Hey there, mommas. If you’ve tuned in on this one, I’m guessing you’re probably hurting right now. Or at least you have been.
I’m here to tell you that pelvic pain during pregnancy is certainly (or at least not usually) a laughing matter. There are certainly those moments where we HAVE to laugh at ourselves.
Aaand sometimes each other.
But all in good fun.
At this point, and largely depending on how far along you are, you may not fully appreciate my humor around this potentially serious topic. Please understand that, as a labor and delivery nurse, it is definitely something that every nurse must learn at some point.
Sometimes, if you can’t laugh, the only other thing is to CRY.
Seriously though, pelvic pain during pregnancy can be extremely tough to live with and work around, particularly if you still have an active job or are chasing around other kids that preceded this latest little bump.
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- Is it normal for your pelvis to hurt during pregnancy?
- Pelvic pain during pregnancy
- Coping with pelvic pain during pregnancy
- When to get help for pelvic pain during pregnancy
- What you need to know about pelvic pain during pregnancy
Is it normal for your pelvis to hurt during pregnancy?
Lady, here are the facts: pain is totally normal. Pelvic pain symptoms can be hard to ignore, but you are certainly not the first to feel them and it doesn’t necessarily mean that something has gone wrong.
Now, huuuuge caveat here, I am NOT a doctor, and all I can provide is overview information and a good push in the right direction.
As always, talk to your medical provider THE MOMENT you think your pain might be excessive or is accompanied by other symptoms.
Now that’s out of the way, let’s get a little deeper here.
Yes, pelvic pain is pretty normal with pregnancy. Without giving the whole thing away, let’s just say that with nothing else at all to contribute to it, we can safely assume that a 6-9 lb creature sitting DIRECTLY on your guts is always going to be a little uncomfortable.
With that settled, let’s take a bit of a peek inside. Figuratively.
Is it pelvic pressure or pain?
There is one thing that can be very maddening about diagnosing and treating pelvic pain. Sometimes it’s almost impossible to tell the difference between pain and pressure.
The former is usually pretty obvious. Right? You say “Ow!”, and that’s that.
“Pressure” is tough because it translates to the central nervous system in much the same way. At least when the pressure is great enough.
Ever have to pee so bad you thought you were going to burst? That’s pressure, not pain. But it “hurts“, doesn’t it?
The reality is that it’s super important to know if you’re experiencing pain or pressure in your pelvic region during pregnancy since they can mean two VERY different things.
So take a minute to soul search this out.
Pelvic pain symptoms
You probably nailed this one right out of the gate. The symptoms of pelvic pain tend to be..well..pain. In your pelvic region.
But what does that mean, exactly?
Your pelvis is the large scooping bone that makes up your hips. Those big nobbly bones that poke out the sides of your low rider jeans? You guessed it. That’s the tip of the pelvic iceberg.
I just made that up by the way.
Anything between those two juts of bone is considered the pelvic region. That’s going to encompass your ovaries, uterus, bladder, some of your upper and lower intestines.
So, pain in the pelvic region, whether pregnant or not, will usually have something to do with the lady bits or your waste removal systems. Your food and drink are on their way to the pelvic region.
Most women describe pelvic pain during pregnancy as a sharp pain or a very persistent throbbing. It can be gradual or come suddenly, last for days or shoot a single burst of pain that is gone as quickly as it comes.
Pelvic pain during pregnancy
So what causes pelvic pain? We’ll take some time to high-level #allthethings that can cause pelvic pain during pregnancy.
Pelvic pain during early pregnancy / first trimester
The first cause of pelvic pain you’re likely to encounter during your first trimester is a cramping sensation that accompanies the expansion of your uterus.
Yup, you heard it right momma. Your uterus is going to get bigger BEFORE the baby even starts to fill the space. The movement of this little expansion causes muscle tension and a sort of cramp-like sensation.
If it’s just the cramping, I wouldn’t worry too much. It shouldn’t be any worse than your slightly over-average menstrual cramps, and won’t last very long either.
With that said, keep an eye out for any kind of spotting or discharge. A miscarriage can accompany any type of discharge (although other times discharge is TOTALLY normal).
So, while the cramping itself may not be anything bad, get with your doctor immediately if that cramping comes in a package deal with other troubling symptoms.
Beyond that, the other more common cause for pelvic pain during your first trimester (or pelvic pressure during early pregnancy, in this case) will be constipation.
You’ve probably felt it before, particularly if you’ve ever been on iron supplements or taken any kind of opiate for pain relief.
Sometimes your bowels get blocked up because of one of these things, or even something unrelated.
But if traffic slows down enough for it to become a problem, you can sometimes feel the bump through your skin (and intestines). That’s the easiest way to know if the off-ramp is just congested.
There are a few ways to solve for this. My tried-and-true has always been Miralax, because it doesn’t absorb into the bloodstream at all. Because it simply draws water into the intestines to re-hydrate anything that’s stuck in the pipe, it is usually very safe as long as YOU stay hydrated.
