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Pelvic Pain During Pregnancy

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Added on July 17, 2019

Pregnancy is a beautiful thing, but it can also take a toll on a woman's body. 

Many women experience discomfort, and sometimes pain, during pregnancy due to the pressure a growing baby puts on your bladder, back, hips, pelvis, and pelvic floor.

Pelvic pain and incontinence are common conditions that can happen at any stage of life, and you don't have to suffer in silence. Don't ignore your pelvic floor or symptoms of pain, especially when you are trying to stay healthy and grow another human.

Generalized pelvic pain or pressure during pregnancy is different than symphysis pubis dysfunction (SPD) or pregnancy-related pelvic girdle pain (PGP). These uncomfortable symptoms can be caused by stiffness of your pelvic joints or the symphysis pubis may become stretchy and unstable due to a rise in hormones. 

The joints also can move unevenly at either the back or front of your pelvis. During pregnancy, a woman's center of gravity and body mass are changing, so any muscle weakness or joint instability can lead to pain.

Symptoms of pelvic pain  

You may experience pelvic pain at different stages of pregnancy or due to different conditions:

  • First trimester: accommodation pain due to your expanding uterus
  • Second trimester: round ligament pain that starts in your side as the ligament that goes from the top of the uterus down to the groin stretches
  • Third trimester: Pressure from your baby's weight putting pressure on the nerves that run from your vagina into your legs

Diastasis recti occurs when your rectus abdominis muscles separate during pregnancy. This can cause pelvic pain similar to SPD. In addition, ovarian cysts can grow larger during pregnancy and cause persistent pain.

Urinary tract infections and constipation may also cause pelvic pain or discomfort. They are common conditions can be treated with antibiotics, iron supplements, eating fiber-rich foods, staying hydrated and using a stool softener.   

Pelvic pain during pregnancy can make it hard to get around or do daily activities. You may feel pain:

  • At the front or center of your pubic bone, level with your hips
  • On one or both sides of your lower back
  • In your perineum, the area between your vagina and anus
  • When you spread your thighs 
  • You may feel a clicking or grinding in the pelvic area

The pain can come and go and get worse when you:

  • Walk, bend and twist to lift, or push heavy objects 
  • Climb up and down stairs
  • Stand on one leg
  • Turn over in bed
  • Move your legs apart or try to get out of a car
Pelvic floor therapy can help

Physiotherapy and physical therapy help to relieve or ease pain, improve mobility, and improve pelvic joint position and stability. Physical therapy and specialized pelvic floor therapy during and after pregnancy can help decrease low back and pelvic pain and post-delivery bladder problems. 

As movement specialists, PTs are medical professionals trained to identify and address the source of pain. They educate expecting moms about safe exercise and body mechanics, including how to lift, stand and carry other children while pregnant. 

Treatment options include:

  • Manual therapy to help joint alignment and your pelvis, hips, and spine move normally
  • Exercises to support your pelvic floor, stomach, back and hip muscles
  • Addressing pain triggers such as posture, flexibility, or nerve involvement 
  • Education on lifestyle changes to reduce pain 
  • Water-based exercises
  • Advice on positions for sleeping, sex and labor and birth
  • Pelvic support belt or crutches
  • Rest when necessary and use safe over-the-counter pain relievers with your doctor's permission

It's important to stay active and do gentle exercise during pregnancy. It's also important to recognize your pain limits and avoid activities that make the pain worse. You may have to call on your partner and family and friends to help with housework, especially if you have to climb stairs to do laundry or make dinner and care for other young children.  

Other lifestyle changes can help:

  • Move your bedroom to the first floor
  • Wear flat, supportive shoes
  • Sit down to get dressed
  • Take a warm bath or shower and let the water hit your back
  • Get a prenatal or lymphatic massage
  • Try gentle exercises such as walking, prenatal yoga, or pelvic tilts  
  • Keep your knees together when getting out of the car or turning over in bed
  • Sleep on your side with a pillow between your legs
  • Take the stairs one at a time, or go upstairs backwards on your bottom
  • Avoid bending and twisting to lift or carrying a baby on one hip
  • Limit sitting or standing for long periods, crossing your legs, or sitting twisted
  • Minimize lifting or carrying heavy shopping bags, vacuuming or pushing heavy objects such as a supermarket cart 

 Pelvic pain is not something to tough out or dismiss because you are pregnant. And physical therapy is not just for post-birth recovery; it can be a valuable part of prenatal care

Specialized pelvic floor rehab can help your pregnancy and delivery go smooth and relatively pain-free or restore strength and address incontinence postpartum. Ivy Rehab treats a variety of Pelvic Floor Dysfunction (PFD) related to pregnancy, delivery, trauma such as a fall or car accident, surgery, obesity. Pelvic floor physical therapy can improve other pelvic conditions including endometriosis, interstitial cystitis, or prolapse.




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