Hormonal health

Fibroids in Pregnancy: What to Expect

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Most fibroids stay stable during pregnancy and cause no problems, though some grow in the first or second trimester. The main complication is red degeneration, a self-limited fibroid pain. Fibroids can modestly raise the chance of cesarean, breech position, or preterm birth, but most pregnancies with fibroids go well.

Last updated: July 2026

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Do fibroids grow during pregnancy?

Most fibroids stay about the same size during pregnancy, and only a minority grow noticeably. When growth does happen, it tends to occur in the first half of pregnancy, often before about 20 weeks, driven by the rise in estrogen and progesterone 1. Fibroids are common to begin with, affecting up to 80% of women by age 50, so many pregnancies involve at least one.

Growth is not the same as trouble. A fibroid that enlarges may cause pressure, back discomfort, or a heavy feeling, yet plenty of women feel nothing at all 1. If you are learning about your fibroids for the first time, our guide to fibroid symptoms and treatment covers the basics beyond pregnancy.

What is red degeneration?

Red degeneration is the most common fibroid complication in pregnancy, and it causes sharp, focused pain over the fibroid. It happens when a growing fibroid outstrips its own blood supply, so the tissue begins to break down 2. The pain is usually self-limited and managed conservatively with rest, hydration, and pregnancy-safe pain relief chosen by your clinician 2. It typically improves within about 1 to 2 weeks.

Because the pain can be intense, it sometimes prompts an urgent visit to rule out other causes. Appendicitis, a kidney stone, or a pregnancy complication can feel similar, so evaluation focuses on sorting benign fibroid pain from something that needs prompt treatment 3.

Can fibroids cause pregnancy complications?

Fibroids raise certain pregnancy risks modestly, though most pregnancies with fibroids still go well. The Office on Women's Health lists a higher chance of miscarriage, preterm birth before 37 weeks, breech position, and cesarean delivery, particularly with large fibroids over 5 cm, multiple fibroids, or those beneath the placenta 1. The size and location of a fibroid influence which risks, if any, apply.

Bleeding and pain deserve attention in any trimester. Some spotting in early pregnancy is common and often harmless, but heavier bleeding needs assessment, and fibroids can occasionally contribute to miscarriage 4. Most women with fibroids never experience these complications at all.

How do fibroids affect delivery?

Fibroids influence delivery mainly through their position rather than their number. A fibroid low in the uterus or near the cervix can block the baby's path or contribute to a breech position, raising the likelihood of a cesarean 1. Many women with fibroids still deliver vaginally, and the decision is individualized. If a cesarean is needed, our guide to cesarean recovery explains what to expect.

Fibroids usually improve after birth. As estrogen and progesterone fall, most fibroids shrink back toward their pre-pregnancy size, commonly within about 3 to 6 months 1. Across the lifespan, fibroids tend to grow through the reproductive years and shrink after menopause, so pregnancy is one chapter in a longer hormonal story. The NICE antenatal guideline recommends monitoring known fibroids as part of routine prenatal care 3.

When fibroids in pregnancy need an obstetrician

An obstetrician can fold your fibroids into your overall pregnancy plan. Sharing where your fibroids sit, how big they are, and any pain or bleeding lets the care team anticipate issues like degeneration pain or a possible cesarean 2. Most women with fibroids have healthy pregnancies, and monitoring is often all that is needed 3. An ultrasound can locate the fibroids relative to the placenta and cervix, which helps the team plan for delivery and watch for issues like malposition 1. Severe abdominal pain, heavy bleeding, or a fever always warrants prompt evaluation during pregnancy. Gale can help you prepare for that conversation.

Common questions

Usually not on their own. Most women with fibroids have healthy pregnancies. Large, multiple, or low-lying fibroids can raise the chance of complications like cesarean or preterm birth, so your care team may monitor them more closely, but many pregnancies need only routine care.

The most likely reason is red degeneration, when a growing fibroid outgrows its blood supply and the tissue breaks down. The pain is usually sharp and focused over the fibroid, tends to be self-limited, and is managed with rest and pregnancy-safe pain relief guided by your clinician.

Often yes. Many women with fibroids deliver vaginally. A cesarean becomes more likely mainly when a fibroid sits low near the cervix and blocks the baby's path or contributes to a breech position, which your obstetrician assesses as your due date nears.

Usually. As hormone levels fall after birth, most fibroids shrink back toward their pre-pregnancy size over the following months. Any new heavy bleeding or lasting pain after delivery is still worth mentioning to your clinician.

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Fibroid symptoms in pregnancy that need prompt care

  • —Severe or worsening abdominal pain during pregnancy is a reason to seek same-day medical care
  • —Heavy vaginal bleeding during pregnancy is a reason to seek urgent evaluation
  • —A fever alongside fibroid pain is a reason to seek prompt clinician review
  • —A noticeable decrease in the baby's movements is a reason to contact your maternity team right away

If you have severe abdominal pain, heavy vaginal bleeding, a high fever, or reduced fetal movement, seek care right away by contacting your maternity team or going to the nearest emergency room, or call 911.

This article is general health education, not medical advice. How fibroids affect your pregnancy depends on their size, location, and your history, and should be managed with your obstetrician or midwife.

References

  1. 1.Office on Women's Health (U.S. HHS) (2025). Uterine fibroids. Office on Women's Health (womenshealth.gov), U.S. HHS. link ✓Patient-facing overview describing fibroid behavior in pregnancy, including possible growth, higher chances of miscarriage, preterm birth, breech position and cesarean, and post-birth shrinkage.
  2. 2.American College of Obstetricians and Gynecologists (2021). Management of Symptomatic Uterine Leiomyomas: ACOG Practice Bulletin, Number 228. Obstetrics & Gynecology. doi:10.1097/AOG.0000000000004401 ✓ACOG practice bulletin covering symptomatic leiomyomas, including red degeneration and conservative, pregnancy-appropriate management of fibroid pain.
  3. 3.National Institute for Health and Care Excellence (2024). Antenatal care (NG201). National Institute for Health and Care Excellence (NICE). link ✓Antenatal care guideline supporting monitoring of known fibroids and assessment of abdominal pain during routine prenatal care.
  4. 4.Hartmann KE, Fonnesbeck C, Surawicz T, Krishnaswami S, Andrews JC, Wilson JE, Velez-Edwards D, Kugley S, Sathe NA (2017). Management of Uterine Fibroids (Comparative Effectiveness Review No. 195). Agency for Healthcare Research and Quality (AHRQ). PMID 30789683 ✓Comparative effectiveness review summarizing fibroid-related pregnancy outcomes, including the contribution of fibroids to bleeding and pregnancy loss in some cases.

4 sources, numbered by first appearance. General health information, not medical advice. AI-assisted editorial content — every citation independently verified. Editorial policy

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