Pelvic pain during pregnancy

Pelvic pain and discomfort is a common symptom during pregnancy. Approximately about 80% of all pregnancies experience this. Pelvic pain and discomfort occurs due to the following changes:

  • Ligaments begin to stretch
  • Hormonal levels fluctuate
  • Internal organs shift around to accommodate the growing uterus

Common causes

Aside from relaxed pelvic joints and the pressure from the growing baby, enlisted below are the common causes of mild pelvic pain and discomfort during pregnancy:

Accommodation pain

Accommodation pain refers to a cramp – like pain that feels like the next menstrual cycle is nearly approaching. It is caused by the expansion of the uterus which usually occurs during 8 – 12 weeks of pregnancy.

First – time mothers are less likely to experience this than in succeeding pregnancies.

Functional ovarian cysts

Pregnancy week by week

Functional ovarian cysts are noncancerous and harmless cysts which grow larger as the pregnancy progresses. These cysts form when the ovaries’ way of sorting out and releasing eggs change.

These types of cysts caused [persistent] pelvic pain and discomfort due to the pressure of the growing uterus on the ovaries.

Round ligament pain

Round ligament pain (RLS) refers to the soreness in the sides of the abdomen which begins during the 2nd trimester and tapers off during the 24th week of pregnancy. RLS is caused by the following:

  • Stretching of the ligaments [that ranges] from the top of the uterus down the groin
  • Tilting of the uterus which pulls on the ligaments

Round ligament pain usually triggers whenever a pregnant woman walks and/or gets up from a chair.

Pelvic region pressure

Pelvic region pressure occurs when the weight of the rapidly growing fetus presses on the nerves that stretch from the vagina down the legs. This type of pressure usually begins during the 3rd [and final] trimester.

Pelvic region pressure is triggered with various movements [which cause the growing baby to bounce] such as:

  • Walking
  • Getting inside a vehicle

Braxton – Hicks contractions

Braxton – Hicks contractions (also called as practice contractions) refers to the sporadic painless, tightening sensation in the pelvic region [where the uterus suddenly feels hard and then relaxed].

Practice contractions usually occur around the 20th week of pregnancy and disappear on its own. Also, these types of contractions are triggered by dehydration.

Relaxed pelvic joints and ligaments

Relaxed pelvic joints occur when the ligaments become stretchy [and tend to loosen a bit] in preparation for childbirth. The joints and ligaments tend to relax due to the surge of the relaxin hormone.

Furthermore, joint and ligament problem is caused by the following:

  • Pain near [or around] the pubic bone
  • Unstable legs

Colon congestion

Colon congestion (commonly known as constipation) happens since pregnancy hormones tend to slow down the movement in the digestive tract. It is considered as a common complaint on pregnant women.

Urinary tract infection

Did you know that about 10% of expectant mothers experience UTI? Urinary tract infection (UTI), from the name itself, this infection affects any part of the urinary system such as the kidneys, ureters, urethra, and bladder.

Furthermore, UTI is accompanied by the following symptoms:

  • Feeling of a sudden need to urinate
  • Pain and/or burning sensation while urinating
  • Bloody urine
  • UTI accompanied with abdominal pain

Severe complications caused by pelvic pain and discomfort

Sometimes, pelvic pain and discomfort indicates something more severe such as the following complications below:


Miscarriage (also called as spontaneous abortion and pregnancy loss) refers to the natural death of an embryo or fetus, a pregnancy that has ended on its own during the 1st 23 weeks. Approximately about 10 – 20% of all pregnancies end in miscarriage.

Furthermore, miscarriage is accompanied by the following symptoms:

  • Vaginal bleeding
  • Rhythmic and/or resemble menstrual – like cramps

Ectopic pregnancy

Ectopic pregnancy (also called as tubal pregnancy) is when the egg abnormally implants itself outside the uterus [most often in the fallopian tube]. It usually occurs between the 6th and 10th week, as the tube becomes swollen.

Pre – term labor

Pre – term labor is characterized by persistent and sporadic back pain and pelvic pressure. If an expectant mother experiences this before the 37th week of pregnancy, she might be having a pre – term labor.

Pre – eclampsia

Approximately about 5 – 8% expectant mothers experience pre – eclampsia. Pre – eclampsia usually occurs after the 20th week of pregnancy and is characterized by the following symptoms:

  • High blood pressure – compresses the uterine vessels that supplies the fetus with nutrients and oxygen, which slows down the fetus’s growth
  • Fluid retention
  • Proteinuria

Placental abruption

Placental abruption (abruptio placentae) refers to the peeling off of the placenta from the uterine wall. It is a rare but dangerous condition where only 1 out of 200 pregnancies experience it.

Uterine fibroids

Uterine fibroids (also called as leiomyomata) are noncancerous growths in or outside the uterus.

Uterine fibroids stimulated by pregnancy hormones [they may or may not hurt as they grow larger] which usually occur during a woman’s childbearing years.

