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Pelvic Pain during Pregnancy

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).

Symptoms of Pelvic Bone Pain in Pregnancy

  • Pain over your pubic bones especially at the front and central parts
  • Pain across the sides of the lower back region as well as the upper legs along with the pelvic bones
  • Pain in and around the perineum area (between the vagina and anus)
  • Pain radiating from the pelvic area to the thighs with a characteristic clicking or grinding feeling or sound
  • Sharp pain in the pelvic region during activities like walking and climbing stairs
  • In some cases, the pain makes it difficult to move the legs apart, such as when getting into a car

Causes for Pelvic Pain during Pregnancy

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.

Pelvic Pain Location During Pregnancy Picture

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.

Pregnancy Pelvic Pain Treatments

Regular exercise, physiotherapy and massage are some of the best treatment options:

  • Manual therapy by an expert physiotherapist for ensuring proper movement of your spine, hip and pelvis joints
  • Prenatal massage
  • Soft tissue strengthening, mobilization and stabilization exercises for strengthening your stomach, back, hip and pelvic floor muscles (check Exercises During Pregnancy)
  • Postural exercises
  • Pool workout or exercise in water (check Pregnancy Water Exercises)

Management of Pelvic Pain in Pregnancy

You can avoid or reduce the frequency of the sharp pain in your pelvic area during pregnancy by following these simple tips:

  • Taking a warm shower helps to relax your muscles and reduce the chances of pain. Make sure that the water is not too hot as it may be harmful for your baby.
  • Applying ice or a cold pack on the pubic symphysis area regularly helps to keep the pain and inflammation in check.
  • Application of a heat-pad on the surrounding musculature can help to relax the muscles by reducing the spasm and tightness.
  • Make sure to sit down before performing activities that may trigger the pain.
  • Get plenty of rest.
  • Do not step over object lying on the ground.
  • Avoid bearing weight for a prolonged period of time.
  • Do not lift or carry heavy objects as it puts additional pressure on the pelvic region.
  • To get into your car, sit on the seat before bringing the legs together into the car.
  • To get out of a car, first bring both of your legs out and then get your body out. Make sure to push equally with both the legs while standing up to avoid the pain.
  • While rolling in bed, keep your legs together by placing a pillow between your knees.
  • To get in bed, first sit on the edge keeping the legs together, then lie down on your side before bringing both your legs up sideways.
  • Avoid climbing stairs as much as possible.
  • Avoid deep squatting.
  • Avoid quick movements or twisting and turning your body sharply as these may put pressure on the pelvic region.
  • Wear flat or low-heeled shoes providing proper arch support. Do not wear high heels.
  • You can also wear pelvic support garments that help to minimize the pressure of the growing uterus on the pelvis.

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.

Published on June 11th 2013 by under Pain During Pregnancy.
Article was last reviewed on 22nd August 2014.

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9 Responses to Pelvic Pain during Pregnancy

  1. Monica says:

    Im 5months pregnant with twins. i have been feeling pain in my pubic area by my bikini area along with lower back pain. it feels like its splitting in half like a period. im not bleeding but i was currently on bed rest due to a 8 centimeter bleed. should i be concerned?

    • Pregmed Editorial Team admin says:

      The symptoms you are describing may be resulting from another common pregnancy complication known as round ligament pain and since you are carrying twins, there may be some more serious cause behind the pain and discomfort. The best thing for you to do is to contact your doctor and describe these symptoms to them so they can help ease your concern as well as your pain. There is nothing to get worried about yet, but as you are at quite an advanced stage of pregnancy, it is best not to ignore even the simplest of symptoms.

  2. ada says:

    Hi.. i’m in my 11weeks pregancy. I feel pain in my right pelvic and also with my back. I never suspect it like a kidney problem because i pee normally, no pain, no bleeding. I’m thinking it might me normal because of the growing fetus inside my womb but why is it just my lower right part of my pelvic?

  3. Stacey says:

    I am currently 22 weeks pregnant with my second child. I have been having vaginal pain and pressure for the past two weeks. I have told my physicians and they just kind of ignored it. I also have swelling in my ankles. It hurts to walk, stand, turn, sit, etc. I also have degenerative joint disease in my lower back along with two herniated disks and sciatica. Pain is “normal” for me, but this is ridiculous. So far I’ve heard that as the pregnancy progresses the pain is only going to get worse. I am a full-time student and I work as a CNA in home health care. Any advice….

  4. Rasha says:

    i have severe left hip pain with actual burning sensation over the left side of Symphysis Pubis
    I am 36 weeks pregnancy

  5. Lindsay Guillen says:

    Hi, I’m having pain only on the left side of my pelvis. I’m 32 weeks pregnant almost 33. It doesn’t bother me when I’m sitting, it hurts when I left my left leg. It isn’t a strong pain just consistent. Should I be concerned?

  6. Rachel Tipsword says:

    Im 36 weeks along and i constantly have this severe pain in my pelvic, lower back, and upper thighs. The pain decreases when im sitting but isnt fully gone. The pain is worse when i wake up from sleeping and try and sit up and get out of bed or reposition myself. Every morning when i wake up my pelvic bone pops and on some days it will pop more than once throughout the day. The pain is severe and I can no longer reposition myself or sit up from the laying position by myself, i have to have help. I notified my OB when it first started happening and he said it was the strong tissue in my pelvic area loosening up so the baby could pass through easily. The pain wasnt quite severe then but not its completely unbearable, please help.

  7. laura says:

    I have taken two pregnancy tests and they were positive and the pregnancy calculator says I’m 5 weeks. I have been doing nothing but researching since I found out. Just today I started noticing pelvic pain on my right side and I’m really worried I could be having an ectopic pregnancy which is devastating because I really want this baby. I’m going to a pregnancy crisis center hopefully tomorrow or monday. Does anyone have any reassuring news before I go? I’m so scared right now :/

  8. Ann says:

    I am currently 24 weeks pregnant with my third child. I am experiencing very strong pains in my pelvis, lower back and it is most severe while walking, climbing stairs, and especially if I have to lift my pelvis when repostioning myself. I’ve let my OBGYN know and she either isn’t concerned or is dismissing me. Either way it hurts very much. I work 12 hours a day, 3 days a week. And I can hardly make it through my shifts. I am at my breaking point and I do not know what else to do.

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