Round Ligament Pain in Pregnancy: What Causes It and How to Get Relief

Round ligament pain is a sharp and shooting sensation in the lower abdomen and groin. It can easily catch you off guard, and may leave you worrying that something’s wrong. Fortunately, while it can be unsettling, round ligament pain is usually harmless and temporary.

Let’s explore what round ligament pain is in more detail, as well as how it feels and how you can get some relief.

Your round ligaments support your uterus and connect it to your groin. As your uterus expands in the first and second trimesters of pregnancy, these ligaments start to thicken and stretch to accommodate its increasing size and weight.

This stretching can cause pain, especially when you make sudden movements, such as sneezes or laughter. 1

Round ligament pain is a common complaint among pregnant women. Approximately 50%–80% experience some form of back pain, including round ligament pain, during pregnancy. 2 3

What does round ligament pain feel like?

Round ligament pain can feel different from person to person. It’s variously been described as:

• Sharp or stabbing
• A “pulling” or throbbing sensation
• A dull ache or cramp  4

You may feel the pain on one or both sides of your lower abdomen, and it may radiate outwards. It may even radiate to your lower groin. It’s more common on the right side, although doctors aren’t sure why this is.

Common triggers for round ligament pain

As mentioned, round ligament pain is often triggered by sudden, “explosive” movements, including: 5 6

• Standing up quickly
• Rolling over in bed
• Coughing, sneezing, or laughing
• Exercising

With that said, sometimes, it may also strike when you’re just walking around or even doing nothing much at all.

Round ligament pain vs. Braxton Hicks contractions

In your second and third trimesters, you may also experience Braxton Hicks contractions. These “practice” contractions are your body’s way of preparing for labor, and you might confuse them for round ligament pain.

Here’s a quick key to tell the difference:

• Round ligament pain: Usually sharp and painful, although not extremely so. Round ligament pain usually lasts for less than a minute.
• Braxton Hicks contractions: These typically cause a mild, cramping pain and are irregular (i.e., with no pattern or rhythm). Braxton Hicks contractions usually last from 30 seconds to two minutes. 7

While Braxton Hicks contractions can catch you off guard, they (like round ligament pain) aren’t anything to worry about. If anything, they’re a good sign that your body is gearing up for the big day. 8

Round ligament pain typically begins around the end of the first trimester or early in the second trimester as your uterus starts to expand more rapidly. It’s less common before the 12th week or after the 24th week, although there are no guarantees, and in some pregnancies, it manifests at other times, too. 9 10

Luckily, round ligament pain is usually short-lived. Each episode will probably just last a few seconds or minutes. It often eases up a few weeks after it begins, though some women experience it off and on throughout their pregnancies. 11 12

Once you give birth, your hormone levels will drop and your uterus will return to its pre-pregnancy size. Your round ligament pain should clear up when that happens. 1

While you can’t completely prevent round ligament pain, there are some things you can do to reduce its frequency:

• Change positions slowly: Avoid sudden movements. Get up slowly when you’re sitting or lying down, and roll over gently in bed (be sure to avoid sleeping in any of the wrong positions for pregnancy, such as flat on your back).
• Support your belly: Wear a maternity belt or girdle to provide extra support for your growing belly and reduce pressure on your ligaments. These can also improve your posture, another possible cause of pregnancy aches and pains. Use pillows to support your belly when lying on your side. 13
• Prepare for coughs and sneezes: When you feel a cough or sneeze coming on, flex your hips to minimize the strain on your ligaments. You can also try holding your belly for support.
• Gentle stretching: Try gentle stretches like prenatal yoga poses. Getting on your hands and knees and lowering your head towards the ground while keeping your bottom up can help. 11
• Swimming: Spending some time in the pool can ease the strain on your muscles. 14

How to find relief from round ligament pain

When round ligament pain strikes, you can relieve it in a few ways: 1

• Rest: Stop what you’re doing and sit or lie down in a comfortable position for a few minutes.
• Warm compress: You can relax your aching muscles with a warm compress. Just make sure you do not apply heat directly to your belly and avoid hot baths, as those activities are not recommended during pregnancy. 15
• Over-the-counter pain relief: If your pain is interfering with your daily activities, talk to your doctor about taking acetaminophen (Tylenol). This OTC medication is generally safe to take while you’re pregnant, but it’s still a good idea to get their input.

Not all groin pain during pregnancy is caused by your ligaments stretching to accommodate your growing uterus. Joint aches, including in your pelvis, can also be caused by:

• The strain that your added weight puts on your muscles
• Your posture—you may be prone to slumping as your center of gravity shifts
• The effects of relaxin, a pregnancy hormone

The last point is a particularly big deal. Your body releases relaxin to loosen your ligaments before you go into labor. 16 17 After you give birth, your levels of this hormone will drop, and your pain will resolve.

Conditions that cause groin pain

Further potential causes of groin pain include:

• Symphysis pubis dysfunction (SPD): Also called pregnancy-related pelvic girdle pain (PGP), this occurs when your pelvic joints are stiff or move unevenly. PGP is sometimes even called lightning crotch, since it can cause a sharp shooting pain that feels like an electric shock. 18
• Sacroiliac joint pain: The sacroiliac joint connects the spine and hips and may get strained by the weight gain of pregnancy, leaving you with nasty lower back pain. 19

If you suspect you may have SPD/PGP or sacroiliac joint pain, talk to your doctor. They’ll likely recommend physical therapy to manage these conditions.

Round ligament pain is usually harmless, and doesn’t require medical attention. However, as mentioned, you should get seen if you suspect you have other conditions, which may manifest as more persistent or severe pain.

You should also contact your doctor if you experience: 11 5

• Severe or persistent pain (lasting more than a few minutes)
• Fever or chills
• Nausea or vomiting
• Vaginal bleeding or spotting
• Pain or burning during urination

All of those can indicate an infection or another major pregnancy complication that requires immediate treatment.

If you experience more than four contractions in an hour, that could indicate preterm labor, especially if your contractions are accompanied by any of the other classic labor symptoms, like your water breaking. 20 Needless to say, if you think you might be going into labor, get yourself to the hospital.

No mom-to-be wants their pregnancy to be painful, but unfortunately, round ligament pain is a common grievance for many pregnant women. The good news is that it’s generally harmless and will clear up after you give birth.

In the meantime, get plenty of rest, and don’t be afraid to contact your doctor if you’re concerned about your pain or have any other worrying symptoms. This part of pregnancy isn’t fun, but all of it will be worth it the minute you lay eyes on your newborn!