnancy, the hCG rate for twins after IVF is twice as high. A sharp increase in hCG is characteristic of a number of pathologies: cystic drift, preeclampsia, diabetes mellitus. Doctors carefully monitor the well-being of a pregnant woman in order to exclude a pathological increase in hCG.

The maximum concentration of hCG is observed at the 10th week of gestation. By this time, it reaches from 42,000 to 206,000 mU / ml. The level of hCG is measured on the 14th day after implantation of the fetus. By this time, the embryos are attached to the wall of the uterus (with a favorable development of pregnancy).

Average norms - hCG table with twins (IVF) by day.

Pregnancy (days)	HCG concentration at twins (in mU / ml)
14	60-340
15	80-540
16	140-800
17	240-1160
18	440-1680
19	740-2600
20	1100-4000
30	21 000-40 000
40	50,000-110,000
50	10,000-300,000
60	40,000-400,000
70	40,000-200,000
80	35,000-180,000
90	30,000-120,000

Deviations

If the values in the analysis deviate, do not delay going to the doctor: immediately go to the appointment with the received data. Especially dangerous is a sharp decrease in the concentration of hCG during the first weeks. If the hCG level is outside the normal range, the attending physician will prescribe additional studies to rule out possible pathologies.

HCG norms by weeks of pregnancy

HCG norms by weeks of pregnancy - Private maternity hospital Ekaterininskaya Clinics

Content

Table of average hCG norms
Table of average hCG norms for carrying twins
Table of average hCG values after IVF with engrafted twins
Limits for free hCG β-subunit
Norm РАРР-А
What if I am at high risk?
How to confirm or deny the results of screening?
The doctor says I need an abortion. What to do?

One of the main tests during pregnancy is the study of the level of pregnancy hormone - hCG or human chorionic gonadotropin. If expectant mothers want to know if the hormone level is normal, we made a summary table of values

Table of average hCG norms:

Gestation period	HCG in honey/ml	HCG in mIU/ml	HCG in ng/ml
1-2 weeks	25-156	5-25 (doubtful result)	-
2-3 weeks	101-4870	5-25 (doubtful result)	-
3-4 weeks	1100 – 31500	25-156	-
4-5 weeks	2560 – 82300	101-4870	-
5-6 weeks	23100 - 151000	1110 -31500	-
6-7 weeks	27300 – 233000	2560 -82300	-
7-11 weeks	20900 – 291000	23100 -233000	23.7 - 130.4
11-16 weeks	6140 – 103000	20900 -103000	17. 4 - 50.0
16-21 weeks	4720 – 80100	6140 – 80100	4.67 - 33.3
21-39 weeks	2700 – 78100	2700 -78100	-

Table of average hCG norms when carrying twins:

Gestation period, weeks	Mean range of hCG concentration (mU/ml)
1-2 weeks	50 – 112
2-3 weeks	209 – 9740
3-4 weeks	2220 – 63000
4-5 weeks	5122 – 164600
5-6 weeks	46200 – 302000
6-7 weeks	54610 – 466000
7-11 weeks	41810 – 582000
11-16 weeks	12280 – 206000
16-21 weeks	9440 – 160210
21-39 weeks	5400 – 156200

Table of average hCG values after IVF with engrafted twins:

Gestational age, weeks	HCG range, mU/ml
1-2 weeks	50 – 600
2-3 weeks	3000 - 10000
3-4 weeks	20000 – 60000
4-5 weeks	40000 – 200000
5-6 weeks	100000 – 400000
6-7 weeks	100000 – 400000
7-11 weeks	40000 – 200000
11-16 weeks	40000 – 120000
16-21 weeks	20000 – 70000
21-39 weeks	20000 – 120000

Free hCG β-subunit limits

Measuring free hCG β-subunit levels can more accurately determine the risk of Down syndrome in an unborn child than measuring total hCG.

Norms for free β-hCG subunit in the first trimester:

Gestational period, weeks	HCG in ng/ml
9 weeks	23.6 - 193.1 ng / ml, or 0.5 - 2 MoM
10 weeks	25.8 - 181.6 ng/mL or 0.5 - 2 MoM
11 weeks	17.4 - 130.4 ng/mL or 0.5 - 2 MoM
12 weeks	13.4 - 128.5 ng/mL or 0.5 - 2 MoM
13 weeks	14.2 - 114.7 ng/mL or 0.5 - 2 MoM

Norms in ng / ml may vary in different laboratories, therefore the data indicated is not final, and in any case you should consult your doctor. If the result is indicated in MoM, then the norms are the same for all laboratories and for all analyzes: from 0.5 to 2 MoM.

