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What does the pelvic girdle mean?
The pelvic girdle includes the pelvic bones and their joints. At the front, the two sides meet near the pubis; At the back, the sacrum is connected to the pelvis by the sacroiliac joints. Muscles and ligaments help make these structures work when you walk, change position, or carry a load.
Pelvic girdle pain is musculoskeletal pain, that is to say linked to movement structures. It is different from pain coming from the uterus, bladder or intestines, although the area felt may be close. This guide alone does not explain bleeding, abdominal pain or urinary problems.
Understand the picture
The pelvic girdle, front and back
At the front
The symphysis connects the two sides near the pubis.
At the back
The SI joints connect the sacrum to the pelvis.
Around the pelvis
Muscles, ligaments and daily tasks are part of the assessment.
How can symptoms appear?
The pain may be located near the pubis, in the groin, in the buttocks or at the back of the pelvis. Certain movements can trigger the pain: standing on one leg, moving the legs apart, getting out of the car, walking for a long time or turning over in bed. The difficulty may vary depending on the day and stage of pregnancy.
These descriptions help prepare the assessment without confirming a cause. Specify what you can no longer do, the positions that provide relief and what has changed recently. Very intense pain or a significant reduction in mobility deserves appropriate help; you don't have to wait until you give birth to talk about it. After birth, persistent pain may also require evaluation.
Why can pregnancy change constraints?
Pregnancy changes the body, the load carried, the way of carrying out certain activities and sometimes sleep. Hormonal factors, history of pain and daily stresses can contribute to the situation. However, we cannot explain each case by a single hormone or by a specific lack of strength.
The pelvis is not necessarily unstable or out of place. Formulations that are too mechanical can make you afraid to walk or turn over. The goal is to understand difficult tasks and ways to make them more accessible. The pain is real, even when tests don't show a lesion that explains everything, and it doesn't mean you moved wrong.
When to contact the maternity ward or a medical service?
Pelvic pain with bleeding, feeling faint, fever, severe abdominal pain or urinary symptoms requires advice adapted to the context of the pregnancy. Sudden intense pain, fainting or difficulty breathing may be an emergency: call 112 in Luxembourg. Do not try first to see if the pelvis unblocks.
Contact your maternity unit immediately for leaking fluid, bleeding or unusual contractions, and follow its advice. If your baby moves less than usual, call immediately, even at night; do not wait until the next day. After childbirth, pain with fever, heavy bleeding or feeling increasingly unwell requires medical assessment. Known muscle or joint pain does not rule out another problem.
How does the assessment take place?
The professional discusses the pregnancy or childbirth, your history and limited activities. He can observe walking, certain position changes and hip movements. The examination must be explained, adapted to your comfort and carried out with your agreement. Report the instructions of your midwife, obstetrician or doctor.
Imaging is not automatically necessary for a usual presentation of pelvic girdle pain. The doctor decides whether additional examination is useful when another cause is suspected. Pelvic floor problems, such as certain leaks or pain during intercourse, may require a specific evaluation. This does not mean that all pelvic pain can be treated with the same program.
What assistance can be discussed?
The NICE recommendations suggest considering a physiotherapy referral for exercise advice and/or a non-rigid lumbopelvic belt. The evidence and individual responses vary. A belt can be tried on for certain tasks, with adjustment and verification of its usefulness; it is not obligatory nor a repair of the shape of the pelvis.
The program can combine education, adapted movements and temporary aid depending on the limitation. Any manual technique must have an explained comfort objective, without promising to put bones back into place. Ask for advice before taking or changing any medicine during pregnancy or breastfeeding. The choice depends on your medical situation, not just the intensity of the pain.
In everyday life
Make the morning start easier
Prepare
Gather useful things to limit trips back and forth.
Adapt
Sit down to get dressed and try a comfortable way to change position.
Distribute
Make time for travel and discuss what help is needed.
Chapter sources [1]
How to turn over, get dressed and get into the car?
When getting dressed, sitting down can avoid prolonged support on one leg. In bed, try support between the legs and changing position in several small movements. If keeping your knees relatively close helps during a transfer, use this adaptation, without imposing a rigid rule on all your movements.
In a car, you can experiment with sitting down and then moving your legs together if that's more comfortable. Adjust the seat before the trip and plan for breaks. These examples are trials: keep the ones that help you and let go of the ones that increase the pain. A difficult activity can often be modified rather than prohibited until birth.
How to distribute walking, work and care for a child?
A large amount of tasks in a single period can be more difficult than the same tasks spread out. Alternate efforts and recovery times when possible. For walking, choose a distance and terrain suited to your reaction. If an activity causes significantly greater discomfort, its duration or organization can be reviewed.
At work, discuss long periods of standing, loads and accommodation options. If you are caring for a child, move useful objects closer together, sit down for certain tasks and ask for help when possible. These adaptations must support independence. Prolonged immobility or a significant reduction in movement also requires advice from the pregnancy team.
What exercises and what recovery after birth?
The exercises are chosen according to the assessment, the stage of pregnancy, the pain and the obstetrical instructions. The goal may be to maintain comfortable movements, improve a task or work certain muscular abilities. General hip exercises are not a midwifery program or a complete pelvic floor program.
After birth, progression takes into account the type of delivery, tissue recovering, sleep and care burden. Returning to daily activity does not equate to being ready to run or jump. Persistent pain, a feeling of heaviness, leaking or intimate discomfort should be discussed with a competent professional to choose the right orientation.
What recovery can you expect and when to take stock?
Many people improve after giving birth, but it is not immediate for everyone. Activities, fatigue and other associated issues can influence recovery. A duration announced for another person does not predict your situation. Your difficulties deserve to be reassessed if they persist or severely limit daily life.
Choose one or two observable goals, such as turning around or walking to a nearby location. Take stock of what really helps. If the pain increases, changes in character or is accompanied by new medical signs, contact the team sooner. You should not simply increase the repetitions of a program that no longer meets your needs.
Your questions
Does this pain mean my pelvis is damaged?
Pain alone does not allow us to conclude that there is an injury or displacement. An assessment helps to distinguish the causes and useful adaptations. Intense, sudden pain or pain accompanied by other symptoms must nevertheless be evaluated medically.
Is a belt essential?
No. It is one of the options to discuss and try in certain situations. Check if it improves a specific activity and if it remains comfortable. Its use does not replace an assessment, individualized advice or medical guidance when necessary.
Chapter sources [4]
Can I decide the mode of delivery based on this pain?
This guide does not allow you to choose a method of delivery. Discuss your limitations and comfortable positions with the obstetric team. The team takes the entire pregnancy into account and can prepare adaptations if necessary.
Chapter sources [3]
What to do if the pain persists several weeks after birth?
Request a reassessment, especially if your mobility remains reduced or other symptoms appear. The assessment should consider musculoskeletal pain, recovery after childbirth and possible pelvic floor problems. You don't have to wait for automatic recovery.
Sources and references
- [1] Cambridge University Hospitals — Pelvic girdle pain in pregnancy
- [2] NHS — Pelvic pain
- [3] RCOG — Pelvic girdle pain and pregnancy
- [4] NICE NG201 — Antenatal care
- [5] CGDIS Luxembourg — 112
- [6] NHS — Your baby’s movements
- [7] NHS — Signs that labour has begun and when to contact your maternity unit
Text updated on
Medical review: awaiting Hasib Selimovic.