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I am 26 weeks along. While sitting down on the bed, I lost my balance which led to my tummy tightening as I re-gained my balance.

Can the tightening of abdominal muscles harm my baby?

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Your baby can't be injured by temporarily tightening your abdominal muscles while struggling to regain balance at any stage of a normal pregnancy (and the vast, vast majority of pregnancies are "normal"; if not, they are called high-risk pregnancies and the patient is given specific instructions regarding levels of activity.) Even in most high-risk pregnancies, I can't imagine the circumstances you describe hurting the fetus.

Millions upon millions of mothers have been stretching, tightening, squeezing, bumping, and even sleeping on their bellies for thousands of years without discernible bad outcomes for their babies. Falls later in the pregnancy, though, are another matter.

It might be helpful (or it might not; I hope it is) to look at what babies survive and what kind of trauma causes harm to babies.

The leading cause of trauma-related death of fetuses is motor vehicle accidents (~85%), followed by domestic violence, then penetrating injuries (stab wounds, gun shots, etc.) As a general rule, the later the pregnancy, the more at risk the fetus is from these kids of injuries (10-15% in the first trimester and 50-54% in the third trimester.)

Keep in mind that trauma is also the leading cause of maternal death during pregnancy as well.

With life threatening trauma a 50% fetal loss rate exists.

That's an amazing statement; it means that even when the mother is so badly injured that her life is in danger, the fetus survives 50% of the time.

In the case of gunshot wounds to the pregnant abdomen, overall maternal mortality is low (3.9%). Fetal mortality, on the other hand, is high, ranging between 40 and 70%. (Some studies differ with this number.)

That's also an amazing statement; it means that even when the pregnant woman has been shot in the abdomen, the baby survives from 30-60% of the time!

Of 372 pregnant women admitted to Level I/II trauma centers (the highest level trauma care, where people in bad accidents people get flown to for treatment)

84% had blunt injuries and 16% had penetrating injuries. There were 14 maternal deaths (3.8%) and 35 fetal deaths (9.4%).

That is, the injuries were so bad, that for every 2.4 babies who died, one woman also died.

From this, it's pretty clear that for a baby to die, the injury to the female is usually serious.

This is a slightly skewed view, though. When women die from trauma, often the babies do as well; that is, a cesarean section doesn't save many of them.

It's pretty safe to say minor injuries are unlikely to affect the fetus adversely, with an important exception: falls. Pregnant women are more likely to fall, and the farther a woman is along in the pregnancy, the more likely she is to sustain an injury to the uterus/placenta which might cause the fetus harm from a fall.

The most common harmful outcome is placental abruption. The uterus is relatively elastic, while the placenta is not. Acceleration-deceleration injuries (MVAs and falls) result in shearing forces that may separate the placenta from the uterus - partly or completely - this is placental abruption. The most common signs of abruption are painful contractions with vaginal bleeding (for small tears, bleeding might not occur, but the pain will be there.)

After a fall, the most common complication is premature onset of labor where, in one study, 95% of cases produced a viable child. Even with placental abruption, if detected and treated early, the results are good for the baby.

All statistics quoted are arguable because of lack of consistent categorization and reporting practices.
Trauma in Pregnancy
Management of the Injured Pregnant Patient
Fetal Deaths Related to Maternal Injury
Placenta abruptio

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    I think your otherwise great answer could end with symptoms that might indicate a need to see a doctor and a timeframe after which OP can be safe that all is well. (I'm taking your username verbatim while I make this suggestion.) – user4758 Dec 6 '15 at 13:39
  • @what - Oof! It's so long and semi OT as it is... – anongoodnurse Dec 6 '15 at 21:25
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    It might be long but I think it is of awesome help to many expecting parents. I might have a skewed view due to a late child (mid-30's for both parents), but having at least one thing one didn't have to worry himself crazy about is good, given how many other things we were being scared with. – DRF Oct 10 '17 at 8:26

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