If hCG is abnormal, then:

If the free hCG β-subunit is higher than normal for your gestational age, or more than 2 MoM, then the child has an increased risk of Down syndrome.
If the free hCG β-subunit is below normal for your gestational age, or is less than 0.5 MoM, then the baby is at increased risk of Edwards syndrome.

PAPP-A norm

PAPP-A, or "pregnancy-associated plasma protein A" as it is called, is the second indicator used in first trimester biochemical screening. The level of this protein constantly increases during pregnancy, and deviations in the indicator may indicate various diseases in the unborn child.

Norm for PAPP-A depending on the duration of pregnancy:

Gestational period, weeks	HCG in ng/ml
8-9 weeks	0.17 - 1.54 mU/ml, or 0.5 to 2 MoM
9-10 weeks	0.32 - 2.42 mU/ml or 0.5 to 2 MoM
10-11 weeks	0.46 - 3.73 mU/ml, or 0.5 to 2 MoM
11-12 weeks	0.79– 4.76 mU/ml, or 0.5 to 2 MoM
12-13 weeks	1. 03 - 6.01 mU/ml, or 0.5 to 2 MoM
13-14 weeks	1.47 - 8.54 mU/ml, or 0.5 to 2 MoM

Norms in ng / ml may vary in different laboratories, therefore the data indicated is not final, and in any case you should consult your doctor. If the result is indicated in MoM, then the norms are the same for all laboratories and for all analyzes: from 0.5 to 2 MoM.

If PAPP-A is abnormal:

If PAPP-A is lower for your gestational age, or less than 0.5 MoM, your baby is at increased risk of Down syndrome and Edwards syndrome.
If PAPP-A is higher than normal for your gestational age, or more than 2 MoM, but other screening values are normal, then there is no cause for concern.

Studies have shown that a group of women with elevated PAPP-A during pregnancy is no more at risk of fetal disease or pregnancy complications than other women with normal PAPP-A.

What if I am at high risk?

If your screening reveals an increased risk of having a baby with Down syndrome, then this is not a reason to terminate the pregnancy. You will be referred for a consultation with a geneticist who, if necessary, will recommend examinations: chorionic villus biopsy or amniocentesis

How to confirm or refute the screening results?

If you think the screening was not done correctly, then you should be re-examined at another clinic, but for this you need to retake all the tests and get an ultrasound. This method is possible only if the gestational age at the time of the examination does not exceed 13 weeks and 6 days.

The doctor says I need an abortion. What to do?

Unfortunately, there are times when a doctor strongly recommends or even forces an abortion based on screening results. Remember: no doctor has the right to such actions. Screening is not a definitive method for diagnosing Down syndrome and, based on poor results alone, a pregnancy should not be terminated.

Say that you want to consult a geneticist and undergo diagnostic procedures for Down syndrome (or other disease): chorionic villus biopsy (if you are 10-13 weeks pregnant) or amniocentesis (if you are 16-17 weeks pregnant).

The author of the article:

Ananyina Anna Aleksandrovna

Obstetrician-gynecologist

Work experience since 2010
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Eat more foods rich in iron: beef tongue, liver, buckwheat and oatmeal, prunes, dried apricots, green apples, etc. But diet alone will not work to raise hemoglobin.
Medical therapy with iron supplements is required. If the problem is associated with insufficient intake of iron into the body, one set of drugs is needed, if with absorption, another. The doctor must select drugs.
Injection therapy may be required for more severe anemia.

If there are no contraindications, natural childbirth is possible. Only an obstetrician-gynecologist should decide on the possibility of EP.

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With an increase in the duration of pregnancy and the growth of the baby, the uterus increases - this can lead to increased tone. Sometimes tension arises in response to the movements of the child. Strong physical exertion, stress, overwork of a pregnant woman can also lead to increased tone.
In early pregnancy, uterine tone may be associated primarily with reduced progesterone production. In this case, the doctor prescribes the patient treatment with progesterone preparations.
Symptoms of increased tone
All pregnant women experience tone differently. Someone - like heaviness and tension in the lower abdomen. Others - as a pulling pain in the lumbar region. In the 2nd and 3rd trimesters of pregnancy, a woman can feel the tone by putting her hand on her stomach: the uterus becomes "stone", then relaxes.