Pelvic pain in pregnancy is common, but that does not mean you simply have to put up with it.

If walking, climbing the stairs, rolling over in bed, getting dressed or getting in and out of the car has suddenly become uncomfortable, you may have been told that your pelvis is becoming unstable because pregnancy hormones are making everything loose.

But this explanation is far too simplistic and can leave women frightened to move.

So let’s look at what is actually happening.

What is pelvic girdle pain?

Pelvic girdle pain, often shortened to PGP, describes pain experienced around the joints, muscles and structures of the pelvis during pregnancy.

You might feel pain at the front of your pelvis around your pubic bone, around your hips, groin, lower back, buttocks or thighs. For some women it is a mild ache. For others, it can significantly affect everyday movement.

You may particularly notice it when:

• Walking
• Standing on one leg
• Climbing stairs
• Turning over in bed
• Getting dressed
• Getting in and out of the car
• Moving your legs apart
• Carrying a toddler or other load

And while pregnancy certainly changes the way your body moves, pelvic pain is not simply a case of your pelvis becoming loose or unstable.

Is relaxin causing your pelvic pain?

This is one of the biggest myths surrounding pelvic girdle pain.

Hormones including relaxin do contribute to normal adaptations within connective tissues during pregnancy. But research does not support the idea that pelvic pain can simply be explained by having too much relaxin or your pelvis becoming unstable.

Your pelvis is an incredibly strong structure.

During pregnancy, however, your body is adapting rapidly.

Your centre of gravity changes as your bump grows. The way you stand, walk and transfer load through your body can change. Your abdominal wall is adapting to accommodate your growing uterus. The muscles around your hips, pelvis and trunk are working differently. Previous injuries, your individual movement patterns, muscle strength, fatigue and the demands you place on your body can all influence symptoms.

Pain itself is also complex. It is influenced by the nervous system as well as the tissues where you experience the pain

"So rather than thinking:

“My pelvis is unstable and I need to protect it.”

I want you to think:

“My body is adapting to pregnancy and it may need some additional support to manage those changing demands.”

That shift matters because fear of movement can sometimes lead us to move less, become weaker and feel even less confident in our bodies.

Should you stop exercising if you have pelvic pain?

Not necessarily.

In fact, appropriate movement and strengthening can be incredibly helpful.

The important word here is appropriate.

If a particular movement repeatedly causes a significant increase in your symptoms, forcing yourself through it is unlikely to be useful. But completely avoiding movement is rarely the answer either.

Instead, we want to find the level of movement your body currently tolerates and build from there.

This might include strengthening the glutes, hips and muscles around your trunk, adapting your exercise technique and reducing movements that are particularly provocative while symptoms settle.

A pelvic health physiotherapist can be invaluable here because pelvic girdle pain is individual. What aggravates one woman may feel completely comfortable for another.

Small changes can make a big difference
 

Think about the movements that trigger your symptoms and see whether you can temporarily modify them.

For example, sit down to get dressed rather than balancing on one leg.

When getting out of the car, swivel your whole body rather than twisting while one leg remains inside.

Experiment with a pillow between your knees and ankles when sleeping.

Take stairs more slowly if needed and consider taking them one at a time during a painful flare.

Try varying positions throughout the day rather than remaining in one position for long periods.
 

Keep active within your comfortable limits.

And importantly, get support early.

You do not need to wait until you can barely walk before asking for help.

What about pelvic support belts?

Some women find pelvic support belts helpful, particularly during activities that normally aggravate their symptoms.

They are not fixing an unstable pelvis. Instead, they can provide additional external support and may make certain movements feel more comfortable.

Again, they are one tool rather than the entire solution.

Will pelvic pain affect my birth?

Having pelvic girdle pain does not automatically mean you cannot have a vaginal birth.

Most women with PGP can give birth vaginally.

One useful piece of preparation is understanding your comfortable range of movement before labour.

For example, notice how far you can comfortably open your knees or move into different positions without triggering pain. You can then communicate this during labour, particularly if you have an epidural and cannot rely on pain to tell you when a position is uncomfortable.

Birth positions also do not have to mean lying on your back with your legs wide apart.

Side lying, kneeling, forward leaning and all fours positions may all be worth exploring depending on what feels comfortable for you.

The biggest thing I want you to know

Pelvic pain during pregnancy does not mean your body is failing.

And it does not mean your pelvis is falling apart.

Pain is a signal that deserves attention, not something you should simply accept as an inevitable part of pregnancy.

Getting individualised support early can help you understand what is contributing to your symptoms, adapt the way you are moving and build strength and confidence as your pregnancy progresses.

Pregnancy asks your body to adapt enormously.

Sometimes the answer is not to ask it to do less. It is to give it better support to do what you are asking of it.

Written by Midwife Pip

Pip an experienced practicing NHS Midwifery Sister, MSc, author of Midwife Pip’s Guide to a Positive Birth, KGH hypnobirthing diploma, founder of the Midwife Pip Podcast, pelvic health specialist, pre and postnatal trainer and, importantly, a mum. Pip is an enthusiast of all things womens health and wellness. Having worked with many families, for many years Pip see’s every day the void in high quality information available. Pip is on a mission to change this and to make sure that all women can access the information they deserve and need to be empowered and supported through their pregnancy, birth and postpartum journeys.

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