Reviewed by James Brann, M.D.

Pelvic Pain during Pregnancy

Causes of pelvic pain

It's obvious, baby's growing and so are you. As your pregnancy progresses toward its end stage, you may notice pressure or pain in your pelvic area. Sometimes it's an ache in the pelvic bones. Sometimes it's pressure in the lower pelvis and vagina. Both are uncomfortable and can be scary.

Round ligaments can cause pelvic pain:

As your uterus grows larger duirng pregnancy, you may experience a dull ache or a sharp, piercing pain in your groin or pelvic area. This pelvic pain is caused by the round ligaments and called round ligament pain.

The round ligaments are strong bands of tissue that support your growing uterus. These bands of support tissue attach to the top uterus and run down to into the vagina where they attach.

Pelvic pain from the round ligaments may hit when you're changing positions suddenly, coughing or sneezing, or even when you roll over when sleeping. The dull ache or stabbing pain in the pelvis you feel should only last from a few seconds to a couple of minutes.

You can decrease the frequency of round ligament pelvic pain by avoiding quick and sharp movements. Rest is all you need to aliveate the pain.

Pressure on the pelvic bones by the enlarging uterus:

As pregnancy progresses the uterus continues to enlarge and move deeper into the pelvis. This places more and more pressure on the pelvis and vagina, giving you a pressure sensation that may sometimes be described as pelvic pain.

You will have to get off your feet and rest inorder to feel better with the pelvic pain associated with an enlarging uterus.

"Lightning" (baby drops into pelvis):

Pelvic pressure is very common after the baby drops into the pelvis. You many start to waddle when walking. Walking may become uncomfortable and cause pelvic pain.

After the baby drops you will feel the baby’s head bouncing on top of the vagina every time your baby moves. This will give you a pressure sensation in the pelvis that also can be painful.

Sorry, but nothing you do will help with the discomfort felt from your baby moving and bouncing off your pelvis.

Braxton-hicks contractions:

Braxton-Hicks contractions are early labor pains and they are the way your body prepares for childbirth. Most women experience Braxton-Hicks as menstrual like cramping or brief tightening in the lower abdomen and pelvis. Braxton-Hicks contractions do result in pelvic discomfort or pain.

Braxton-Hicks contractions will continue off and on until you go into true labor. Increasing your fluid intake and resting may help decrease the strength of the contractions, but it is only a matter of time before they do not stop and true labor begins.

Bladder infection:

You may have a urinary tract infection causing pelvic pressure and pain. Because the frequent urge to urinate is often a regular pregnancy symptom, you may not even know that you have a urinary tract infection.

If you do test positive for a bladder infection, your physician will give you an antibiotic and antispamodic to stop your discomfort.

Preexisting groin hernias:

A hernia in your groin may become more symptomatic for the first time during pregnancy. A groin hernia can cause pelvic discomfort, and feels similar to the round ligament pain.

To get relief from an hernia will require surgical repair after delivery, in the mean time avoid weight bearing activities.

Increase mobility of pelvic joints:

Pregnancy increases mobility of pelvic joints and makes the pelvic area vulnerable to pain. Tylenol will give you some relief from the pain, but it will be a persitant discomfort until after delivery.

Pubic symphysis separation:

The front bone of the pelvis is the pubic symphysis. In pregnancy the bone separates from the surround pelvic bones and can causes severe pelvic pain, and tenderness.

The pain is made worse by walking and climbing stairs, turning in bed, lifting, or getting up from a chair. So decrease your activities to feel better.

Pelvic girdle pain:

Learn about the causes of pelvic pain in pregnancy.

Pelvic pain during pregnancy that is mainly felt in your lower back and anal region is caused by the sacroiliac joint. It has been described as a stabbing pain in the buttocks and felt as far down as the knee. The pain is worsening with weight-bearing and comes and goes with many pain-free intervals.

If you feel aching or pressure in your pelvis or vagina, it's a signal to rest. Get off your feet and once you have rested awhile, the pain or pressure should subside.

If you notice this pressure on a daily basis, you may need to evaluate the amount of physical activity you undertake regularly. This doesn't mean becoming a couch potato; it means taking things down a notch. Maybe your evening walk around the neighborhood should be a little shorter in terms of distance and time. Maybe you can leave the groceries in the trunk until you have someone else to carry them in.

If the pressure or pelvic pain during pregnancy does not subside after relaxing or lightening your load, talk to your doctor.
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