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Dealing with Pelvic Pain during Pregnancy

Updated on April 26, 2011

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Pelvic Pain during Pregnancy

Pregnant moms ask me almost daily what can be done to relieve the constant pain in the front of their pelvis. Most of them tell me that they feel like they are are being pulled apart at the seams. Some even say that if they move too quickly or roll over in bed that everything is going to fall out the bottom. Many moms have been told by friends, family and worst of all, their doctor, that is is a normal part of pregnancy and that nothing can be done about it. Today, I hope to help pregnant moms understand the different types of pelvic pain, clarify some of the misinformation being taught and provide a few practical solutions for those of you with this common problem.

Causes of Pelvic Pain during Pregnancy

  • Symphysis Pubis Dysfunction- (a.k.a. Pubic Symphysis Dysfunction, Osteitis Pubis, Diastasis Symphysis Pubis, Pelvic Girdle Pain) Accepted as the most common cause of pelvic pain during pregnancy. Relaxin and other hormones of pregnancy cause ligaments throughout the body to relax, becoming pliable and stretchy. This process prepares the pelvic ligaments to stretch sufficiently during delivery. Laxity of the pelvic ligament allows the pelvic bones to separate more than they before pregnancy, causing a significant amount of pain. Typical symptoms include the sensation of "falling apart at the seems", painful clicking or popping of the pubic bones, sharp pelvic pain when rolling over in bed, lifting a heavy object or standing on one foot. A lot of the waddling walk of pregnancy is attributable to SPD. Many women experience SPD for months after delivery
  • Round Ligament Pain- The round ligament suspends the uterus against the abdominal wall as it grows. Round Ligament Pain (RLP) is very different than SPD. Pain is typical sharp and stabbing, occurs on one side of the abdomen and goes away in seconds. It is thought to be caused by a spasm or cramp of one of the round ligaments. RLP usually resolves soon after delivery although it has been rarely reported non-pregnant women. Sadly, with little questioning or investigation most health care providers attribute all types of pelvic pain to RLP.
  • Gravity Induced Pelvic Pain- Hopefully this cause of pelvic pain is more intuitive. As baby grows in-utero, the simple weight of the uterus and it's contents increasingly compress the superior portion of the pelvis. This type of pelvic pain is usually described as dull and achy and typically less intense than the two causes listed above. Luckily, most women find some relief late in the third trimester as baby's head settles lower into the pelvis.
  • Other causes such as inguinal hernias, appendicitis, local infection, or uterine fibroids are known causes of pelvic pain but will not be discussed here.

Solutions for Pelvic Pain during Pregnancy

1. Symphysis Pubis Dysfunction- Finding reliable relief from SPD requires understanding of the cause. As described above, SPD stems from laxity or stretching of the pelvic ligaments. A comfortable and adjustable maternity belt is the best solution for most women with SPD. Be careful not all maternity belts are created equal. Almost all commercially available maternity belts are designed to lift the baby off of the pelvis rather than compress the pelvis and support the pelvic ligaments. In all of my searching, I have only found two belts that seem to work.

  • Symphysis Maternity Belt- I can't say enough about this belt. I recommend it to every pregnant mom with SPD. It's the only maternity belt I've found that adjustable, washable and provides enough compression to prevent pelvic pain caused by SPD. If you've tried other belts and are not satisfied, I'd give the Symphysis Maternity Belt a try. You won't be disappointed.
  • Serola Belt- Also a great option for SPD. It's washable, adjustable and comfortable. The only drawback for pregnant moms is that the Serola Belt was designed to treat low back pain. Many pregnant moms find good relief with this belt, however it's a little thick in the front and can become quite uncomfortable in the later stages of pregnancy. Slightly more expensive than the Symphysis Maternity Belt but still a decent option.

2. Round Ligament Pain- The only definitive treatment is delivery of the infant or surgical removal of the underlying cause. Here are a few palliative options for those with RL

  • Analgesics. Acetaminophen is generally regarded as safe to take during pregnancy and is commonly prescribed for pain relief for pregnant women with RLP
  • Rest. Resting is one of the best remedies against RLP.
  • Changing position and modifying movements. Sudden movements often aggravate RLP. Doing things like sitting up, lying down, standing up, sneezing, or coughing. Try to avoid sudden movements that can cause spasms of the ligament. When about to sneeze or cough, brace yourself by bending at the hips to minimize the strain on the ligaments.
  • Heat application. Some women find that applying a hot compress to the area of pain may provide some relief. Soaks in a hot baths may also help.
  • Physical exercises. Daily stretching exercise are commonly recommended by an obstetrician. Ask you physician for a list of helpful stretches.
  • Surgery. In RLP, pathological causes of RLP include, varicosities, endometriosis, and adenomyosis, surgery may be necessary to perform resection of the ligament or removal varicosity, cyst or myoma.

3. Gravity Induced Pelvic Pain- Similar to RLP, the only true solution is delivery. There are dozens of styles and brands. Some of the more well known and time tested are Gabrialla, Belly Belt, Medela, and Prenatal Cradle. You might have to try a few different styles before finding one that works for you. I recommend borrowing one from a friend or family member before making the investment.

Know that there are solutions for your pelvic pain of pregnancy, whatever the type. Don't accept the statement that pelvic pain is a normal part of pregnancy and that nothing can be done about it. Especially those of you with Symphysis Pubis Dysfunction. Take responsibility for the problem and the solution. Best wishes through the rest of your pregnancy.


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    • mag76 profile image

      mag76 6 years ago

      Thanks for clarifying some crucial issues to me. See, I'm sixteen weeks pregnant and this type of pain is very much present. I know it's supposed to be normal, but still...

      Thanks anyway

    • DoctorMom profile image

      DoctorMom 6 years ago

      I wish her good luck with her pregnancy.

    • cathylynn99 profile image

      cathylynn99 6 years ago from northeastern US

      my niece is pregnant. will keep this in mind. thanks.