What it is
Pelvic girdle pain is pain in the joints of the pelvis during pregnancy. If your pubic bone hurts, your hips hurt pregnant, or you get a jolt of lightning crotch when you move, this is likely it. The older name is SPD, symphysis pubis dysfunction. Providers now say pelvic girdle pain, or PGP, because the pain can come from the back joints too.
The pelvis is a ring of three bones held by ligaments. In pregnancy, hormones soften those ligaments, and the growing weight shifts your center forward. The joints can move unevenly, and the muscles around them tense up to protect you. That is what hurts.
About 1 in 5 pregnant women have pelvic girdle pain. For some it is a nuisance. For others it makes walking, stairs, and turning in bed hard. It is not harmful to the baby, and it does not mean you cannot have a vaginal birth.
What's typical
Pain can start any time, but it often begins between weeks 18 and 30. It can be in the front, at the pubic bone, in the groin, or at the back near the dimples of the sacrum. Common triggers are standing on one leg, stairs, getting out of a car, rolling over in bed, and walking far. Some mothers hear or feel a click.
Most pelvic girdle pain eases in the weeks after birth. About 1 in 10 mothers still have some pain at three months. Lightning crotch, the brief zap felt late in pregnancy, is often the head of the baby pressing on nerves. It is a different thing from steady joint pain.
What's known
Physical therapy is the treatment with the best evidence. European guidelines and the Pelvic Partnership in the UK both say early referral to a pelvic floor physical therapist shortens the course. Support belts help some mothers. Acupuncture has moderate support in trials. Some chiropractors and osteopaths work with pregnant pelvises; ask about their training. Pain medicine options exist; ask your provider. The old advice to just rest until birth is not what the research supports.
What helps
- Keep your knees together when you roll in bed, get out of the car, or get dressed. Sit to put on pants.
- Take stairs one at a time, leading with the leg that hurts less.
- Sleep on your side with a pillow between your knees and one under your belly.
- Shorten your stride and walk less far, more often. Stop before the pain starts, not after.
- Ask for a referral to a pelvic floor physical therapist. In California you can often book one directly.
- Tell your birth team. Ask them to measure how far your knees can open without pain and write it in your chart for labor.
When to call someone
- Nowpain with bleeding, fever, or a sudden inability to bear weight after a fall.
- Todaypain with numbness in your legs, trouble peeing, or loss of control of your bladder or bowels.
- Todaynew pain that comes in waves with a tight belly, which may be contractions.
- At your next visitany pelvic pain that limits walking, sleep, or work. Ask for a physical therapy referral and do not accept that it is just pregnancy.
Who helps
Tools: Birthworker Directory · Birth Plan Generator
Related
- Back pain and sciaticaPregnancy: Your Body
- Round ligament painPregnancy: Your Body
- Your pelvic floor after birthPostpartum: Your Body
- Pushing and positions for birthGetting Ready for Birth
- Moving your body in pregnancyPregnancy: Your Body
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Sources
- Pelvic Partnership — Pelvic girdle pain: information for women
- Royal College of Obstetricians and Gynaecologists — Pelvic girdle pain and pregnancy patient information
- American College of Obstetricians and Gynecologists — Patient FAQ on back pain during pregnancy
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