Understanding Pelvic Pain During Pregnancy

by Shannon Pacella, PT

Pregnancy is an incredible and transformative experience—but it’s not without its physical challenges. One common issue that many pregnant individuals face is pelvic pain. While some discomfort is common as your body adapts to pregnancy, persistent or severe pelvic pain can significantly affect your quality of life.

At Wellest Integrative Health, we specialize in helping expecting parents navigate these changes with confidence and comfort. In this post, we’ll explore what causes pelvic pain during pregnancy, what’s common versus concerning, and how pelvic floor therapy can help.

1. What Does Pelvic Pain in Pregnancy Feel Like?

2. Clinical Presentation of Pregnancy-Related Pelvic Pain

3. Common Causes of Pelvic Pain in Pregnancy

   1. Pelvic Girdle Pain (PGP)

   2. Pubic Symphysis Dysfunction

   3. Hormonal Influences

   4. Altered Biomechanics and Posture

   5. Pelvic Floor Dysfunction

   6. Muscle Imbalances or Weakness

4. When Is Pelvic Pain During Pregnancy a Concern?

5. How Can Pelvic Floor Therapy Help?

6. You Don’t Have to Suffer Through It

What Does Pelvic Pain in Pregnancy Feel Like?

Pelvic pain during pregnancy can vary widely from person to person. Some experience sharp, shooting pains, while others feel a dull ache or pressure. It may be localized in the front (pubic area), in the lower back, hips, groin, or even down into the thighs. You may also feel vaginal and or rectal pain. 

Common descriptions include:

• Pain while walking, standing, or changing positions

• Discomfort during sleep or after prolonged activity

• A feeling of instability in the pelvis

• Clicking or shifting in the pelvic joints

Clinical Presentation of Pregnancy-Related Pelvic Pain

Pelvic pain during pregnancy may present in various anatomical regions and patterns, including:

• Anterior pelvic pain: typically localized over the pubic symphysis.

• Posterior pelvic pain: affecting the sacroiliac joints or lower back

• Perineal pain: often described as pressure or heaviness

• Radiating pain: into the groin, thighs, or buttocks

  
  

Symptoms may be provoked by functional activities such as:

• Rolling in bed

• Walking or standing for extended periods

• Climbing stairs

• Single-leg weight-bearing tasks

  
  

Pain may range from dull and achy to sharp, stabbing sensations. In some cases, joint instability or abnormal movement patterns are observed.

Common Causes of Pelvic Pain in Pregnancy

Your body undergoes dramatic changes during pregnancy. These natural shifts—while essential for supporting your growing baby—can place stress on the pelvic joints, ligaments, and muscles. The etiology of pelvic pain during pregnancy is multifactorial, often involving musculoskeletal, hormonal, and biomechanical contributors. Common contributors to pelvic pain include:

1. Pelvic Girdle Pain (PGP)

A spectrum of conditions involving pain in the sacroiliac joints, pubic symphysis, and surrounding structures. PGP is estimated to affect up to 20–30% of pregnant individuals, with varying levels of functional limitation. 

2. Pubic Symphysis Dysfunction

Instability or misalignment at the pubic symphysis (joint in the front of the pelvis) that can lead to localized pain and an audible or palpable clicking or shifting sensation during movement.  

3. Hormonal Influences

The hormone relaxin increases during pregnancy, softening the ligaments and leading to joint hypermobility in the pelvis to prepare for birth. While helpful, this can reduce joint stability and lead to pain or dysfunction. 

4. Altered Biomechanics and Posture

As your baby grows, your center of gravity shifts, and compensatory postural changes can overload specific muscles and joints—particularly in the lumbo-pelvic region. This can strain the lower back, hips, and pelvis, and can affect the alignment of your pelvic girdle. 

5. Pelvic Floor Dysfunction

Dysregulation of the pelvic floor—whether from hypertonicity (tension), weakness, or incoordination—can exacerbate pelvic and perineal pain. 

6. Muscle Imbalances or Weakness

Tension or weakness in surrounding hip, core, or lower back muscles can contribute to pelvic pain. 

When Is Pelvic Pain During Pregnancy a Concern?

While some pelvic discomfort is common, you should seek medical advice if your pain is:

• Sharp, severe, or sudden

• Associated with bleeding or fever

• Interfering with your ability to walk or perform daily tasks

• Not improving or worsening over time

Always consult your healthcare provider to rule out more serious conditions.

How Can Pelvic Floor Therapy Help?

Pelvic floor therapists are specially trained to evaluate and treat the muscles, joints, and connective tissues of the pelvis. At Wellest, we provide safe, pregnancy-informed care to reduce pain and improve movement.

A personalized therapy plan may include:

• Manual therapy to release tight muscles and improve joint alignment

• Postural education to reduce strain on your pelvis

• Gentle exercises to strengthen the core, hips, and pelvic floor

• Breathing techniques to support relaxation and pelvic function

• Labor and delivery prep to build confidence and body awareness

You Don’t Have to Suffer Through It

Pelvic pain is common during pregnancy—but it’s not something you just have to “live with”.  Early treatment can make a world of difference, helping you stay active, sleep better, and enjoy your pregnancy with less discomfort.

Early recognition and management—particularly through pelvic floor therapy—can significantly improve outcomes for pregnant individuals, enhancing mobility, function, and overall quality of life.

If you're experiencing pelvic pain during pregnancy, we're here to help. Contact Wellest Integrative Health to schedule an evaluation with one of our experienced pelvic floor therapists. 

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