Articles

Key takeaways

• Pelvic girdle pain (PGP) is common during pregnancy.
• Hormones, baby's weight, and posture can cause PGP.
• Manage pain with gentle movements and supportive aids.
• Contact your midwife or GP if pain affects your daily movement.

Understanding pelvic pain in pregnancy

Pain in your pelvic area during pregnancy is common. This is often called pelvic girdle pain (PGP). Pain at the very front of your pelvis is sometimes called symphysis pubis dysfunction (SPD).

PGP is a collection of uncomfortable symptoms. It happens when your pelvic joints become stiff. It can also occur if the joints move unevenly at the back or front of your pelvis.

PGP can cause pain anywhere from your lower back down to your thigh. This pain can be at the front or back of your body.

Common symptoms of pelvic pain

You might feel pain in different areas of your body.

• Over the pubic bone – at the front in the centre, roughly level with your hips.
• Across one or both sides of your lower back.
• In the area between your vagina and anus (the perineum).
• Spreading to your thighs.
• Deep in your pubic area, lower back, hips, groin, thighs, or knees.

Some women may also feel or hear a clicking or grinding in the pelvic area. You might find it difficult to walk. You may find you have a waddling walk.

The pain can feel worse during certain movements.

• Walking a long way or on rough ground.
• Going up or down stairs.
• Standing on one leg, for example, when getting dressed.
• Turning over in bed.
• Moving your legs apart, such as when getting out of a car.
• Getting in and out of a car or bath.
• Having sex.

Causes of pelvic pain

Pelvic pain usually occurs in pregnancy due to the hormone relaxin. This hormone softens the ligaments in your body. This allows your pelvis to open up.

It makes room for your baby to be born. As this hormone gets to work on your muscles and ligaments, it can sometimes cause discomfort or problems with your balance.

PGP is often caused by your joints moving unevenly. This can make your pelvic girdle less stable and painful.

As your baby grows, the extra weight puts more strain on your pelvis. Changes in how you sit or stand also add to this strain.

Symptoms can increase as your pregnancy progresses. This is due to changes in your body's centre of gravity and posture.

Strategies for preventing and managing pelvic pain

There are many simple things you can do to help manage pelvic pain.

Daily tips for managing pain

• Keep active – but also get plenty of rest.
• Stand tall – with your bump and bottom tucked in a little.
• Change your position frequently – try not to sit for more than 30 minutes at a time.
• Sit down – when getting dressed and undressed.
• Put equal weight on each leg – when you stand.
• Keep your legs together – when getting in and out of the car.
• Lie on the less painful side – while sleeping.
• Keep your knees together – when turning over in bed.
• Use a pillow – place it under your bump and between your legs for extra support in bed.
• Wear supportive shoes – for better posture and stability.
• Ask for help – family and friends can help with everyday activities.

Activities to avoid

You should try to avoid anything that makes your symptoms worse.

• Lifting anything heavy, such as shopping.
• Going up and down stairs too often.
• Stooping, bending, or twisting to lift or carry a toddler or baby on one hip.
• Sitting on the floor, sitting twisted, or sitting or standing for long periods.
• Standing on one leg or crossing your legs.
• Activities that put your pelvis in an uneven position. This includes sitting cross-legged, reaching, pushing or pulling to one side.

Support and treatment options

Your midwife or GP can refer you to a physiotherapist. They will assess you and create a treatment plan.

Physiotherapy aims to relieve pain and improve muscle function. It can also improve your pelvic joint position and stability.

This may include:

• Exercises – to strengthen your core (stomach and back) and pelvic (pelvic floor and hip) muscles. These exercises can improve your balance, posture, and spinal stability.
• Manual therapy – hands-on treatment to your muscles and joints by a specialist. This helps to gently move your joints back into position.
• Equipment – such as crutches or a pelvic support belt. Support belts can be effective if used regularly for short periods.
• Heat and cold therapy – such as warm baths, or heat or ice packs.
• Hydrotherapy – special exercises in a warm-water pool.
• Acupuncture – a treatment where fine needles are inserted into the skin.

While treatment can make a big difference to your symptoms, many people find the discomfort doesn't fully go away until after their baby is born. However, treatment from an experienced practitioner can improve your symptoms during pregnancy.

When to seek help for pelvic pain

Speaking to your midwife or GP as soon as you notice symptoms is a great first step. An early diagnosis can help keep your pain to a minimum and avoid long-term discomfort.

Call your midwife or GP if you have pelvic pain and:

• It is hard for you to move around.
• It hurts to get out of a car or turn over in bed.
• It is painful going up or down stairs.

These can be signs of pregnancy-related pelvic girdle pain. You may be referred to a physiotherapy service. This service specialises in pelvic problems that happen during pregnancy.