Pelvic Pain During Pregnancy: Symptoms, Risk Factors, Causes, Treatments and Recommendations

A physical therapist can help with treatment and give you techniques to control pain and discomfort.

Some women develop pelvic pain during pregnancy. This is sometimes called pregnancy-related pelvic girdle pain (DCPE) or symphysis pubis dysfunction (PSD).

Definition

Pelvic pain is a collection of uncomfortable symptoms caused by misalignment or stiffness of the pelvic joints at the back or front of the pelvis.

DCPE is not harmful to your baby, but it can cause severe pain in the pelvic area and make it difficult for him to move. Different women have different symptoms, and some women have DCPE worse than others.

Symptoms of pelvic pain during pregnancy

Symptoms can include:

  • Pain over the pubic bone in the front or in the center.
  • Pain on one or both sides of the lower back.
  • Pain in the area between the vagina and the anus ( perineum ).

The pain can also radiate to the thighs, and some women feel or hear a click or crack in the pelvic area. The pain may be more noticeable when you:

  • Walk.
  • You are standing on one leg (for example, when you are getting dressed or going upstairs).
  • Toss and turn in bed.
  • It can also be difficult to spread your legs, for example when you get out of a car.

There is treatment to help and techniques to control pain and discomfort. With proper counseling and treatment early on, DCPE can usually be controlled and symptoms can be minimized.

Occasionally, the symptoms even go away completely. Most women with DCPE can have a normal vaginal delivery.

Risk factor’s

DCPE, or DSP as it is sometimes known, is estimated to affect up to one in five pregnant women to some extent.

It is not known exactly why pelvic pain affects some women, but it is believed to be related to a number of problems, including previous damage to the pelvis, pelvic joints that move unevenly, and the weight or position of the baby.

Causes

Factors that can make a woman more likely to develop DCPE include:

  • A history of lower back or pelvic girdle pain.
  • Previous injury to the pelvis, for example from a fall or accident.
  • Having DCPE in a previous pregnancy.
  • Hard physical work.

When to get help for pelvic pain during pregnancy?

Receiving a diagnosis as soon as possible can help keep pain to a minimum and avoid long-term discomfort.

Treatment by a physical therapist usually involves gently pressing or moving the affected joint, helping it to function normally again.

If you notice pain around your pelvic area, tell your midwife, doctor, or obstetrician. Ask a member of your maternity team to refer you to a physical therapist with experience treating pelvic joint problems.

These problems tend not to fully improve until the baby is born, but treatment by an experienced professional can significantly improve symptoms during pregnancy.

Treatments

Physical therapy aims to relieve pain, improve muscle function, and improve the position and stability of the pelvic joint, and may include:

  • Manual therapy to make sure the pelvic, hip, and spine joints move normally.
  • Exercises to strengthen the pelvic floor, stomach, back, and hip muscles.
  • Exercises in water.
  • Tips and suggestions including jobs and births, caring for your baby, and positions for sex.
  • Pain relief.
  • Equipment if needed, such as crutches or pelvic support belts.

Coping with pelvic pain in pregnancy (recommendations)

Your physical therapist may recommend a pelvic support belt to ease your pain or crutches to help you move. It can help you plan your day to avoid activities that cause you pain. For example, don’t go up or down stairs more than necessary.

  • Stay as active as possible within pain limits and avoid activities that make pain worse.
  • Rest when you can.
  • Get help with housework from your partner, family, and friends.
  • Wear flat, supportive shoes.
  • Sit down to get dressed, for example, don’t stand on one leg when you put on your jeans.
  • Keep your knees together when getting in and out of the car; a plastic bag on the seat can help it turn.
  • Sleep in a comfortable position, for example on your side with a pillow between your legs.
  • Try different ways to roll over in bed, for example rolling with your knees together and squeezing your buttocks.
  • Take the stairs one at a time, or take the stairs back or down.
  • If you use crutches, have a small backpack to carry things.
  • If you want to have sex, consider different positions.

You should also avoid:

  • Stand on one leg.
  • Cross your legs.
  • Sit on the floor.
  • Sitting or standing for long periods
  • Lifting heavy weights, such as shopping bags, wet clothing, or a young child.
  • Vacuuming.
  • Pushing heavy objects, such as a supermarket cart.
  • Carry anything in one hand (try using a small backpack).