Pelvic girdle pain in pregnancy: symptoms, management and what to avoid

Pregnancy · Updated July 2026 · All articles

Pelvic girdle pain affects roughly one in five pregnancies and ranges from a mild ache that is a nuisance to a severe pain that affects walking, sleep and daily life. Despite how common it is, many people suffer for weeks or months before seeking help, partly because it is normalised as just being part of pregnancy. It does not have to be. There are evidence-based treatments that make a real difference, and getting help early consistently produces better outcomes than waiting until the pain becomes severe.

What pelvic girdle pain is

Pelvic girdle pain (PGP) is an umbrella term for pain arising from one or more of the joints that make up the pelvic ring. The pelvis is held together by three joints: the symphysis pubis at the front (where the two halves of the pelvis meet), and the two sacroiliac joints at the back (where the pelvis connects to the base of the spine). PGP can affect any of these joints, alone or in combination.

The condition was previously known as symphysis pubis dysfunction (SPD), a term that specifically referred to pain at the symphysis pubis joint at the front. PGP is the broader term now preferred by the Pelvic, Obstetric and Gynaecological Physiotherapy (POGP) group because it acknowledges that pain often affects multiple sites and that the sacroiliac joints at the back are very commonly involved, sometimes more so than the front.

PGP is caused by a combination of the hormonal changes of pregnancy (particularly relaxin and progesterone, which loosen ligaments to prepare for birth), the mechanical changes as the uterus grows and alters the body's centre of gravity, and individual variation in joint stability and previous history. It is more common in subsequent pregnancies and in people with a previous history of lower back or pelvic pain.

How common is it?

Research estimates suggest that PGP affects between 14 and 26 percent of pregnant people to some degree. Mild cases are probably more prevalent but go unreported. It can start at any point in pregnancy but most commonly begins in the second trimester as the uterus grows and the relaxin effect on ligaments becomes more pronounced. In some cases it begins very early, in the first trimester, particularly in people who have experienced PGP in a previous pregnancy.

Recognising the symptoms

PGP presents differently depending on which joints are involved. Common presentations include:

Symphysis pubis pain: pain at the front of the pelvis, in the pubic area, often described as a burning, stabbing or grinding sensation. It may radiate down the inner thighs. It is typically worse when spreading the legs apart, standing on one leg, or walking up stairs. In severe cases even turning over in bed can be intensely painful.

Sacroiliac joint pain: deep pain in the lower back, the buttocks or the hips, on one or both sides. It may feel like sciatica but comes from the joint rather than the nerve root. It is often worse after prolonged sitting or standing, and when changing position.

Combined symptoms: many people have pain at both the front and the back, creating a general pelvic instability that makes sustained activity difficult. Some describe a feeling that the pelvis is "shifting" or "clicking" with movement.

A physiotherapist can assess exactly which joints are involved and which movements are implicated, which is important for giving specific rather than generic advice.

What makes it worse

The activities that most commonly aggravate PGP are those that require the legs to move apart or the weight to shift onto one leg at a time. The practical list includes: climbing stairs step-over-step (both feet on each step is less painful); getting in and out of a car (leading with both legs together rather than one at a time helps); turning over in bed; getting up from low seats; carrying shopping or a child on one hip; walking on uneven or hilly ground; standing for extended periods; and in some cases sexual intercourse, particularly positions that involve wide hip abduction.

Activities that are less likely to aggravate PGP include: walking on flat ground at a controlled pace; swimming (freestyle rather than breaststroke); cycling on a stationary bike; and gentle exercise in water. The key principle is keeping the legs symmetrical and close together during activities.

Physiotherapy and professional treatment

Physiotherapy is the recommended first-line treatment for PGP in pregnancy and it is available on the NHS through a referral from your midwife or GP. A women's health physiotherapist will assess your specific pattern of pain, identify which joints are affected and which movements are problematic, and provide a tailored management plan.

Ask for a referral early. A common pattern is for people to report PGP to their midwife and be reassured that it is normal and will pass after birth. While it is true that most cases resolve postnatally, waiting until the condition becomes severe and debilitating before seeking treatment makes the management harder and recovery slower. You have a right to a physiotherapy referral and it is appropriate to ask if it is not offered.

Treatment typically includes: targeted exercises to improve the stability of the pelvic joints; advice on a pelvic support belt; guidance on pain-free movement strategies for daily activities; and in some cases manual therapy to the joints. Water-based physiotherapy is particularly useful in later pregnancy when land-based exercise is more restricted.

