Hip pain during pregnancy is extremely common, and the good news is that most of it responds well to simple changes in how you sleep, move, and support your body. The discomfort typically stems from hormonal shifts that loosen your joints, combined with the increasing weight and postural changes of a growing belly. Here’s what’s happening and what actually helps.
Why Pregnancy Causes Hip Pain
Your body produces a hormone called relaxin that loosens the muscles, ligaments, and joints around your pelvis, back, and abdomen to prepare for delivery. Relaxin levels rise through the first trimester and peak around 12 to 14 weeks, then decline before surging again just before birth. While this flexibility is necessary, it comes at a cost: your pelvis and back feel looser and less stable, which can shift your posture and put uneven stress on your hip joints.
On top of that, as your uterus grows, your center of gravity shifts forward. Your body compensates by adjusting how you stand and walk, which often overloads the muscles around your hips and lower back. The combination of joint laxity, extra weight, and altered mechanics is what makes hip pain so predictable during pregnancy, particularly in the second and third trimesters.
Sleep Position and Pillow Placement
Side sleeping is the recommended position once your abdomen starts expanding, and sleeping on your left side with your knees bent is ideal for blood flow. But spending hours on your side puts direct pressure on the hip joint, which is why nighttime pain is one of the most common complaints.
The single most effective adjustment is placing a firm pillow between your knees and lower legs. This keeps your hips aligned with your spine and prevents the top leg from pulling your pelvis forward. You can also tuck a pillow under your belly to keep it from dragging downward and another against your lower back for stability. Full-body pregnancy pillows do all of this at once and are worth trying if individual pillows shift around during the night.
If you’re still waking up with sore hips, consider your mattress. A pressure-relieving mattress topper, such as an egg crate foam layer, can reduce the compression on your hip when you’re lying on your side for hours.
Exercises That Ease Hip Tension
Gentle movement is one of the best tools for managing hip pain, because stronger muscles around the pelvis compensate for the stability your loosened ligaments can no longer provide.
Pelvic tilts are a go-to exercise recommended by the Mayo Clinic. Lie on your back with your knees bent and feet flat on the floor. Flatten your lower back against the floor by tightening your abdominal muscles and tilting your pelvis slightly upward. Hold for up to 10 seconds, then release. Repeat 10 to 15 times. This strengthens your deep abdominal muscles and takes pressure off your lower back and hips. (In later pregnancy, you can do this standing against a wall if lying on your back feels uncomfortable.)
Pelvic floor exercises (Kegels) support the muscles at the base of your pelvis. Tighten the muscles you’d use to stop urinating midstream, hold for a few seconds, and release. These work well paired with pelvic tilts.
Swimming and water exercise are particularly helpful because water supports your body weight while allowing you to move freely. Low-impact activities like these are easier on loosened joints than cycling or heavy lifting. Avoid movements that involve wide leg spreading, twisting, or sudden changes of direction, as these can aggravate an unstable pelvis.
Support Belts and Daily Habits
Maternity support belts wrap around your lower abdomen and pelvis to provide external stability. Research on their effectiveness is mixed, but a 2021 study found that 82% of participants reported improvement after four weeks of use, and a 2024 study measured a meaningful drop in pain scores. They won’t fix the underlying cause, but many people find they make walking and standing significantly more comfortable.
Small changes to your daily routine also add up:
- Wear cushioned, supportive shoes. Flat, unsupportive footwear increases strain on your pelvis.
- Avoid sitting for long stretches. Get up and shift positions every 30 to 45 minutes.
- Stand tall. Keep your shoulders back and tuck your tailbone slightly under. This counteracts the forward pull of your belly.
- Keep your knees together when getting in and out of a car or rolling over in bed. Swinging one leg wide stresses the pubic joint.
- Ice your pelvis for 15 to 20 minutes after a particularly painful day. A bag of frozen peas wrapped in a towel works well.
When It Might Be Symphysis Pubis Dysfunction
If your pain is concentrated at the front of your pelvis, right at the pubic bone, you may have symphysis pubis dysfunction (SPD). This happens when the joint connecting the two halves of your pelvis becomes too loose or inflamed. SPD affects a significant number of pregnancies and ranges from mild discomfort to sharp, debilitating pain.
Signs that point toward SPD include a sensation that your pelvis is loose or wobbly, shooting pain from the front or back of your pelvis, a clicking or grinding sound when you walk, and pain that radiates into your groin, inner thighs, or lower back. Some people also notice difficulty with urination or unexplained fatigue.
The management strategies overlap with general hip pain relief (pillow between the knees, support belt, ice, good posture) but SPD often benefits from professional help. A physical therapist can teach you pelvic stabilization exercises tailored to your specific pattern of instability and show you safer ways to bend, lift, and move. Acupuncture, massage therapy, and chiropractic care are also options that some people find effective for reducing pelvic pain during pregnancy.
Professional Help Worth Considering
If home strategies aren’t giving you enough relief after a week or two, prenatal physical therapy is the next step. A physical therapist who works with pregnant patients will assess how your pelvis is moving, identify which muscles are weak or tight, and design an exercise program specific to your body. Pelvic stabilization exercises, which strengthen the muscles that hold your pelvis steady, are the core of this treatment and often produce noticeable improvement within a few sessions.
Acupuncture is another option with a reasonable evidence base for pregnancy-related pelvic pain. It’s generally considered safe during pregnancy when performed by a licensed practitioner experienced in prenatal care.
Pain That Isn’t Just Hip Pain
Most pregnancy hip pain is musculoskeletal and, while uncomfortable, not dangerous. But certain symptoms can signal something more serious, like preterm labor. Contact your provider if your hip or pelvic pain is accompanied by regular or frequent belly tightening (contractions), a dull low backache that comes and goes in a rhythm, pressure low in your pelvis that feels different from your usual discomfort, vaginal spotting or bleeding, or a gush or steady trickle of fluid from the vagina. These symptoms, especially before 37 weeks, need prompt evaluation.