Pelvic Pain in Pregnancy
Your pelvis might feel like one hard bone, but it is actually made up of moving parts which can flex and move to create space for your baby to be born. During labour, babies move through the space in the pelvis and they need to rotate in order to descend and be born. To support this process, during pregnancy, your clever body starts to increase levels of a hormone called Relaxin. Relxain does exactly what it sounds like it should do. It relaxes the muscles and ligaments of the body - increasing the flexibility of the ligaments that connect the bones of the pelvis, making it easier for your baby to make their way through.
Pelvic pain is not uncommon in pregnancy. It is not always clear what the cause is, although some people may be more susceptible - for example, those with a history of pelvic trauma, hypermobility disorders or pelvic muscle disfunction. There range of symptoms and severity is broad - some pregnant women and birthing people may find that there are periods of time where their pelvis is uncomfortable, but that simple paracetamol and rest can help fairly quickly. The increase in Relaxin can make it easier to strain muscles unintentionally, and this may mean that your discomfort eases once that strain has passed.
There are some easy adaptations that you can make to reduce the likelihood of this kind of strain. Regular, gentle exercise is great in pregnancy, listening to your body and noting activities that aggravate pelvic discomfort is sensible and adapting your activity to accommodate this should see a reduction in symptoms. For example, swimming in breaststroke can cause pain in the ligament that joins the pelvis at the pubic arch. In fact, any movement that causes the legs to be opened wide (eg getting out of the car one leg at a time) can cause this kind of discomfort. Walking up the stairs also destabilises the pelvis, and you may find that walking one step at a time, rather than a foot on each step as you perhaps would usually, can help too.
Pelvic Girdle Pain (PGP) is a collection of uncomfortable symptoms in pregnancy, with stiffness in the joints of pelvis and/or the bones of the pelvis moving unevenly at the back and front of the pelvis. You may feel a clicking or grinding as you move, and find discomfort in the perineum, lower back, front of the pelvis or down the thighs.
If you feel that your symptoms are not improving with rest, paracetamol and some modification of movements then please contact your care provider for a referral to a physiotherapist. Physio may focus on exercises to strengthen the muscles of the pelvis and surrounding areas, manual manipulation to realign joints, and even support belts or crutches if required.
Most women and birthing people with PGP go on to have vaginal births, you may want to discuss birth with your physio and midwife to think about how you can be supported to be mobile within any limitations that PGP may have caused.
For more information on pelvic health in pregnancy, check out our Ultimate Birth Pack.
