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Pelvic Pain in Pregnancy – Causes and Management

Medically reviewed by Dr. Sadaf Iftikhar, MBBS, FCPS—Written by Dr. Ramisha Farooq, MBBS on August 4, 2021.

Around 80% of females complain of pelvic pain in pregnancy, caused by stiffness of the joints in front or back of the pelvis. This condition was previously called pregnancy-related pelvic girdle pain (PGP) or symphysis pubis dysfunction (SPD) as it was known to involve symphysis pubis but recent researches concluded that it affects other joints of the pelvis as well.

Symptoms

Pelvic girdle pain is not harmful to the mother or baby’s health but is a very uncomfortable and painful situation. The symptoms are:

  • Pain across the lower back
  • Pain radiating to your thighs
  • Pain is experienced over the pubic bone at the front, in the center.
  • Pressure in pelvis
  • Clicking or grinding sensation in the pubic area
  • Pain is aggravated by vigorous activities like walking, tossing and turning in the bed, running, and even parting your legs

Causes of pelvic pain in pregnancy

Pelvic pain in pregnancy can be caused by several reasons, as your body is accommodating the baby and is also making room for it to pass through the pelvis. The changes that take place during pregnancy, which may trigger the pain are different for each semester.

Pelvic pain in the first trimester:

  • The pain during the first trimester is just caused by growth spurts of the uterus and fetus
  • Other than this, digestive issues like GERD also worsen in the first trimester
  • Rupture of the corpus luteum during the first trimester can also cause considerable pain

Other underlying causes can be:

Pelvic pain during the second trimester:

One major ligament that supports the uterus is the round ligament that stretches and thickens to accommodate the growing fetus during pregnancy. Any sort of sudden movement can make these ligaments retract rapidly causing severe pain that lasts only for a few seconds.

Pelvic pain during the third trimester:

The symphysis pubis is a fixed joint which also becomes softer and begins to move from its place due to constant strain. The pain due to this is debilitating enough for you to require crutches or a wheelchair to move around. The pain is experienced at the level of your hips, one side of your lower back, or in the perineum. The pain is accompanied by an uncomfortable clicking and grinding sensation in the pubic area.

Who gets pelvic pain in pregnancy?

Every one in five pregnant females experiences pelvic pain at some point in pregnancy. Some of the factors that may make women more at risk to develop pain are:

  • History of trauma to the pelvis
  • History of PGP in a previous pregnancy
  • Obesity
  • Being pregnant with twins or triplets
  • History of lower back or pelvic pain
  • The job that requires physical exertion

Management of pelvic pain in pregnancy

Most of the time women consider this pain to be a part of pregnancy and think they should just put up with it and do not seek help, this is not how it should be. If you are suffering from pregnancy-related pelvic girdle pain you should talk to your practitioner and seek help. Several approaches are used to manage the symptoms depending upon the intensity and severity of the condition.

Diagnosis:

Diagnosing the exact cause of pelvic pain in pregnancy is very important as the pain can also be indicative of other underlying conditions.

  • In early pregnancy, your practitioner will ask for a pregnancy test to confirm gestation
  • A blood picture is required to look for any sort of infection
  • Urine analysis and culture to rule out urinary problems like UTI
  • Pelvic examination to assess the situation of the symphysis pubis
  • Ultrasound pelvis and abdomen to rule out other causes such as kidney stones, appendicitis, and others
  • MRI can also be conducted if any other cause is suspected

How to prevent pelvic pain in pregnancy?

Some actions may trigger or worsen the pain and should be avoided:

  • Avoid standing on one leg
  • Crossing your legs or sitting on a hard surface
  • Lifting heavy weights or pushing any heavy object
  • Sitting or standing for a longer period

Treatment:

There is no proper treatment for pelvic pain in pregnancy but some medications can be used for temporary pain relief and physiotherapy can help with better mobility at the joints

Medical treatment

  • Over the counter painkillers for pain relief
  • A TENS machine can be used

Therapeutic treatment

  • Manual physiotherapy can help with mobility at joints
  • Kegel exercises strengthen the pelvic floor, back, and hip muscles
  • Exercises in water are a great option

Lifestyle changes and home remedies

Pelvic girdle pain during pregnancy is a long-term condition and coping with the pain is not an easy job. But making some lifestyle adjustments can ease your pain and decrease the discomfort.

  • Take proper rest
  • Use help with your daily chores from your family
  • Wear flat and comfortable shoes
  • In case of severe pain don’t hesitate to use structures or even a wheelchair
  • Get dressed while sitting down
  • Do movements within your pain limits and avoid any sort of rigorous activity like running, having sex, or walking too much
  • Sleeping with pelvic pain during pregnancy is not easy, a plastic bag to slide on while turning your side
  • Turn over with your knees together
  • Use a pregnancy pillow for a comfortable sleep or sleep with a pillow between your legs while lying on the side
  • Using a heating pad but not for more than 10 minutes at a time
  • A maternity belt can also be used for extra support

When to consult a doctor?

If your pelvic pain is accompanied by any of the symptoms you should consult your gynecologist as soon as possible:

  • Fever
  • Rigor and chills
  • Nausea or vomiting
  • Lightheadedness
  • Slow movements of the baby
  • Vaginal bleeding
  • Any sort of vaginal discharge
  • Recurrent episodes of diarrhea
  • Blood in stool

FAQ

How to sleep with pelvic pain during pregnancy?

  • Lie on one side and place a pillow between your legs
  • Use a plastic bag to slide on while changing sides

Where is pelvic pain located in pregnancy?

Pain is generally experienced in the lower back, groin, on one side across the pelvis or both, and in thighs.

How to relieve pelvic pain during pregnancy?

Manual physiotherapy, kegel exercises, over-the-counter painkillers, and a TENS machine are some options to reduce pelvic pain.

What does pelvic pain feel like?

Pain is gripping in character, ranging from mild to severe in intensity. The pain sometimes becomes so debilitating enough for the mother to use crutches or a wheelchair to move around.

Last medically reviewed on August 4, 2021.