Discomfort during pregnancy is very common, and pelvic pain in women is unlike any pain ever experienced before pregnancy. Your body is always changing to prepare itself for childbirth. Some women experience more painful changes than other women throughout pregnancy. One in five women experiences symphysis pubis dysfunction (SPD) also known as pelvic girdle pain (PGP) during pregnancy. Round ligament pain (RLP) is common in pregnancy affecting between 10 and 30 percent of pregnant women.
Both conditions cause pelvic pain in women. Both conditions cause difficulty in performing everyday tasks. Both conditions cause limited mobility and affect your quality of life during pregnancy. There is no risk to your baby with SPD or RLP. The conditions just make carrying your baby a little more difficult.
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SPD and RLP not only cause pelvic pain in women during the gestation period but can also cause complications during labor due to your limited mobility and the pain associated with the conditions. However, most women can still have a natural birth with these conditions. Your birth plan should include your diagnosis of SPD and RLP, so your birthing team is aware of your limited mobility and can assist you with the pain and discomfort associated with the diagnosis. Giving birth in water can take the weight off of your joints and can relieve some of the pain associated with SPD and RLP, so a person diagnosed with one of these conditions may want to consider a water birth.
Pelvic Pain in Women: What Is It?
Pelvic Girdle Pain (PGP) or Symphysis Pubis Dysfunction (SPD)
Pelvic girdle pain (PGP) or symphysis pubis dysfunction (SPD) is a condition where the ligaments responsible for keeping your pelvis aligned loosen beyond their normal range causing the pelvic joint that connects the two halves of your pelvic bone to become unstable thus resulting in pelvic pain in women.
This loosening is naturally caused by a hormone called relaxin which is produced by your placenta during pregnancy to get your body ready for birth. Relaxin helps relax the ligaments, joints, and muscles in your body to allow your baby to push through the birth canal, your pelvis when the time comes. SPD is the result of relaxin doing too good a job of relaxing the ligaments responsible for keeping your pelvis aligned. You may be more likely to experience SPD if you have previously suffered from back problems or have had a previous pelvic injury. This results in pelvic pain in women becoming more intense or causing additional discomfort.
The pelvic pain in women who have SPD can be felt over your pubic bone in the front center, across one side or both sides of your lower back, in the area between your vagina and anus, and into your thighs. Some women even feel or hear a clicking or grinding in their pelvic region. There are women who only experience discomfort and pain from SPD when they move around too much while other women experience it consistently no matter how much or little they move around.
Pelvic pain in women that is caused by SPD can make it very difficult to perform tasks that didn’t even take a second thought prior to pregnancy, such as: sitting for long periods, standing for long periods, standing on one leg to put on pants, or underwear, turning over in bed, getting in and out of bed, getting in and out of the car, walking up and down stairs, or walking in general if your groin is already agitated from other normal activities.
Changes You Can Make at Home to Relieve Pelvic Pain In Women With PGP or SPD
There are changes you can make at home to relieve pain caused by SPD or PGP. You can wear flat supportive shoes, sit down to get dressed, keep your knees together when getting in and out of bed or a vehicle, sleep with a pillow between your legs, try different ways of turning over in bed, getting up and down slowly, holding onto a dresser or nightstand to get in and out of bed, and resting as much as you can.
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You should avoid lifting heavy objects, participating in activities that make your pain worse, crossing your legs, standing on one leg to get dressed, carrying anything with only one hand or one side of your body, sitting for long periods in the same position, or standing for long periods of time. You should carry things and move things using both hands to keep your pelvis as aligned as possible to avoid further agitating your condition.
Round Ligament Pain
Round Ligament Pain (RLP) is pain associated with the growth of your uterus. Round ligaments are connective tissues in your pelvis that support the weight of your uterus. Your round ligament attaches the front part of your uterus to your groin where your legs attach to your pelvis. Another way pelvic pain in women is caused occurs is due to the growth of your uterus throughout pregnancy.
This growth causes these ligaments to stretch and can trigger pain in your pelvic region if they are overstretched. RLP is pain caused by the stretching of your round ligament and radiates from your groin to your hips and upper legs. RLP also causes sharp jabbing pains in your groin and lower stomach. RLP is most common in the second trimester of pregnancy and lasts through the end of your pregnancy. RLP does not affect your baby and the pain associated with the condition goes away after giving birth.
You can alleviate some of the pain caused by RLP by stretching, bending, and flexing your hips before doing anything you know causes pain, supporting the weight of your stomach and uterus with a hand when transitioning from standing or sitting positions or while walking, changing positions slowly, using a nightstand or dresser to help you get in and out of bed, sleeping with a pillow between your legs, wearing a belly band and applying a heating pad to your painful areas for ten-minute increments.