These pains should generally be pretty tame. That’s not to say that you can’t have sharp pelvic pain during early pregnancy from one or both of these things.
Be sure to touch base with your doctor if the pain is too great, though.
Pelvic pain during pregnancy: second Trimester
You may keep experiencing pain from the stretching uterus during your second trimester (Yay?), but there are also a few new and exciting pains to watch out for.
Symphysis pubis dysfunction (SPD) or Pelvic girdle pain (PGP)
The first is SPD (Symphysis pubis dysfunction), and it can be a doozy. SPD happens when your walk or gait becomes uneven and you basically start grinding unevenly against the joints in your hip bone.
It can also be called PGP (Pelvic girdle pain).
It is often due to extra hormones causing some of the ligaments related to childbirth to relax.
This one can be mild or intense, depending on a few factors. It’s usually either a pain that’s localized (specific to a single point) on or inside of your pubic bone, or a pain that moves from your thighs and up to your perineum (that stretch of skin between the front door and the back door!).
You might have some additional or first-time round ligament pain through the second trimester too.
Another interesting pain, which ties in with PGP a bit, is accommodation pain, which can include Diastasis Recti (involving the six-pack muscles on your tummy).
Accommodation pain is exactly that. You are in pain because your body is making space for baby. Your body accommodates the growing seedling by basically splitting your muscles up.
Does anyone really use their abdominal muscles for anything important, anyway?
Typically around the second trimester, you’ll also get the chance to feel one of life’s mother nature’s most painful jokes. CONTRACTIONS!
Don’t worry, they aren’t the legit, screaming-so-hard-you-spit-on-the-camera contractions that you get when you’re in labor.
No, these are called Braxton-Hicks contractions. They’re sort of like your body taking some time to pre-game a little. Warm up some of those childbearing muscles and freak you out right in the middle of almost anything that needs a little concentration for the next, oh, say, 4-6 MONTHS.
You’ll mainly notice a sudden and completely involuntary tightening of the muscles around the uterus–kind of like when you have that weird little twitch in your eyelid that just won’t go away, only it’s like your WHOLE BIKINI AREA doing the clenching.
They aren’t typically terribly painful, at least not in the second trimester. Some ladies never have any pain. Some ladies never even NOTICE these. If you’re one of the lucky few for whom these contractions hurt, my heart goes out!
Also important to note – you can tell the contractions are Braxton-Hicks if they aren’t regular.
IMPORTANT!!! If you notice that you start getting contractions regularly once every fifteen minutes, and that last for more than an hour, GO TO THE HOSPITAL.
Pelvic pain during pregnancy: third trimester
All of the above conditions are likely to be a thing in the third trimester, even if they haven’t in previous months. This is particularly true of PGP/SPD.
Add onto this lovely list the following reason for pelvic pain during pregnancy:
A baby is sitting on your guts
This might not need much elaboration, but let me give you a metaphor to consider.
Let’s imagine you are growing a human.
In your tummy.
Now imagine he or she is taking a few minutes every day to stomp on your bladder, prod at your cervix, CORKSCREW on your pelvic floor and do a little JIG to celebrate the experience.
As metaphors go, I think this one is powerful.
Seriously, though, this is really the strongest development of further pain throughout the end of your preggotime. Pressure from baby’s weight will certainly take its toll on your pelvic floor.
All the aforementioned conditions will be more pronounced and (potentially) more debilitating, but by this point, you’ve probably seen the worst of it.
Coping with pelvic pain during pregnancy
The reality is that you’ll very rarely have the opportunity to soothe this type of pain directly. Even a hot pack or cold compress is out of the question most of the time because of the layers of tissue that separate your pains from the outside world.
So what’s a girl to do? What helps with pelvic pain during pregnancy?
Definitely talk to your medical provider. Your OB or midwife has seen and heard it all, and chances are they have few neat little tips and tricks up their sleeves
Beyond that, here are a few common PREGNANCY HACKS to get you through pelvic pain symptoms:
- Water aerobics–this low impact exercise will help strengthen your muscles and work your joints without causing excessive strain on your already strained body.
- Stay active, in general–if you let your body rest too much and too often, those joints will continue to move in different directions without any supplement to the muscles that support them.
- Buy some good walking/standing shoes–you’ll want flat soles and a bit of spring to your step. Don’t go for fashion, go for comfort; this is particularly important if you stand or walk a lot for work or housework.
- Check out the Belly-Only Pregnancy Program. This program is from my friend Kate, who is a pre/postnatal exercise specialist. She definitely knows her stuff, and staying in good shape during pregnancy can help you prevent problems later on.
- Be present/mindful with your body–if you find that you’re overstressing any joints during your daily routine, you are stressing ALL your joints; sit down when you dress, take a bath instead of a shower where possible, and take those stairs one at a time.
