Pelvic pain during pregnancy is extremely common, affecting roughly 44% of pregnant women at some point. It ranges from brief, sharp twinges to deep, persistent aching around the hips, groin, or pubic bone. Most of the time it’s caused by the natural loosening of joints and ligaments as your body adapts to carry and eventually deliver your baby.
Why Pregnancy Causes Pelvic Pain
Your ovaries and placenta produce a hormone called relaxin throughout pregnancy. Relaxin does exactly what it sounds like: it loosens and relaxes muscles, joints, and ligaments, particularly around your pelvis, back, and abdomen. This is your body preparing for delivery by creating more flexibility in the birth canal. The trade-off is that this extra looseness can make your pelvic joints less stable, leaving you feeling weak or wobbly in the hips and lower back.
On top of hormonal changes, the growing weight of your baby shifts your center of gravity forward, putting more mechanical stress on your pelvis and lower spine. The combination of looser joints and increased load is what makes pelvic pain so prevalent in the second and third trimesters, though it can start earlier.
Common Types of Pelvic Pain
Not all pregnancy pelvic pain feels the same. Two of the most common types have distinct patterns that are helpful to tell apart.
Round Ligament Pain
Round ligament pain shows up on one or both sides of your lower abdomen and pelvis. It typically feels like a quick cramp, a stitch in your side, or a sharp stabbing or tugging sensation. The key feature is that it’s brief. It tends to come on suddenly with a change in position (standing up, rolling over, sneezing) and fades quickly once you stop moving.
Symphysis Pubis Dysfunction
Symphysis pubis dysfunction, often called SPD, is a deeper, more sustained pain centered at the front of the pelvis. Many women describe it as a grinding ache or a sensation of the pelvic bones pulling apart. The pain often radiates into the groin, hips, lower back, or inner thighs. Unlike round ligament pain, SPD tends to get worse with movement: walking, climbing stairs, standing on one leg, or rolling over in bed. Some women also hear or feel a clicking or grinding sound coming from the pubic area.
Who Is More Likely to Experience It
While nearly half of all pregnant women deal with some degree of pelvic pain, certain factors raise the likelihood. A history of low back pain is one of the strongest predictors. If you had pelvic girdle pain in a previous pregnancy, you’re more likely to experience it again. Physical activity level matters too, both being very sedentary and having very high occupational demands can contribute. Fatigue during pregnancy, higher body mass index, and psychosocial factors like elevated stress also increase risk.
What Helps With Daily Pain
Sleep is one of the first things pelvic pain disrupts. Lying on your side with a pillow between your knees takes pressure off the pubic joint and hips. As your belly grows, placing a second pillow or rolled-up towel under your bump reduces strain on your hips and lower back even further. If your hips ache at night despite good positioning, your mattress may be too firm. Lying on a single duvet folded in half, or adding a mattress topper, can soften the surface enough to help.
Getting in and out of bed is another pain trigger. The trick is to bend your knees up, gently engage your lower abdominal muscles, and keep your knees together as you turn your shoulder and hip in one single movement. The same principle applies when getting out of a car: keep your knees together and swing both legs out at once rather than stepping out one foot at a time.
Support belts designed for pregnancy can also make a noticeable difference. In a study of 60 women in their third trimester, those who wore a pregnancy support belt experienced a meaningful reduction in both back and pelvic pain compared to their starting levels. These belts work by compressing the pelvis slightly, which compensates for some of the joint looseness that relaxin creates. They’re worth trying as a simple, drug-free option for getting through daily activities with less discomfort.
Exercises That Reduce Pelvic Instability
Strengthening the muscles around your pelvis helps compensate for the ligament laxity that causes the pain. Two exercises in particular are gentle enough for pregnancy and target the right areas.
The first is a lower abdominal engagement exercise. Lie on your back (or sit comfortably) and place your hands on your lower belly, just below your belly button. Breathe in normally, then as you breathe out, gently draw your tummy muscles inward, away from your hands. Hold for about 10 seconds while continuing to breathe. Your abdominal muscles help lift and support the weight of your baby, so building their endurance directly reduces strain on your pelvis and back.
The second is the cat-cow stretch. Start on all fours on the floor or your bed. Round your shoulders and arch the middle of your back up toward the ceiling, then slowly lift your head and let your back curve in the opposite direction. This movement strengthens your core while gently mobilizing your spine and pelvis. Both exercises can be done daily and should feel comfortable, not painful.
If your pain is significant enough to limit everyday activities like walking or dressing, a referral to a physiotherapist who specializes in pregnancy-related pelvic pain can help. They can assess your specific joint movement patterns and design a targeted program.
When Pelvic Pain Signals Something Serious
Most pregnancy pelvic pain is uncomfortable but not dangerous. However, certain patterns are red flags that warrant immediate medical attention. Severe belly pain that doesn’t go away, especially if it starts suddenly or gets progressively worse, can signal conditions like placental abruption or preterm labor. Vaginal bleeding beyond light spotting, fluid leaking from the vagina, or foul-smelling discharge alongside pelvic pain also requires urgent evaluation.
A noticeable change in your baby’s movement pattern, such as reduced kicking or a baby who seems to have stopped moving, is another warning sign to take seriously regardless of whether it comes with pain. There’s no specific number of movements that counts as “normal,” but a change from your baby’s usual pattern is what matters. The CDC lists these among urgent maternal warning signs that call for immediate medical care.