Pelvic Pain and Pelvic Instability During Pregnancy: Causes, Symptoms & Tips

Are you experiencing pelvic pain during pregnancy? You are certainly not alone. Pain around the pelvis, lower back or tailbone is common during pregnancy. Symptoms can range from a dull, aching feeling in your lower back or pelvis to sharp pain when walking, climbing stairs, getting up or turning over in bed.

Many women refer to these symptoms as pelvic instability. Today, the term pregnancy-related pelvic pain or pelvic girdle pain is also commonly used. Whatever you call it, pelvic pain can be uncomfortable and may have a significant impact on your daily life.

But what causes pelvic pain during pregnancy? How can you recognise pelvic instability, and what can you do to relieve the symptoms? In this blog, I explain where pelvic pain can come from and share practical tips to help you support your body during pregnancy.

Why do you get pelvic pain and pelvic instability during pregnancy?

Pregnancy brings many changes to your body. Your pelvis and the surrounding muscles, ligaments and joints have to adapt to the growth of your baby and to changes in the way your body is loaded.

Under the influence of pregnancy hormones, ligaments and connective tissue become more flexible. Your posture also changes as your belly grows and your centre of gravity shifts. This changes the way your pelvis, lower back and hips are loaded.

Pelvic pain during pregnancy usually does not have one single cause. A combination of hormonal changes, altered posture, increased physical load and the way your muscles and joints respond can all play a role.

The term pelvic instability is widely used in the Netherlands to describe pelvic symptoms during pregnancy. In medical literature, the terms pregnancy-related pelvic pain and pelvic girdle pain are also commonly used. Not every woman with pelvic pain actually has an unstable pelvis. The symptoms can result from a combination of hormonal changes, altered physical load, posture and the way the muscles and joints around the pelvis work together.

What are the symptoms of pelvic instability?

Pelvic pain during pregnancy can present itself in different ways. Pain may occur at the front, back or side of the pelvis and can sometimes radiate to the lower back, groin, hips or upper legs.

Common symptoms include:

• pain around the pubic bone or the front of the pelvis
• pain in the lower back
• pain around the sacrum or sacroiliac (SI) joints
• pain in the groin or hips
• a heavy or tired feeling in the pelvis
• pain when walking or climbing stairs
• pain when getting up from a chair or bed
• pain when turning over in bed
• pain when getting dressed or undressed, for example when standing on one leg
• symptoms that become worse after an active day or prolonged standing
• pain or stiffness when starting to walk after sitting or lying down for some time

Some women mainly experience sharp pain, while others describe a dull ache or a heavy feeling. Symptoms can also vary from day to day and may become more noticeable as your pregnancy progresses.

What can you do about pelvic pain during pregnancy?

Fortunately, there are several things you can do yourself to help manage the symptoms:

• Rest before you become exhausted. Build regular moments of rest into your day and spread activities throughout the day.
• Avoid standing for long periods and consider taking several shorter walks rather than one long walk.
• Find a good balance. Staying completely still is usually not helpful, but asking too much of your body can also make symptoms worse. Alternate activity with sufficient rest.
• Pay attention to your posture and change position regularly, both when sitting and standing. Try not to stand on one leg when putting on shoes or getting dressed, and keep your weight evenly distributed.
• Avoid asymmetrical movements where possible, such as carrying your child on one hip or carrying heavy bags on one side. When getting in and out of the car, keeping your knees together may also feel more comfortable.
• Use a pillow between your knees when sleeping. This can help keep your pelvis and hips in a more neutral position. (Read more about this in my blog )
• Stay as active as you comfortably can within your pain limits. Walking, swimming or pregnancy yoga can be enjoyable forms of movement, as long as they do not make your symptoms worse. Try not to push through the pain.

Pelvic pain towards the end of pregnancy

For some women, pelvic pain and pelvic symptoms become more noticeable towards the end of pregnancy. As your belly grows, your body becomes more heavily loaded and everyday movements may require more effort. Fatigue can also make symptoms more noticeable as the day progresses.

Try to listen to your body and alternate activity with enough rest. If your symptoms increasingly interfere with your daily activities, discuss them with your midwife, GP or pelvic floor physiotherapist.

Can pregnancy massage help with pelvic pain?

Apregnancy massage for pelvic pain can be a wonderful way to promote relaxation and experience some relief from discomfort. During the massage, I pay particular attention to the muscles around the pelvis, glutes, hips and lower back. In my practice, women regularly tell me that they experience greater relaxation and relief around their pelvis and lower back after a pregnancy massage.

Research into massage during pregnancy suggests that massage may help reduce pain and improve quality of life. The results are promising, but massage should be considered a complementary treatment and not a replacement for medical or physiotherapy care.

At Adeo Massage Pregnancy & More, each pregnancy massage is tailored to your stage of pregnancy and to how you are feeling on the day. The aim is to help your body relax and gently treat tense muscles around the pelvis and lower back in a comfortable and supportive way.

If you have severe or persistent pelvic pain, it is important to discuss your symptoms with your midwife or GP. A pelvic floor physiotherapist can help you manage your symptoms and work with you on improving your strength and physical capacity.