Pelvic Pain In Pregnancy

Pelvic pain during pregnancy is relatively common. In fact, it is estimated that one in 35 women will get pelvic pain. Symptoms include:

• Pain in the pubic area and groin;
• Pain in the inside of the thighs;
• Lower back and hip pain;
• Pain while walking, moving or going upstairs;
• An audible ‘clicking’ sound that you can hear;
• Difficulty and pain when trying to open the legs.

What causes pelvic pain?

Well, put very simply, when you’re pregnant your body releases a hormone called relaxin, which softens the joints to allow your baby to pass through your pelvis during birth. In women with pelvic pain, it’s thought that this softening combines with changes in your body to put too much stress on the joints, ligaments and muscles of your pelvis. Put another way, the hormone tends to go into ‘overdrive’ and causes the ligaments to soften and stretch too much.

In all cases of pelvic pain, early diagnosis can help to keep the pain to a minimum and avoid long-term discomfort.

When it comes to treatment, healthcare practitioners are divided. Traditionally, gentle pressing on, or moving of the affected joint was the main technique employed.  Recently, however, manipulation of the joint seems to be kept to a minimum and the focus has switched to the strengthening of the ‘pelvic corset’ muscles. Using specific exercises (if appropriate) to strengthen the skeleton’s natural girdle muscles, pelvic floor exercises, exercise ball and specialised pilates are used.

(Yoga is not usually recommended as the joints are already too ‘loose and stretchy’ and yoga will only serve to loosen them further. Work on the core abdominals is preferred, such as Pilates or the Alexander technique.)

Pelvic support belts and briefs can provide immediate relief. Some people will wear one or the other, but many people report wearing both, especially at the end of their pregnancy or if they are on their feet a lot, for maximum comfort.

Acupuncture may help, but your practitioner must be trained and experienced in treating pregnant women.

There are also various ways in which you can help yourself.

Take light exercise to prevent you seizing up, but never walk on an uneven surface, especially the beach, as the stress of your body weight shifting on the sand will do a lot of damage to the symphatic joint.

Use a large pillow in bed between your knees. This keeps your pelvis aligned and stops you sliding over in your sleep. The long body pillows or the u-shaped breastfeeding pillows are ideal for this, as you can position them between your knees and under your bump as well!

Don’t go up and down stairs more than is absolutely necessary. If you must go up, go literally one step/two feet at a time. Keep your knees together getting in and out of your car, skip the bath entirely, and generally limit anything that will move your pelvic bones too much. Look on the bright side: it’s a great excuse not to hoover!

When you are walking, arch your back and swing your arms as though you are marching. This locks your pelvis in a stable position and activates the muscles that stiffen your joints. Doing regular pelvic floor exercises may also help to strengthen your pelvic joints.

During labour

With the right advice, it is rare for pelvic pain to cause problems in labour. If possible, avoid lying on your back to give birth, upright or kneeling positions protect your pelvic joints and are generally more comfortable. If you have to sit on the bed during labour, sitting as upright as possible makes parting your legs easier.

If your symptoms make it difficult for you to open your legs, it may be worth discussing with your midwife or doctor which positions would be best for an assisted birth, if you need one.

After birth

In a few cases, pelvic pain can linger after birth. If it does, it’s important to carry on with your treatment (Ostgaard et al 1994). A few women will have pain that persists, but this is rare. It is not unusual to have a mild recurrence of the discomfort just before your period, as hormones released at this time can have a similar effect to relaxin.

Above all, don’t ignore the pain. It is NOT a normal part of being pregnant and there is PLENTY that you can do to ease the pain.