Experiencing pelvic pain during pregnancy, mostly in the final trimester when the stress on the pelvic region is intense, is quite common. However, many women do not experience it until they are in the early stages of labour.
Pelvic pain can often hit at almost any point during the pregnancy, and its impact ranges from minor – a few twinges, aches or feeling of heaviness and pressure in & around the pelvic region – to debilitating – a burning sensation that wraps around the back to down below the growing belly.
Identifying the issue is often difficult as it could be a wide range of problems, and sometimes it can also be difficult to describe them to the doctor.
1] Understanding Pregnancy-related Pelvic Girdle Pain (PGP)
Experiencing any pelvic pain during pregnancy can be scary. It is often called pregnancy-related pelvic girdle pain (PGP) or symphysis pubis dysfunction (SPD). PGP is a collection of uncomfortable symptoms induced due to stiffness of the pelvic joints or the joints moving unevenly at either the back or front of the pelvis.
It is important to understand the key difference between pelvic pain and pelvic pressure. The latter often signals at the beginning of cervical effacement and dilation, also known as labour.
- Pelvic pressure during pregnancy in the pelvis and rectal area can sometimes feel like a cramp – similar to menstrual cramps – and it can cause groin discomfort. It is also accompanied by low backache and is more likely to occur in second and later pregnancies.
- Symptoms of pelvic pain, on the other hand, likely include wrenching pain in the pelvis and intense discomfort while walking. The pain can sometimes be short-lived, just like a round ligament pain that strikes during the second trimester. However, it can also be intermittent and become worse due to certain positions or activities such as coughing or lifting something heavy.
Pelvic pain can also be due to numerous factors, most of which are often harmless. However, sometimes pelvic pain can be an indication of a problem that requires medical attention. It is advisable to contact a professional gynaecologist if you experience pelvic pain during pregnancy.
2] What Causes Pelvic Pain During Pregnancy?
Pelvic pain is distinct from symphysis pubis dysfunction (SPD). In pelvic pain, the discomfort is more generalised and not caused due to the loosening of ligaments. It is also not like sciatica, as the pain is not caused by pressure on the sciatic nerve. That indicates that it is more localised to the pelvic area and does not shoot down the legs.
When a foetus is burrowing deeper into the pelvis in preparation for birth, and the little head is now pressing against the bladder, rectum, hips and pelvic bones, the pain can be felt the most. This result is ever-increasing stress and strain on the joints, muscles, as well as the pelvis and back region.
However, on the bright side, once the baby is delivered, the uterus will stop pressing up against the diaphragm and lungs, letting you take deeper breaths.
3] Symptoms of Pelvic Pain in Pregnancy
Here’s how to understand whether pelvic pain in early pregnancy or later is normal or requires medical attention.
Pelvic pain in pregnancy was referred to as Symphysis Pubis Dysfunction (SPD). However, health professionals now call it Pelvic Girdle Pain (PGP) as it affects all joints of the pelvis; not just the Symphysis Pubis.
While pelvic girdle pain (PGP) is not harmful to the baby, it can be painful and make it hard for the woman to perform daily activities. Women with pelvic girdle pain/PGP may likely feel pain:
- Over their pubic bone at the front in the centre, roughly at level with the hips
- Across either one or both sides of the lower back or in the perineum (area between the vagina and anus)
- Spreading to the thighs
- Some women may also feel or hear a clicking or grinding sound in their pelvic area
However, the pain can worsen when walking, moving up or down the stairs or turning over in bed. Most women with pelvic girdle pain (PGP) are likely to have a vaginal birth.
4] Tips for Pelvic Pain Relief During Pregnancy
Here are a few things that might help for pelvic pain relief during pregnancy. It is advisable to consult with a doctor before you try these tips.
- Do some pelvic exercises like pelvic tilts
- Take a warm bath. It can help alleviate pain.
- Apply a heating pad to the lower back for 20 minutes. Take at least a 20-minute break before applying the heating pad again.
- Opt for a prenatal massage from a certified therapist.
5] How to Cope with Pelvic Pain in Pregnancy?
The Pelvic, Obstetric, & Gynaecological Physiotherapy (POGP) network has the following advice to offer:
- Be active as much as your body can handle and within your pain limits
- Avoid activities that can elevate the pain and make it worse
- Take rest whenever you can
- Ask family, friends or partner to help with everyday activities
- Wear flat and supportive shoes
- Try not to stand on one leg when putting on jeans
- Keep your knees together when getting in as well as while getting out of the car
- Try sleeping in a comfortable position, on your side with a pillow between the legs
- Try ways of turning over in bed – turning over with the knees together
- Take the stairs one at a time.
Also, with the assistance from a specialist, try to plan your daily activities to avoid activities that cause or elevate the pain. For example, avoid going up and down the stairs frequently. A specialist could also recommend a pelvic support belt to help ease the pain.
As per Pelvic, Obstetric, & Gynaecological Physiotherapy (POGP), it is advisable to avoid:
- Standing on one leg
- Bending or twisting to lift or carry
- Crossing your legs
- Sitting on the floor or sitting twisted
- Standing for a long duration
- Lifting heavy items like shopping bags, wet washing or a toddler
- Pushing heavyweight items, such as bags or supermarket trolleys
- Carrying anything heavy in only one hand
Getting an early diagnosis can help keep pain to a minimum and prevent long-term discomfort. It is always advisable to consult with a specialist who specialises in obstetric pelvic joint problems. They can provide helpful treatments to ease pelvic pain, improve muscle function, and enhance the pelvic-joint position and stability.
It often includes:
- Opting for manual therapy to make sure the joints of the pelvis, hip, as well as spine move normally
- Performing exercises to strengthen the pelvic floor, back, stomach, and hip muscles
- Being open to suggestions for positions for labour and birth.
- Supporting equipment, including pelvic support belts
While pelvic pain may not get better until the baby is born, with treatments from an experienced practitioner, the symptoms during pregnancy can become bearable. An experienced medical practitioner can also offer advice on coping with the emotional impact of living with chronic pelvic pain by using relaxation techniques.
6] Key Highlights of Pelvic Pain During Pregnancy
- Pelvic pain during pregnancy usually results from bodily changes that occur during pregnancy.
- It can result from a specific medical condition related to the pregnancy or the reproductive organs. The doctors’ priority in such a situation is to determine the issue and see whether or not it requires emergency surgery, like for an ectopic pregnancy or appendicitis.
- Ultrasonography should be done.
- General measures like resting and applying heat can also assist in relieving pelvic pain during pregnancy.
Pelvic pain can be very discomforting. If experiencing any pain in the pelvic area during pregnancy, it is often advisable to contact a professional gynaecologist for pelvic pain treatment before taking any precautionary measure basis on any advice. If you feel like something is not quite right or are feeling any of the following symptoms, call your physician immediately:
- Pelvic pain that is making it hard to walk
- Fever or chills
- Any kind of bleeding
- Severe headache
- Swelling of the face, hands, or feet
- Persistent nausea or vomiting
- Watery or greenish or bloody vaginal discharge