Hip pain during pregnancy is common, reported by roughly 38% of pregnant women in survey data. For most, it’s a predictable result of hormonal changes and the physical demands of carrying extra weight. That said, not all hip pain is the same, and understanding what’s behind yours can help you manage it and know when something less routine might be going on.
Why Pregnancy Causes Hip Pain
Your body prepares for childbirth by loosening the connective tissues around your pelvis. A hormone called relaxin drives much of this process. Relaxin breaks down collagen, the tough protein that holds your joints, ligaments, and cartilage together. It ramps up enzymes that dissolve collagen fibers while simultaneously slowing down the production of new ones. The result is looser, more flexible joints throughout your pelvis and hips.
Estrogen and progesterone amplify this effect. They prime the cells in your ligaments, cartilage, and joint lining to respond more strongly to relaxin. This is helpful for delivery, but it also means the hip joint has less structural support than usual. The cartilage ring that lines the hip socket (called the labrum) is particularly sensitive to these hormonal shifts. Its cells produce high levels of the same enzymes relaxin activates, which can weaken the tissue and contribute to pain or instability in the joint itself.
On top of the hormonal changes, the mechanical reality of pregnancy adds pressure. As your center of gravity shifts forward, the muscles around your hips and lower back work harder to keep you upright. The growing weight of your uterus loads your pelvis differently than your body is used to, and the combination of extra load plus looser joints creates the perfect setup for discomfort.
What Normal Hip Pain Feels Like
Most pregnancy-related hip pain shows up in the second or third trimester, when relaxin levels are higher and the baby’s weight is becoming significant. It tends to be a dull ache on one or both sides, often worse at night when you’re lying on your side. You might also notice it when you’ve been standing for a long time, walking uphill, or getting up from a chair.
The pain typically stays in the outer hip, groin, or buttock area. It might shift sides or come and go depending on your activity level that day. Stiffness in the morning that eases once you start moving is another common pattern. This kind of pain is uncomfortable but generally manageable and tends to improve with rest, position changes, and the strategies described below.
Pelvic Girdle Pain: A More Intense Version
Some women develop a more disruptive condition called pelvic girdle pain (PGP), which overlaps with hip pain but affects the entire ring of pelvic joints. PGP can cause pain over the pubic bone at the front, along the groin, in the hips, and across one or both sides of the lower back or buttocks. It often shows up in multiple locations at once.
The distinguishing feature of PGP is how much it interferes with everyday movement. Walking becomes painful. Climbing stairs, getting dressed, or getting in and out of a car can be difficult because these activities require you to put your weight on one leg or part your legs. Turning over in bed or lying on your back may also hurt. If your hip pain is making it hard to move through your daily routine, PGP is worth discussing with your midwife or doctor, because physical therapy and targeted exercises can make a real difference.
Rare Causes Worth Knowing About
In uncommon cases, hip pain during pregnancy signals something beyond the usual hormonal and mechanical causes. Transient osteoporosis of the hip is a rare condition that typically appears in the third trimester. It involves temporary bone loss in the femoral head (the ball of the hip joint), which causes deep, progressive pain that worsens with weight-bearing and doesn’t improve with the usual remedies. Because the bone is weakened, about 12% of confirmed cases in one study involved a fracture.
Transient osteoporosis is difficult to diagnose because the symptoms overlap with ordinary pregnancy hip pain. It’s typically identified through MRI, which is considered low-risk during pregnancy and can reveal the characteristic bone marrow swelling in the femoral head. This condition is rare enough that most providers won’t test for it unless your pain is severe, getting worse despite rest, or concentrated deep in the groin or front of the hip. It usually resolves on its own after delivery, but it needs monitoring to prevent fracture.
How to Sleep With Hip Pain
Nighttime is often the worst stretch for pregnancy hip pain, partly because side sleeping (recommended from the second trimester onward) puts direct pressure on the hip joint. Pillow placement makes a bigger difference than most people expect.
The goal is to keep your upper leg level with your pelvis so your hip isn’t dropping or rotating. Place a firm pillow (or a folded blanket) between your knees, thighs, and feet so that your top leg mirrors the position of your bottom leg. This keeps the pelvis aligned and takes strain off the hip joint. If your shoulder or arm also aches from side sleeping, tuck pillows behind your back and hips so you can roll slightly backward onto them. This distributes the pressure more evenly and takes some weight off the lower shoulder.
A full-length pregnancy pillow can simplify this setup, but a few regular pillows arranged carefully work just as well. Some women also find that a mattress topper adds enough cushion to reduce the pressure point at the hip.
Other Ways to Manage the Pain
Strengthening the muscles around your pelvis and hips helps compensate for the joint laxity that relaxin creates. Exercises that target the glutes, deep hip rotators, and pelvic floor give the hip joint more muscular support. Swimming and water aerobics are particularly helpful because the buoyancy takes weight off your joints while still letting you strengthen the surrounding muscles.
During the day, small adjustments reduce flare-ups. Avoid standing on one leg when getting dressed. Sit down to put on pants or shoes. When getting out of a car, swing both legs out together rather than stepping one leg out first. Keep your knees together when turning in bed, rolling your whole body as a unit instead of twisting at the hips.
Gentle stretching of the hip flexors and outer hip muscles can relieve tightness that contributes to pain. Prenatal yoga classes typically include these stretches in a safe format. A warm (not hot) bath or a heating pad on the sore area for 15 to 20 minutes also helps loosen tight muscles and ease discomfort.
If the pain is significant enough to affect your mobility or sleep quality despite these measures, a physical therapist who specializes in prenatal care can assess your specific movement patterns and create a targeted plan. Some women also benefit from a pelvic support belt, which compresses the pelvis slightly and adds stability to the loosened joints.
What Happens After Delivery
For most women, pregnancy-related hip pain begins improving in the weeks after delivery as relaxin levels drop and the ligaments gradually tighten back up. Pain typically levels off by about six months postpartum. However, recovery isn’t always that straightforward. Some women experience lingering back and pelvic pain for up to three years after childbirth, and research suggests that about 1 in 10 women who had pelvic girdle pain during pregnancy still report significant pain a decade later.
The women most likely to have persistent pain are those whose symptoms were severe during pregnancy and those who weren’t able to address the underlying muscle weakness or joint instability. Postpartum physical therapy, particularly focused on the pelvic floor and hip stabilizers, can shorten recovery time and reduce the chance of long-term issues. If your hip pain isn’t improving in the months after delivery, that’s a signal to seek targeted treatment rather than waiting it out.