Pelvic Girdle Pain

Some women will develop pain in their pelvis at later stages of pregnancy. This may happen during walking or when getting in and out of bed or a car. This is known as pelvic girdle pain (PGP) or symphysis pubis dysfunction (SPD). 

PGP is caused by the hormone relaxin which your body produces in pregnancy to allow it to stretch and grow your baby. Although PGP can be very painful to you, it will not harm your baby. 

Symptoms of PGP

• Pain around your pubic bone
• Pain in the lower back
• Pain between your vagina and anus (perineum) 
• Pain moving into the thighs 
• Clicking or 'grinding' feeling of hips.

The pain may be worse on movement – walking, going up and down the stairs, movement using one leg, turning over in bed, moving legs apart – e.g. getting out of the car.

If you are experiencing symptoms of PGP and are concerned please contact your maternity team. Your midwife or GP may refer you to physiotherapy which may help.

You may be advised to:

• Take regular paracetamol
• Use heat therapy if needed – e.g. warm baths
• Remain active, but within your pain limits
• Exercise in water
• Take regular rest
• Ask for help from friends and family if needed
• Wear supportive shoes
• Sleep on your side with a pillow between your legs
• Get out the car with your legs together and a swivel, rather than one leg at a time
• Go up the stairs one step at a time
• Use acupuncture, support bands and/or crutches
• Avoid carrying heavy things, especially only on one side of the body
• Avoid sitting or standing for long periods
• Avoid sitting with your legs crossed
• Avoid twisting and carrying a baby/toddler on one hip
• Ensure you perform pelvic floor exercises before, during and after pregnancy. 

PGP during labour and birth 

You will still be able to have a vaginal birth with PGP and it isn’t usually recommended you have an induction of labour for this reason alone. Using a birthing pool may assist with the pain of PGP and labour, taking pressure off your joints. Other pain relief is available for you including an epidural.

PGP following the birth of your baby

PGP pain usually improves following the birth of your baby, with only 1 out of 10 women still experiencing ongoing pain. It is advised if this happens, to continue the above advice, with regular pain relief and heat therapy. Physiotherapy may also continue to help if required.

Further information 

For more information on PGP in pregnancy please access the NHS website here , the Royal College of Obstetricians and Gynaecologists patient information leaflet here , and the society of Pelvic Obstetric and Gynaecological Physiotherapy (POGP) leaflet here . 

‘Your body’s journey during pregnancy and after birth’ videos on the link here have been developed by the pelvic health physio team at Imperial College Hospital, London. They are a fantastic resource that we urge you to view them. 

The videos include 'pelvic floor exercises during and after pregnancy' and 'back and pelvic pain during pregnancy'.