Some women may develop pelvic pain in pregnancy. This is sometimes called pregnancy-related pelvic girdle pain (PGP) or symphysis pubis dysfunction (SPD).
PGP is a collection of uncomfortable symptoms caused by a stiffness of your pelvic joints or the joints moving unevenly at either the back or front of your pelvis.
Symptoms of PGP
PGP is not harmful to your baby, but it can be painful and make it hard to get around.
Women with PGP may feel pain:
- over the pubic bone at the front in the centre, roughly level with your hips
- across 1 or both sides of your lower back
- in the area between your vagina and anus (perineum)
- spreading to your thighs
Some women may feel or hear a clicking or grinding in the pelvic area.
The pain can be worse when you're:
- going up or down stairs
- standing on 1 leg (for example, when you're getting dressed)
- turning over in bed
- moving your legs apart (for example, when you get out of a car)
Most women with PGP can have a vaginal birth.
Non-urgent advice: Call your midwife or GP if you have pelvic pain and:
- it's hard for you to move around
- it hurts to get out of a car or turn over in bed
- it's painful going up or down stairs
These can be signs of pregnancy-related pelvic girdle pain.
Treatments for PGP
Getting diagnosed as early as possible can help keep pain to a minimum and avoid long-term discomfort.
You may be referred to a physiotherapy service that specialises in obstetric pelvic joint problems.
Physiotherapy aims to relieve or ease pain, improve muscle function, and improve your pelvic joint position and stability.
This may include:
- exercises to strengthen your pelvic floor, stomach, back and hip muscles
- equipment, if necessary, such as crutches or pelvic support belts
These problems tend not to get completely better until the baby is born, but treatment from an experienced practitioner can improve the symptoms during pregnancy.
Coping with pelvic pain in pregnancy
Your physiotherapist may recommend a pelvic support belt to help ease your pain, or crutches to help you get around.
There are some things you can do to help ease pelvic and lower back pain in pregnancy.
- keep active but avoid doing things that make the pain worse
- rest when you can
- wear supportive shoes
- put equal weight on each leg when standing
- sit down when getting dressed or undressed
- put a pillow between your legs for extra support in bed
- keep your knees together when getting in and out of the car
You should also avoid:
- sitting or standing for long periods
- going up and down stairs too often
- lifting heavy objects, such as shopping bags
The physiotherapist should be able to provide advice on coping with the emotional impact of living with chronic pain, such as using relaxation techniques.
If your pain is causing you considerable distress, then you should let your GP or midwife know. You may require additional treatment.
Labour and birth with pelvic pain
Many women with pelvic pain in pregnancy can have a normal vaginal birth.
Plan ahead and talk about your birth plan with your birth partner and midwife.
Write in your birth plan that you have PGP, so the people supporting you during labour and birth will be aware of your condition.
Think about birth positions that are the most comfortable for you, and write them in your birth plan.
Being in water can take the weight off your joints and allow you to move more easily, so you might want to think about having a water birth. You can discuss this with your midwife.
Who gets pelvic pain in pregnancy?
It's estimated that PGP affects up to 1 in 5 pregnant women to some degree.
It's not known exactly why pelvic pain affects some women, but it's thought to be linked to a number of issues, including previous damage to the pelvis, pelvic joints moving unevenly, and the weight or position of the baby.
Factors that may make a woman more likely to develop PGP include:
- a history of lower back or pelvic girdle pain
- previous injury to the pelvis (for example, from a fall or accident)
- having PGP in a previous pregnancy
- a physically demanding job
- being overweight
Listen to women’s experiences of pain and discomfort in pregnancy, including PGP, on healthtalk.org.
Read more about coping with common health problems in pregnancy, including nausea, heartburn, tiredness and constipation.