What is pelvic girdle pain and how does it feel?

Pelvic girdle pain is chronic pain in the bones of your pelvic girdle. It is very common in pregnancy; according to the Royal College of Obstetricians and Gynaecologists up to one in five women can expect it when they’re expecting. The pain can be constant or intermittent and range from mild to severe. The way you feel it depends on your physiology and medical history. Your doctor may use the term “pelvic girdle pain” to describe pain you experience in your hips, thighs, backside, and lower back in pregnancy. It can feel like period pain. It’s not possible to predict exactly how it will affect you until it happens.

Why does pelvic girdle pain happen in pregnancy?

We don’t know exactly; it could be more than one reason linked to the bones of your pelvic girdle. The word “girdle” may make you think of that 50s-style structured undergarment that predated Spanx and Skims knickers and encircled your waist and hips. The pelvic girdle is a ring of bones that sits lower down, at the base of your spine. It supports the weight of your bump pregnancy, protecting your spine and sharing some of the burden with your legs. In pregnancy, the weight of your expanding abdomen impacts how you move and sit. The three joints of the pelvic girdle may operate unevenly, causing pain. You are more likely to suffer from pelvic girdle pain if you are hypermobile, have been pregnant before, have a history of pelvic injury or back problems, or if you are overweight or obese. The mood disorders depression and anxiety, as well as chronic stress and even work dissatisfaction, are also considered risk factors. We used to relate pelvic pain to the pregnancy hormone relaxin, which makes joints more elastic to prepare them for childbirth, but this has been studied in some depth with no correlation found between its presence and PGP.

Unii's Pelvic Health Expert, Ms. Clare Bourne, writes about her personal experience of PGP after a fall in the gym in Strong Foundations (Thorsons, 2023). Clare believes that catastrophising about how she would cope with PGP, as well as her fear of birth itself, contributed to her pain and that while PGP is never all in a woman's head, it's important to speak to your doctor or pelvic health physiotherapist about how any anxiety about PGP or about birth generally may be exacerbating symptoms.

How is pelvic girdle pain treated in pregnancy?

You can often manage pregnancy girdle pain yourself with Paracetemol, though women who feel pain is too severe to deal with using over-the-counter, codeine-free medications should seek help. There is never a good reason to suffer pain in pregnancy in silence, and your quality of life matters to the health of your baby and your pregnancy. You may not feel like exercising, but research suggests that regular physical exercise is crucial to PGP management. It’s also important for pregnancy health, unless your doctor specifically advises otherwise. A pelvic health physiotherapist or yoga or Pilates instructor qualified to deal with pregnant women will be able to help you with exercises that provide relief, though daily walking, swimming, and other gentle activities should also help you.

Wearing sensible shoes and a supportive belt (if advised) can help with pain. Manual therapy is recommended in some cases. Reducing your stress and maintaining good sleep hygiene are important to pregnancy generally but can also help with PGP. You should also seek to manage any mental health problems you experience as quickly as possible, even where you’ve had no history of them prior to falling pregnant. Your mental health is just as important to your pregnancy as how you feel in your body.

Is pelvic girdle pain dangerous in pregnancy?

Pelvic girdle pain will not harm your baby directly, but changes to your quality of life—disrupted sleep, decreased mobility, and the poor mental state that chronic pain promotes—can make it a worry. Immobility in pregnancy, should it happen as a result of severe PGP or anything else, puts you at a higher risk of developing blood clots, and support stockings may be recommended to you.

Is pelvic girdle pain the same as SPD?

Sort of, symphysis pubis dysfunction describes pain in the pubic symphysis joint, which is at the very front of the pelvis, but pelvic girdle pain is a more general term for pain related to the pelvis as a whole. So, we can say that PGP includes SPD, but the term symphysis pubis dysfunction only partially describes pelvic girdle pain.

Is pelvic girdle pain the same as round ligament pain?

No, round ligament paint is not the same. You have two round ligaments, one on either side of the uterus, so they’re nowhere near your pelvic girdle. Round ligament pain comes from the stretching and spasming of your round ligaments as your uterus grows in pregnancy. It usually feels like sharp, intermittent pain in the abdomen or groin and can happen at any time in pregnancy.

Can I prevent pelvic girdle pain in pregnancy?

Pelvic girdle pain in pregnancy is not your fault. As mentioned, we don’t know precisely why it happens, and it is a common problem that affects different women in different ways. It may not be possible to completely prevent it. However, staying fit and active, managing your stress and any mental health problems, and maintaining a healthy BMI can all lower your risk.

Can I have a normal delivery with pelvic girdle pain?

Yes, most women who experience pelvic girdle pain and are planning a vaginal birth can have it. This pain does not itself mean you’ll have to deliver by caesarean, forceps, or ventouse, though you may still have to give birth by one of these methods for some other reason. In addition, most women with PGP do not need to be induced.

Will pelvic girdle pain go away after childbirth?

Yes, pelvic girdle pain usually subsides after birth, though the RCOG says that one in ten women experiences ongoing pain. For some women, PGP only begins after birth. If you experience PGP while postpartum, symptoms can improve with support from a pelvic health physiotherapist.

Will pelvic girdle pain come back in every pregnancy?

Past experience of pelvic girdle pain in pregnancy is considered a predictor of future cases. However, this doesn’t mean there is nothing you can do to lower your risk of experiencing it in future pregnancies. Staying fit and healthy, protecting your pelvis from injury, staying within a healthy BMI range, and working on your pelvic floor strength are all advised. Even if these steps don’t prevent PGP—and we cannot guarantee anything will—they all contribute to a healthy pregnancy.

For more advice on taking care of yourself in pregnancy, labour, and birth, check out Unii’s Antenatal Classes, with prenatal video episodes taught by senior NHS midwives, an award-winning obstetrician and gynaecologist, and six other leading healthcare experts. Only at unii.com.

For more information on how to manage symptoms in every week of pregnancy, check out Unii’s Pregnancy Journey video course with Dr. Shree Datta.

Antenatal Class Questions: What is pelvic girdle pain?

Ouch! Unii looks at pelvic girdle pain in pregnancy and how to alleviate it.