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Education2026-03-06•7 min read

Pelvic Girdle Pain During Pregnancy: Why It Happens and How to Find Relief

What Is Pelvic Girdle Pain?

Pelvic girdle pain (PGP) during pregnancy is pain in the joints that make up your pelvis—the sacroiliac joints in back and the pubic symphysis in front. It can occur on one side, both sides, or at the front of the pelvis.

It's also called symphysis pubis dysfunction (SPD) when it primarily affects the front joint.

How Common Is It?

About 20% of pregnant women experience significant PGP. It can start as early as the first trimester but most commonly begins in the second or third trimester.

What Causes It?

Hormonal Changes

Relaxin:

The hormone relaxin increases during pregnancy to loosen ligaments for delivery. But it loosens all joints, including pelvic joints, making them less stable.

Mechanical Changes

  • Weight gain
  • Shift in center of gravity
  • Postural changes
  • Widening of pelvis for delivery

    • Contributing Factors

  • Previous pelvic or back injury
  • Hypermobility (naturally loose joints)
  • History of PGP in prior pregnancy
  • Physically demanding job
  • Multiple pregnancy (twins, etc.)

    • Symptoms

    Location

    Posterior (back):

  • Pain over sacroiliac joints
  • Deep in buttock
  • May radiate to back of thigh

    • Anterior (front):

  • Pain at pubic bone
  • Clicking or grinding sensation
  • May radiate to groin or inner thigh

    • Combined:

  • Both front and back
  • Feels like pelvis is "falling apart"

    • What Makes It Worse

  • Walking (especially stairs)
  • Standing on one leg
  • Turning in bed
  • Getting in/out of car
  • Lifting
  • Prolonged standing or sitting

    • What Helps

  • Resting
  • Keeping knees together
  • Lying down
  • Support belt

    • Diagnosis

    Usually diagnosed by symptoms and physical exam. Healthcare provider may:

  • Assess gait
  • Test specific movements
  • Palpate painful areas
  • Rule out other conditions

    • Imaging rarely needed unless another cause suspected.

    Management Strategies

    Movement Modifications

    Keep legs together:

  • Get in/out of bed by rolling (knees together)
  • Get in/out of car by swinging legs together
  • Avoid straddling movements

    • Reduce single-leg activities:

  • Sit down to dress
  • Avoid standing on one leg
  • Take stairs one at a time (or avoid)

    • Equal loading:

  • Carry items close to body
  • Split loads between two bags
  • Avoid asymmetric positions

    • Pelvic Support Belt

    How it helps:

  • Compresses pelvis
  • Adds external stability
  • Worn around pelvis (not waist)

    • When to wear:

  • During activity
  • May not need at rest
  • Position below belly

    • Rest

  • Rest when needed
  • Lie on side with pillow between knees
  • Alternate activity and rest
  • Don't push through severe pain

    • Exercises

    The goal is to stabilize the pelvis without aggravating symptoms.

    Pelvic Floor Exercises

    Kegels:

  • Contract pelvic floor muscles
  • Hold 5-10 seconds
  • Relax fully
  • 10 reps, 3x daily

    • The pelvic floor helps stabilize the pelvis.

    Core Stabilization

    Abdominal bracing:

  • Gently draw belly button toward spine
  • Hold while breathing normally
  • 10-second holds

    • Bird-dog (modified):

  • Hands and knees
  • Extend opposite arm and leg (within comfort)
  • Keep back still
  • 5 each side

    • Glute Strengthening

    Bridges (if tolerated):

  • Lie on back, knees bent
  • Squeeze glutes, lift hips
  • Avoid if increases symptoms
  • 10-15 reps

    • Clamshells:

  • Side-lying, knees bent
  • Lift top knee, keeping feet together
  • 10-15 each side

    • What to Avoid

  • Wide squats
  • Lunges
  • Single-leg exercises
  • Anything that increases pain

    • Other Treatments

    Physical Therapy

    Pelvic health physiotherapist can:

  • Assess specific dysfunction
  • Provide manual therapy
  • Guide exercise program
  • Fit support belt

    • Massage

    May help with muscle tension. Ensure therapist is trained in pregnancy massage.

    Acupuncture

    Some evidence for pain relief. Ensure provider is trained in treating pregnant women.

    Medications

    Acetaminophen (Tylenol) is generally considered safe. Discuss with healthcare provider.

    Sleep Positions

    Best Position

  • Side-lying (left side often recommended for circulation)
  • Pillow between knees
  • Pillow supporting belly
  • Pregnancy pillow can help

    • Getting In/Out of Bed

  • Roll onto side first
  • Keep knees together
  • Push up with arms while lowering legs
  • Reverse to get back in

    • Daily Living Tips

    Dressing

  • Sit down to put on pants, underwear, shoes
  • Avoid standing on one leg

    • Sitting

  • Supportive chair
  • Avoid crossing legs
  • Use cushion if helpful

    • Driving

  • Swing legs in together
  • Limit long drives
  • Consider lumbar support

    • Work

  • Sit when possible
  • Avoid prolonged standing
  • Communicate needs to employer
  • May need accommodations

    • Labor and Delivery Considerations

    Communicate with Team

    Let providers know about PGP. It affects:

  • Positioning during labor
  • Pushing positions
  • Pain management decisions

    • Positions to Try

  • Side-lying
  • All fours
  • Supported squat (if tolerated)
  • Avoid extreme hip opening

    • Epidural

    May provide relief but also removes feedback about joint positioning. Team should monitor leg position.

    Postpartum

    Usually Improves

    Most PGP resolves within weeks to months after delivery as hormones normalize.

    If It Persists

  • Continue exercises
  • See pelvic health physiotherapist
  • May need more intensive treatment
  • Usually resolves by 6 months

    • Pelvic girdle pain is challenging during pregnancy but manageable. Keep movements symmetric, use a support belt, strengthen what you can without pain, and rest when needed. It does get better—most women see significant improvement once baby arrives and hormones normalize.

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