Uterine rupture

Uterine rupture is a life – threatening condition where a prior scar [caused by a previous surgical operation] of the uterus tears open. This type of rupturing happens when a woman feels a sudden, severe tearing pain in the midline.

Unfortunately, there is no way to prevent uterine rupture.

Ovarian torsion

Ovarian torsion refers to a twisted ovary. This usually happens during the early weeks of pregnancy [but it can happen any time].


Appendicitis refers to the inflammation of the appendix [whether or not she is pregnant]. It occurs when the lower right quadrant of the abdomen is aching.

Kidney stones

Having kidney stones is characterized as the feeling of severe waxing and waning pain down the side of the abdomen.

Treatment options for pregnancy – induced pelvic pain

For an average pelvic pain during pregnancy, here are the different ways to lessen the burden:

Regular exercise

Exercising regularly prevents pelvic pain and discomfort in the 1st place.

Lie and/or sleep on the left side

Always make sure to lie and/or sleep on the left side. This type of position is recommended for pregnant women due to the following benefits:

  • Improves the circulation of blood (optimal blood flow)
  • Removes the growing baby’s pressing weight away from the pelvic region

Stay well – hydrated

Staying well – hydrated during pregnancy brings a lot of benefits such as:

  • Lowers the instances of Braxton – Hicks contractions
  • Prevents colon congestion

Fiber – rich foods

Prevent colon congestion by consuming fiber – rich foods such as the following:

  • Corn
  • Avocado
  • Whole – wheat bread and pasta
  • Brown rice
  • Edamame
  • Lentils
  • Pear
  • Artichoke
  • Oatmeal
  • Raspberries
  • Peas
  • Broccoli
  • Apple
  • Almonds
  • Barley

Glycerin suppository

Glycerin suppository is a hyperosmotic laxative. It irritates the gastrointestinal tract and increases the amount of fluid so that stools can easily pass through.

Pelvic support garments

Wear pelvic support garments (such as a pelvic support belt), it brings a lot of benefits such as:

  • Stabilize loose ligaments and unstable legs
  • Prevents the uterus from pushing and/or pressuring down on the pelvis

Take a warm bath

Take a warm bath or shower and/or let the warm water pour down her back.

Mid or low – heeled shoes

Wear mid or low – heeled shoes with a good arch support.

Urine tests

Urine tests are necessary to take in every OB – GYN appointment. This is because urine tests are used to check any signs of bacteria which can lead to UTI.

If UTI has been detected early, it can be easily treated with lots of water and antibiotics.

Blood pressure measurement

Blood pressure measurement is necessary to take in every OB – GYN appointment to determine the following:

  • Hypotension
  • Hypertension
  • Pre – eclampsia

What to avoid

  • Hot bath
  • High heels
  • Rapid movements
  • Sudden turns at the waist

When to call the obstetrician – gynecologist

An expectant mother must call the obstetrician – gynecologist if pelvic pain and discomfort is accompanied by the following symptoms:

  • Bloody vaginal discharge
  • Unusual lochia (vaginal discharge) that is watery and greenish in color
  • Severe cramps
  • Severe headache
  • Dizziness
  • Sudden edema
  • Fever and/or chills
  • Persistent nausea and vomiting
  • Less than 10 fetal kicks in 1 hour, from 28 weeks until child delivery day
  • More than 4 contractions in 1 – 2 hours
  • Pelvic pain to the point of being unable to walk or speak

Accommodation pain

Accommodation pain is accompanied with vaginal bleeding.

Ruptured ovarian cysts

Ruptured ovarian cysts worsen the pelvic pain and discomfort. During the consultation, here are the things to expect from the obstetrician – gynecologist:

  • If she has a history record of ovarian cysts
  • If she have developed the ovarian cysts during pregnancy
  • An obstetrician – gynecologist will perform an ultrasound to determine the cyst’s current size [if the cysts have grown too large or not]

Ovarian torsion

An ovarian torsion refers to a rare and serious condition where a functional ovarian cyst becomes twisted. This usually happens when an expectant mother engages herself in sudden and/or rigorous activities [such as running and having a sexual intercourse].

Moreover, ovarian torsion is caused by the following symptoms:

  • Constant stabbing pain
  • Nausea and vomiting
  • Sweating
  • Fever
  • Lower abdominal pain

Furthermore, this type of condition is accompanied with the following risk factors:

  • Stimulation of ovulation
  • Distended ovaries

Braxton – Hicks contractions

Braxton – Hicks contractions that are characterized with 4 or more contractions for 1 – 2 hours.

Urinary tract infection

The urinary tract infection has progressed to kidney infection. This then increases the risk of pre – term labor.

Uterine fibroids

Uterine fibroids have outgrown and degenerate the blood supply which causes pain. These fibroids need to be surgically removed to prevent the cessation of pregnancy.

Uterine rupture

A mother has the risk factors of having a uterine rupture. Because of that, her health condition and her symptoms need to be closely monitored, especially when the pain develops and worsens [during the latter months of pregnancy].


Inflamed appendix that has elevated higher in the abdomen requires immediate surgery to avoid the risk of rupturing.