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You should not exceed ten minutes with a heating pad as it will raise the baby’s temperature if you use the heating pad for a longer period of time. Raising the baby’s temperature can be dangerous.
You should avoid sudden movements if you have RLP. Sudden movements cause strain on the round ligament like a rubber band snapping. The strain feels like a sudden jabbing or stabbing feeling in either your groin or lower stomach. Exercise, sneezing, coughing, laughing, rolling over in bed, and standing up too quickly can also cause sharp sudden spasms in your belly and groin. It is important to take it easy when you are suffering from RLP.
However, you will still want to get some exercise during your pregnancy to prepare for birth. Your doctor may recommend swimming as a way to get exercise because it will not put a strain on your round ligament-like regular exercising can.
Pelvic Pain in Women: When to Contact Your Doctor
Pelvic pain in women can be life-altering. You should contact your doctor if it is hard to move around, it’s painful to get in or out of bed or a car, it’s painful going up and down stairs or you notice a limit in mobility due to pain. These are all signs of SPD and RLP. Although there is no risk to the baby if you have SPD or RLP, it is important to be properly diagnosed as doctors can give you tips and tricks on how to alleviate the pain associated with SPD and RLP.
Your doctor can also refer you to a physiotherapist who specializes in helping relieve pelvic pain in women caused by pelvic joint problems. Physiotherapists aim to relieve or ease the pain caused by SPD and RLP. They can do that by helping you improve your muscle functions and your pelvic joint position. A physiotherapist may use manual therapy to ensure your pelvis, hips, joints, and spine move normally.
Physiotherapy also includes exercises meant to strengthen your pelvic floor, back, and hip muscles to relieve pain caused by SPD and RLP. Your doctor or physiotherapist may also recommend doing exercises in water to allow your joints to move more freely without your body weight working against you. In more severe cases of SPD, a doctor or physiotherapist may recommend a pelvic support belt, crutches, pain medicine, or a tens machine to alleviate the pain.
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It should be noted that the pain associated with SPD and RLP will not completely go away until after you give birth. Some women even continue to experience pain associated with SPD after giving birth and should alert their doctor if they do. The exercises and tips given by the physiotherapist and your doctor are meant to alleviate or relax some of the pain associated with SPD and RLP. These tips and tricks will not resolve the pain altogether no matter what you do.
As the baby grows, the pain can actually become more unbearable, so having exercises you can do will help you cope with the growing pain and discomfort. In rare cases, SPD can worsen after delivery and require medical intervention. However, most women have their ligaments return to normal after giving birth.
While pelvic pain in women during pregnancy can be overwhelming, it’s not the end of the story. Pain can be managed and relieved and you can actually begin or continue to enjoy this special time in your life. If pregnancy reminds us of anything, it’s that a little bit of time can change quite a lot, and once the pregnancy is over, nature takes its course and things return to a bit of normalcy as you enter the new chapter of your life.
PHOTO CREDIT: Pexels
SOURCES:
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Mother and Baby Medical Panel. “Pregnancy Pelvic Pain: 13 Ways to Relieve and Treat Groin Pain In Pregnancy.” Viewed 9 July 2021,
NHS “Pelvic Pain In Pregnancy” viewed 9 July 2021
O’Connor, Amy. “Symphysis Pubis Dysfunction (SPD) During Pregnancy.” 22 October 2020. Viewed 9 July 2021.
Pelvic Partnership. “Pelvic Partnership Supporting You.” 2021. viewed 9 July 2021.
Stewart, Darienne Hosley. “Round Ligament Pain.” Baby Center. 17 July 2020. Viewed 17 August 2021.
University OB/GYN Associates. “Pregnancy: Pain in Groin and Inner Thigh- What Can I Do?” 25 January 2019. University OB/GYN Associates Blog, Tips and Advice for Healthy Women and Newborns. Viewed 9 July 2021.
Villines, Zawn. “What to Know About Groin Pain in Pregnancy.” 21 July 2020. Medical News Today. Viewed 9 July 2021.
WebMD. “Round Ligament Pain During Pregnancy.” Reviewed by Traci C. Johnson, MD 15 June 2021. Viewed 17 August 2021.
“What is Symphysis Pubis Dysfunction (SPD)?” 31 January 2020. Viewed 9 July 2021
Young, Becky. “What is Symphysis Pubis Dysfunction?” 5 Dec. 2018. Viewed 9 July 2021.
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