Pelvic pain, also referred to as PPGP (pregnancy-related pelvic girdle pain), is a normal symptom associated with pregnancy. It can result from a wide range of factors from the changing hormone levels to the relaxing muscles and ligaments for the growth of the uterus. In some women, mild to severe pelvic pain may occur during the first trimester as an early sign of pregnancy. But, sometimes, the pain may indicate a more serious health condition such as kidney stones. Pelvic pain in pregnant women can also be associated with a condition named symphysis pubis dysfunction (SPD).
The principal factors may vary depending on the stage of your pregnancy:
Accommodation of the Growing Uterus – You may feel a cramping pain in the pelvic area between the eighth and twelfth weeks of pregnancy. The pain resembles that occurring before a period. It is caused by the expanding uterus which pushes the muscles and organs to make room for the baby. This type of pain is more common in a first pregnancy compared to subsequent ones.
Picture 1: Pelvic Pain Location
The pain worsens as the growing uterus gradually dislodges the pelvic joints and muscles
Ovarian Cysts – These cysts often develop due to any alteration in the way the ovaries produce or release eggs. They are generally noncancerous and harmless, growing larger in size during pregnancy. The growing uterus often puts pressure on the ovaries which can lead to persistent pain. It is advisable to seek medical assistance if you suspect the presence of an ovarian cyst as they may cause extreme pain in case of a rupture.
Round Ligament Pain – This is often the reason behind pelvic pain during the second trimester. It is caused by stretching of the ligament that runs down to your groin area from the upper regions of the uterus. You are most likely to feel the pain while walking or rising from a sitting position.
Pressure from the Baby’s Weight – Lower pelvic pain commonly felt during the third trimester is usually caused by the increasing weight of the growing fetus. As the fetus grows in size, it applies pressure on the nerves running from the vagina into the legs. It is usually felt during movements like walking, rolling in your bed at night and riding in a car.
Braxton Hicks Contractions – Pressure felt in the pelvis region, coming and going on their own without causing considerable pain, is most likely to be caused by practice contractions known as Braxton Hicks contractions. The main difference between a true labor contraction and a Braxton Hicks one is that the latter occurs more sporadically and is generally painless. This practice contraction is commonly caused by dehydration occurring from the 20th week of pregnancy.
Relaxed Pelvic Joints – During the later part of pregnancy, your body produces higher amounts of the hormone named relaxin, which helps to stretch the muscles and ligaments to prepare your body for childbirth. Additionally, relaxin often loosens the pelvic joint and separates the two bones to a certain extent. These factors can lead to mild to moderate pain near the pubic bones and a feeling of instability in your legs.
Constipation – Constipation during pregnancy can lead to pelvic pain and discomfort in some women.
Urinary Tract Infection or UTI – Around 10% of all women get affected by UTI at some stage in their pregnancy. IT can lead to various symptoms including pain or burning sensation with urination, bloody urination, pelvic pain and abdominal pain.
More serious causes may include ectopic pregnancy, miscarriage, preterm labor, uterine fibroid, uterine rupture and appendicitis.
Regular exercise, physiotherapy and massage are some of the best treatment options:
You can avoid or reduce the frequency of the sharp pain in your pelvic area during pregnancy by following these simple tips:
It is never advisable to follow any exercise schedule without consulting with your doctor and physiotherapist. They will be able to educate you on the strategies and mechanics for minimizing the pain while performing all your daily activities.