Self-management at home

Keep your legs together: the principle of keeping the legs symmetrical and moving together rather than apart runs through almost all self-management advice for PGP. This means sitting down to get dressed rather than standing on one leg, getting in and out of the car by sitting sideways and swinging both legs together, and stepping onto each step with both feet before climbing to the next one on stairs.

Pelvic support belt: a properly fitted pelvic support belt worn below the bump provides compression of the sacroiliac joints and reduces the instability that causes pain. They are most helpful during walking and other activities. A physiotherapist can advise on correct positioning; wearing it too high (over the bump) does not help.

Pacing: activity pacing, doing less in each session and resting more between activities, is one of the most practical strategies for managing PGP day to day. Pushing through pain typically leads to a significant worsening the following day. Learning your pain threshold for different activities and stopping before you reach it preserves more functional capacity overall.

Paracetamol: paracetamol at the recommended dose is safe to use in pregnancy and can help manage PGP pain. Stronger pain relief, including ibuprofen and aspirin, should be avoided in pregnancy unless specifically advised by your doctor.

Sleeping with PGP

Sleep is often badly disrupted by PGP. Several adjustments make a real difference. Placing a firm pillow or a pregnancy pillow between the knees keeps the hips in a neutral position and reduces sacroiliac joint pain while lying on your side. Rolling over by bringing the knees together and rolling as a unit (like a log roll) rather than swinging the top leg over reduces the pain of position changes. Going to bed and getting up at consistent times, even when sleep is poor, helps manage the fatigue that worsens pain perception.

After the birth

The majority of PGP cases improve significantly within the first three months after birth, as relaxin levels fall and the mechanical demands on the pelvis reduce. For many people the improvement begins within days of delivery. A small proportion of people continue to experience symptoms beyond three months and will benefit from postnatal physiotherapy, which is different in focus from antenatal treatment.

The postnatal period brings its own pelvic load from breastfeeding positions, lifting, carrying and the physical demands of caring for a baby. Continuing the exercises and movement strategies recommended by a physiotherapist through the early postnatal period helps protect the joints while they recover. If you are still experiencing significant pelvic pain at your six-week postnatal check, ask specifically for a physiotherapy referral rather than assuming it will resolve on its own.

Frequently asked questions

What is pelvic girdle pain in pregnancy?

Pelvic girdle pain (PGP) is an umbrella term for pain in the pelvic joints during pregnancy. It includes symphysis pubis dysfunction (SPD), where the joint at the front of the pelvis becomes painful, and sacroiliac joint pain affecting the joints at the back. It affects around one in five pregnancies.

What makes pelvic girdle pain worse?

Activities that involve standing on one leg or moving the legs apart tend to aggravate PGP. These include climbing stairs (one leg at a time), getting in or out of a car, rolling over in bed, walking on uneven ground and sex. Prolonged standing or sitting in one position can also increase pain.

Can physiotherapy help pelvic girdle pain in pregnancy?

Yes. Physiotherapy is the recommended first-line treatment for PGP in pregnancy. A women's health physiotherapist can assess which joints are affected, provide targeted exercises to stabilise the pelvis, advise on a pelvic support belt, and give guidance on the activities and movements to modify. Early referral generally leads to better outcomes.

Will pelvic girdle pain go away after birth?

For most people, yes. The majority of PGP cases resolve within three months of birth. A small proportion of people continue to experience symptoms postnatally and benefit from postnatal physiotherapy. Continuing the pelvic stabilisation exercises recommended by a physio throughout pregnancy and into the postnatal period supports recovery.

Is a pelvic support belt safe to use in pregnancy?

Yes, pelvic support belts (also called SI belts or pelvic girdles) are safe to use in pregnancy and can significantly reduce pain during walking and daily activities. They work by compressing the pelvic joints and reducing the range of movement that causes discomfort. A physiotherapist can advise on correct positioning for your specific situation.

Can I still exercise with pelvic girdle pain in pregnancy?

Some forms of exercise are appropriate and helpful, and others worsen PGP. Swimming (not breaststroke, which stresses the hip joints) and walking on flat surfaces are generally well-tolerated. Exercise involving lunges, wide-leg movements or single-leg loading tends to aggravate symptoms. A physiotherapist can give you a safe, tailored exercise plan.

This article is for general information only. Always consult your midwife, obstetrician, or GP for advice specific to your pregnancy.