- Keep The Postpartum Cure bookmarked for use postpartum. Remember how we talked about your pelvic floor and the fact that pregnancy can weaken it? Kate (my pre/postnatal specialist friend) has a whole section of the course dedicated to strengthening your pelvic floor, so it’s worth keeping in mind.
When to get help for pelvic pain during pregnancy
We all know that pregnancy and childbirth are NOT all butterflies and rainbows. There are risks and dangers in pregnancy that we’ll always have to watch out for.
Bleeding or discharge
Keep a close eye out for any spotting or bleeding in your vaginal area. You shouldn’t be using a tampon for a while, so you’ll have to watch your toilet paper twice as closely.
What we’re watching for are the signs of a miscarriage, ectopic pregnancy, preterm labor or placental abruption.
Miscarriage is when the embryo or fetus dies naturally before it’s able to live independently, and it’s heartbreaking to think about.
A miscarriage is typically assumed to be the result of chromosomal abnormalities (malformed genes, per clinical research). Miscarriage typically occurs in the first trimester of pregnancy, and many women don’t even realize they’re pregnant when it happens.
While it doesn’t do away with the sting, many women bounce back and can have a normal pregnancy and childbirth after experiencing this.
Ectopic pregnancy is when conception literally happens in the wrong space. When you have your period, the egg separates from your ovaries and moves down the fallopian tube to exit the body.
If it’s during this process that conception happens, the embryo literally cannot develop. This also happens in early pregnancy, and the pregnancy cannot move forward normally. It is extremely rare.
We’re also watching for preterm labor, which is where your body moves into labor earlier than anticipated. Spotting, consistent contractions, and pelvic pressure are the things to watch out for here.
Placental abruption is when the placenta separates from the uterine wall. It can happen suddenly or over time, and spotting and pain are the first signs. It doesn’t mean the end of your pregnancy unless it goes untreated, so be sure to contact your OB at the FIRST sign of bleeding or spotting.
I’m gonna say that again. Be SURE to contact your OB at the FIRST SIGN of bleeding or spotting.
If you have sudden and excessive bleeding, hopefully you didn’t pause to take some time to read this article.
Go go GO to the emergency room if you have excessive bleeding. This doesn’t exclude the possibility that it’s one of the conditions described above. What we’re most worried about is a uterine rupture on this one.
Uterine rupture is when the wall of the uterus is physically torn, which can allow your fetus to travel out of the uterus and into the peritoneal cavity (the space in your tummy which is occupied by your guts).
This one’s a big deal, and should be treated immediately. The excessive bleeding will be accompanied by sharp pain, and you’ll sometimes even see a bump where the fetus has trespassed into unauthorized territory.
Sudden changes to vision and/or extreme onset headaches
Plenty of ladies have headaches before, during and after pregnancy. If it becomes extreme, though, we want to see you immediately.
This is particularly true if you suddenly find it difficult to see.
What we’re watching for is preeclampsia. This is a potentially serious condition where blood vessels in the placenta don’t develop properly over time. This results in less blood flowing to the baby and your own body.
It’s a tough one because sometimes there are little or no symptoms. Low blood pressure and changes over time are really the best way to spot this SERIOUS condition, short of the extremes we’ve outlined above.
Sudden or sharp pelvic pain during pregnancy
There are a few other things that can get you all worked up over nothing at all (well, not nothing, but nothing regarding baby, specifically).
Ovarian torsion is when an ovary twists around inside the body, effectively limiting or cutting off the blood flow. This can lead to intense pain in the abdomen.
Most everyone has heard of appendicitis. It’s a painful condition that results from infection of a small space in the intestines that is considered a vestigial organ (outdated by evolution) called the appendix.
We don’t really think we use it anymore, but it sure does cause us a lot of pain when it goes.
Appendicitis has a hallmark you can usually detect, though: it occurs in the lower right side of the abdomen in most people, and the upper right side in pregnant women (generally up and to the right of your belly button).
You can also typically tell it’s appendicitis if you are unable to pass gas, are nauseous, and have zero appetite.
Another thing to watch out for (well, FEEL for) is kidney stones. If you have an urgent need to pee, a burning sensation when you do, and that’s all coupled with abdominal pain and/or lower back pain, you might just be passing some stones.
I’m here to tell you, momma, kidney stones are no fun.
Of course, not much of this stuff is any fun, but kidney stones stand alone. I’ve heard people say that they are the only thing that rivals childbirth in terms of pain.
What you need to know about pelvic pain during pregnancy
Hopefully the information we’ve been over here gives you a good firm grasp on what to watch out for and when to start worrying with that pesky pelvic pressure or pain.
I’m always rooting for you, and I KNOW you’ll beat the pain just like you’ll wreck it at childbirth. Hang in there and communicate with your healthcare practitioner. You owe it to yourself and your little one to be safe and taken care of.
You’re amazing, momma, and I know a little thing like pelvic pain during pregnancy won’t you down or out.
Happy baby-making, momma!