Pelvic Pain During Pregnancy: Symptoms, Causes & Treatment

Along with backaches, tummy cramps, and round ligament pain, pelvic pain is one of the most common complaints among pregnant women. About 1 in 5 expectant mothers experience it at some point in their pregnancies. 1

The pain can range from a mild twinge to a debilitating ache. Thankfully, there are ways to ease it.

Read on to learn the causes and symptoms of pelvic pain, how to manage your discomfort, and when it’s time to see a doctor.

The feeling of pelvic pain, also known as pelvic girdle pain (PGP), can vary from person to person and may even vary throughout your pregnancy.

You might feel it as:

• A general feeling of pressure or weight in your pelvic region
• Sudden, sharp, stabbing, or wrenching pangs that come out of nowhere
• Discomfort that radiates to your lower back, the back of your leg, and even your knee or foot.

The last point refers to sciatica, a condition that can occur when your uterus puts pressure on your sciatic nerve. 2

Certain activities might make your pelvic pain worse, such as having sex during your pregnancy, walking or sitting for a long time, or going to the toilet. 3

When does pelvic pain start?

Pelvic pain can start as early as your first trimester, but it often gets worse as you progress further into your pregnancy. The good news is that it’ll usually get better after you give birth. 1

What to know about pelvic pain and pelvic pressure

Note that pelvic pain is different from pelvic pressure, which typically feels like your baby is pushing down. You’ll also feel that the pressure comes and goes. 4

If your pelvic pressure is accompanied by abdominal cramps with or without diarrhea, regular uterine contractions (6 times or more in 1 hour), and a low, dull backache below your waistline, these could be signs of preterm labor (labor before week 37 of your pregnancy). You’ll need to contact your doctor immediately. 4 5

Several factors can lead to pelvic pain during pregnancy, including: 2

Hormonal changes

During pregnancy, your body produces the hormones relaxin and progesterone, which loosen your ligaments and joints in the pelvic area.

While these hormones are important for a healthy pregnancy, they can stretch your ligaments too far and cause pelvic pain. 6

Moreover, your increased levels of progesterone can slow down your digestive system and lead to digestive issues like gas, constipation, or pregnancy-induced bloating. These conditions can spark pain in your pelvis and may even feel similar to labor pain. 7

Your baby’s growth and position

As your baby grows, she’ll push your pelvis forward. This can put a strain on the muscles and ligaments in and around it.

As your baby drops lower into your pelvis in preparation for birth, her head will press against your bladder, rectum, hips, and pelvic bones, putting even more stress on those areas.

Your uterus expanding throughout your pregnancy can also put pressure on and cause pain in your pelvic area.

Urinary tract infections

Pregnant women are more likely to get urinary tract infections (UTIs), which happen when bacteria enter the urethra and bladder. You may feel pain in your back, lower abdomen, or pelvis, and a burning sensation when you pee. 7 8

Other pelvic pain conditions

Sometimes, your pelvic pain might be linked to a specific condition, such as sacroiliac joint pain. The sacroiliac joint connects the spine and the pelvis. It may hurt as your pelvis widens during pregnancy. 9

Another common condition that can lead to pelvic pain is round ligament pain. In the early part of your second trimester, typically between 16 weeks to 18 weeks of your pregnancy, you might feel a sharp, brief pain in your lower abdomen due to your round ligaments (the ligaments that support your uterus) stretching. 10

You’re more likely to develop pelvic pain during your pregnancy if: 1

• You’ve had multiple pregnancies (especially if you had pelvic pain in a previous pregnancy)
• You have hypermobility syndrome (more flexibility than normal in your joints) 11
• You have a history of back or pelvic pain or injury
• Your job involves strenuous activities (e.g., lifting, twisting, or bending)
• You’re overweight or carrying a large baby (macrosomia)

While you can’t prevent pelvic pain during pregnancy, there are many ways to ease the pain. For instance, you can wear belly slings and pregnancy girdles, bands, or belts. They can support your belly’s weight and take some pressure off your pelvis.

Exercises for combating pelvic pain

Water exercises and other gentle exercises, such as prenatal yoga and walking, can also make your pelvic area more comfortable.

For some women, Kegels (also known as pelvic floor exercises) can strengthen the pelvic floor muscles and ease pregnancy-related discomfort.

That said, you should check with your doctor to ensure that you don’t have hypertonic pelvic floor dysfunction first. This condition causes your pelvic muscles to tighten too much, and Kegels will only make this worse. 12

Getting rest with pelvic pain

While a little physical activity is helpful, try to avoid physically demanding tasks and get as much rest as possible.

When you sleep, use pregnancy pillows to support your belly and hips. You can also put a pillow between your knees to align your hips. Heating pads (so long as you use them on the lowest possible setting and for short periods of time), ice packs, and maintaining good posture are also good remedies. 13

You can usually manage pelvic pain on your own, but sometimes, the discomfort may get out of hand. Call your doctor immediately if your pelvic pain is severe enough to interfere with your daily activities.

If your pain is accompanied by bleeding, nausea, or vomiting, or if it hurts when you pee, you should also get in touch with your doctor, as it could be a sign of a more serious underlying condition. 14

Your doctor may give you a physical examination and movement tests to diagnose you. Sometimes, they might give you an ultrasound or MRI.

How to treat pelvic pain during pregnancy

If your pelvic pain is severe and the self-care tips listed here don’t work, your doctor may suggest one of various treatment options.

• Physical therapy: Your doctor may refer you to a physical therapist specializing in prenatal care, who can teach you stretches and exercises that’ll strengthen your core, pelvic floor, and back.
• Prenatal massage: You could also look into getting prenatal massages from a massage therapist certified in treating pregnant women. However, due to the risk of miscarriage in the first trimester, many therapists recommend waiting until your second trimester or third trimester to get massages.
• Pain relievers: Your doctor might give you pregnancy-safe pain relievers like acetaminophen (Tylenol). 15 Never take more than the recommended amount.

Your body will undergo many changes as it prepares and makes room for your baby. Feeling your little one grow bigger and bigger inside your belly is a joy in many ways, but it comes with some not-so-fun aspects, like aches and pains.

If pelvic pain happens to you, try our tips to manage the pain, and if the pain is unbearable, don’t hesitate to reach out to your doctor. Remember that this pain is temporary and will go away soon after birth.