Pregnancy can be hard on your body in many ways. Unexpected symptoms and pains aren’t uncommon, and women can have wildly different experiences during pregnancy, which may make typical symptoms difficult to track, especially if this is your first pregnancy.

Pelvic pain is one of the many symptoms you can experience during your pregnancy. One study showed that nearly a quarter of women experienced pelvic pain while pregnant. Let’s talk about what can cause pelvic pain during pregnancy, how to treat it, and the best sleeping positions to bring you relief.

Causes of pelvic pain during pregnancy

Pelvic pain can be annoying and debilitating, but a lot of the time it isn’t a serious condition. Here are a few common causes of pelvic pain during pregnancy and how they may affect you:

• Symphysis pubis dysfunction (SPD) — There’s a joint in the front of your pelvis known as the symphysis pubis. During pregnancy, that joint can become unstable, which may cause pelvic pain. You may experience a shooting pain in the front of your pelvis, and bending over, climbing stairs, or getting in and out of bed may make it worse. This type of pain can occur soon after conception and tends to get more severe toward the end of the pregnancy. While this condition isn’t usually harmful to your baby, it can be very painful.
• Accommodation pain — As you progress in your pregnancy, your uterus grows to accommodate the baby. Unfortunately, in the first trimester, it can be painful for you. You may feel mild twinges or cramps as your uterus expands, but this condition shouldn’t be harmful to you or the baby. If you experience bleeding or severe pain, call your health care provider.
• Round ligament pain — During your second trimester, you might begin to feel a sharp, aching or stabbing pain toward the side of your pelvis. As your baby grows, the tissue surrounding your uterus gets stretched as well. This can affect the ligaments that are connected between your uterus and groin. This pain may get worse while walking or moving from sitting to standing, and lying on the affected side may make the pain disappear. Most of the time, this pain resolves itself at around 24 weeks.
• Diastasis recti — This condition is common both during and after pregnancy and may feel similar to SPD. Diastasis recti occurs when the abdominal muscles separate as the body prepares to give birth. While this condition usually resolves itself after birth, some people may need to do specific exercises to realign their abdominal muscles. In severe cases, your health care provider may recommend surgery.
• Fetal weight gain — In your last trimester, your baby can press down on nerves in your pelvic region that run from your vagina into your legs. As the baby gains weight, the pressure on those nerves increases, potentially causing pain. This pain may get worse while walking or riding in a car due to your momentum. You can try to ease the pressure by lying down on one side and resting.
• Ovarian cysts — During pregnancy, ovarian cysts can grow and create pelvic pain due to pressure on the ovaries. Generally, these cysts are noncancerous and harmless, but if a cyst ruptures, that pain can get worse. In severe cases, a ruptured cyst can cause the ovary to twist in on itself. If you have sharp, severe abdominal pain with possible nausea and vomiting, contact your health care provider.
• Braxton Hicks contractions — Also known as “practice contractions,” Braxton Hicks contractions tend to feel more like pressure or a tightening in the pelvis rather than painful. They also appear more sporadically than labor contractions. Braxton Hicks contractions usually begin to occur in the second or third trimester and can be brought on by dehydration, so make sure to drink plenty of water. Braxton Hicks contractions should resolve on their own, but if you experience more than four contractions an hour for two hours, call your health care provider to see if you might be in labor.
• Urinary tract infection (UTI) — UTIs during pregnancy present similarly to UTIs in everyday life, with the sudden urge to urinate, a burning sensation during urination, and possibly blood in your urine. You may also experience abdominal pain. However, during pregnancy, a UTI can create serious complications for you and your baby that may cause you to go into preterm labor. If you think you have a UTI, contact your health care provider so they can give you a diagnosis.
• Constipation — Constipation is fairly common during pregnancy, and it can cause pelvic pain. Increasing your exercise, changing your prenatal vitamins, and eating lots of fiber-rich foods may help with your constipation. You can also contact your health care provider about pregnancy-safe over-the-counter treatments. While annoying, this condition isn’t usually harmful to you or your baby. 
• Vulvodynia — This is a condition that can cause chronic pain in the pelvic area, but it has no obvious cause. It can be incredibly painful and difficult to treat, but it shouldn’t cause harm to your baby. An epidural may help ease your labor and delivery pain.

While most of the time pelvic pain won’t cause harm to you or your unborn baby, there are cases where it can become serious. If you have pelvic pain alongside symptoms like fever and vaginal bleeding, call your health care provider right away. You may be dealing with a more serious condition that could cause preterm labor or miscarriage.

How to relieve pelvic pain during pregnancy

Unfortunately, there’s no one-size-fits-all solution for pelvic pain during pregnancy. Your health care provider can help you determine the best treatment methods to try to relieve your pain. Here are a few common treatments they may suggest you try:

• A warm (not hot) bath or shower.
• A prenatal massage with a certified massage therapist.
• Avoiding sitting or standing for long periods.
• Changing clothes while seated.
• Balancing weight between both of your legs when standing.
• A pelvic support garment, which can prevent your uterus from pushing down on your pelvis.
• Low-heeled shoes with good arch support.
• Avoiding quick movements and sharp turns.
• Exercising regularly.

If your pain is severe but not harmful to you or your baby, consider seeking treatment from a physical therapist who specializes in pelvic floor disorders. A physical therapist can use manual therapy and specialized exercises to help bring you relief.

Best sleeping positions for pelvic pain during pregnancy

Sleep is vital during pregnancy, but it can be challenging to get comfortable if you’re dealing with pelvic floor pain. Here are a few tricks that may help you sleep better with pelvic pain:

For sleep position:

• Lie on your back with a pillow under your knees.
• Lie on your side with a pillow between your legs.

For extra comfort:

• Use supportive pillows such as body pillows, wedge pillows and C-shaped pillows.
• Make sure your mattress isn’t too soft or too firm.
• Try breathable, moisture-wicking bedding materials if you get too hot at night.
• Incorporate relaxation techniques such as deep breathing in bed.

Pregnancy can be a challenging time, especially if you’re dealing with pelvic pain. If you need extra support to address your pain, our experts at Lattimore PT are highly trained in women’s health and pelvic floor disorder. 

We’re here to help you find the best methods to deal with your pelvic pain during pregnancy, and we can guide you on your postpartum pelvic health journey as well. Contact our team today for more information or to schedule an initial appointment.