Finding out you have fibroids during pregnancy can feel frightening, but it is a common situation. Fibroids are non-cancerous growths in the uterus, and many women carry them without any problems. For most women, fibroids do not cause serious complications during pregnancy. When problems do happen, they can usually be managed with careful monitoring and safe treatment options.
What Are Fibroids and How Common Are They in Pregnancy?
Fibroids, also called uterine leiomyomas, are growths made of muscle and connective tissue. They develop in or on the walls of the uterus. They are not cancer. About 20 to 50 percent of women have fibroids, and the rate is higher among Black women. Many women do not know they have fibroids until they become pregnant or have an ultrasound.
During pregnancy, estrogen levels rise significantly. Because fibroids are sensitive to estrogen, some can grow larger during the first trimester. Most fibroids stay the same size or grow only slightly. Some may even shrink after delivery.
Fibroids vary in size, number, and location. A fibroid can be as small as a pea or as large as a grapefruit. Location matters more than size in most cases. Fibroids that press into the uterine cavity, called submucosal fibroids, are more likely to cause problems than those on the outer wall.
What Symptoms Can Fibroids Cause During Pregnancy?
Most pregnant women with fibroids have no symptoms at all. When symptoms do occur, they can range from mild to severe. The most common symptom is pain. Pain usually happens when a fibroid outgrows its blood supply. This condition is called red degeneration. It causes the fibroid to break down and release chemicals that trigger pain and sometimes a low-grade fever.
Other symptoms can include:
- Abdominal pressure or a feeling of fullness
- Mild to moderate pelvic pain
- Backache
- Spotting or light bleeding
- Frequent urination if the fibroid presses on the bladder
Red degeneration typically occurs in the second or third trimester. The pain can be sharp and sudden. It usually resolves on its own within a few days to a couple of weeks. Over-the-counter pain relief, when approved by your doctor, can help manage the discomfort.
How Can Fibroids Affect the Pregnancy and Baby?
Most fibroids do not harm the pregnancy or the baby. However, some fibroids create higher risks. The location and size of the fibroid determine the level of risk.
Fibroids that block the cervix or the birth canal can make vaginal delivery difficult. In these cases, a cesarean section may be necessary. Fibroids can also increase the risk of:
- Preterm labor and preterm birth
- Placental abruption, where the placenta separates from the uterine wall early
- Fetal growth restriction, meaning the baby grows more slowly than expected
- Malpresentation, such as breech position
- Postpartum hemorrhage, or heavy bleeding after delivery
These risks are real but relatively small. Most women with fibroids deliver healthy babies at full term. Your doctor will monitor you more closely if you have fibroids, which means problems are more likely to be caught early.
How To Deal With Fibroids During Pregnancy Safely?
The safest approach to fibroids during pregnancy is careful monitoring and symptom management. Surgery to remove fibroids, called myomectomy, is rarely performed during pregnancy. It carries risks of heavy bleeding and preterm labor. Surgery is only considered in extreme cases, such as a twisted fibroid causing severe pain that does not respond to medication.
Your doctor will likely schedule extra ultrasounds to track the fibroid’s size and position. These scans also check the baby’s growth and the placenta’s health. This monitoring is the foundation of safe fibroid management during pregnancy.
For pain, acetaminophen (Tylenol) is generally considered safe during pregnancy when taken as directed. Your doctor may recommend it for fibroid-related pain. Non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen are usually avoided during pregnancy, especially in the third trimester, because they can affect the baby’s heart and kidneys. Always ask your doctor before taking any pain medication while pregnant.
Rest and heat therapy can also help. A warm heating pad on the abdomen, not directly over the uterus, may ease discomfort. Gentle stretching and prenatal massage, with your doctor’s approval, can reduce muscle tension around the fibroid.
When Should You Call Your Doctor Immediately?
Some symptoms require urgent medical attention. Do not wait for your next scheduled appointment if you experience any of these:
- Severe or sudden abdominal pain that does not improve
- Heavy vaginal bleeding
- Fever over 100.4°F (38°C)
- Contractions before 37 weeks
- Decreased fetal movement
- Fluid leaking from the vagina
These symptoms can indicate a complication that needs immediate evaluation. Red degeneration can cause significant pain but is not an emergency. However, your doctor needs to rule out other causes like appendicitis, kidney stones, or placental problems. Only a medical evaluation can determine the cause of your symptoms.
Can Fibroids Cause Miscarriage?
Fibroids can increase the risk of miscarriage, but most women with fibroids do not miscarry. The risk depends on the fibroid’s location. Submucosal fibroids, which distort the uterine cavity, have a stronger association with early pregnancy loss. Fibroids that are large or located near the placenta can also interfere with blood flow to the developing embryo.
Research suggests that women with submucosal fibroids have a higher miscarriage rate compared to women without fibroids. However, the overall risk remains low for most women. If you have had recurrent miscarriages and fibroids, your doctor may discuss surgical removal before your next pregnancy. This decision is made on an individual basis after a full evaluation.
What Happens During Labor and Delivery With Fibroids?
Your birth plan may need adjustments if you have fibroids. Many women with fibroids deliver vaginally without issues. Your doctor will assess the fibroid’s position late in pregnancy to determine if vaginal delivery is safe.
Fibroids located low in the uterus, near the cervix, can block the birth canal. In this case, a planned cesarean section is recommended. Fibroids high in the uterus usually do not interfere with delivery.
After delivery, fibroids typically shrink. The drop in estrogen after birth causes them to reduce in size. This process takes several months. Some women find their fibroids cause fewer symptoms after pregnancy, while others notice no change.
Heavy bleeding after delivery, called postpartum hemorrhage, is more common in women with fibroids. Your care team will watch for this and have treatments ready if needed. This is another reason why delivering in a hospital with a full maternity unit is safest when you have fibroids.
Can You Prevent Fibroids From Growing During Pregnancy?
There is no proven way to prevent fibroids from growing during pregnancy. Hormones drive fibroid growth, and you cannot control hormone levels during pregnancy. Some lifestyle factors are associated with lower fibroid risk in general, but none are proven to stop growth during pregnancy.
Maintaining a healthy weight, eating a diet rich in fruits and vegetables, and staying physically active are linked to lower fibroid risk in non-pregnant women. These habits are good for pregnancy anyway. But do not expect them to halt fibroid growth. If a fibroid grows, it is not because of something you did or did not do.
Frequently Asked Questions
Can fibroids harm my baby during pregnancy?
Most fibroids do not harm the baby. Some fibroids raise the risk of preterm birth or growth restriction, but the majority of women with fibroids deliver healthy babies.
Is fibroid surgery safe during pregnancy?
Surgery is rarely performed during pregnancy because it carries risks of bleeding and preterm labor. Doctors only consider it in extreme cases when medication cannot control severe symptoms.
Will I need a C-section if I have fibroids?
Not necessarily. Many women with fibroids deliver vaginally. A C-section is only needed if a fibroid blocks the birth canal or causes other delivery complications.
Do fibroids go away after pregnancy?
Fibroids usually shrink after delivery when hormone levels drop. This shrinking takes several months, and some fibroids may not change at all.
Fibroids during pregnancy can feel overwhelming, but most women navigate this condition without major problems. Regular prenatal care, honest communication with your doctor, and knowing which symptoms require urgent attention are the safest tools you have. Your care team will monitor you closely and adjust your plan as needed. Trust the process and ask questions whenever something feels unclear.
