Pelvic Girdle Pain in Pregnancy (PGP): Understanding It and What May Help

Pelvic girdle pain (PGP) affects a large proportion of pregnancies, with research suggesting roughly one in five pregnant women experience it to some degree.[1]

If you are pregnant and finding that movements such as turning over in bed causes pain, the stairs need taking one at a time or that a sharp pain at the front or back of your pelvis catches you when you stand on one leg to get dressed, you are describing textbook PGP.

PGP is a common condition during pregnancy and is well recognised by the medical profession. It is not something should have to just have to tolerate for the duration of that time. It is a mechanical problem of pregnancy, not a sign that anything is wrong with your baby.

You may have heard it called symphysis pubis dysfunction (SPD) or pregnancy pelvic girdle pain (PPGP). Those older names describe the same condition and pelvic girdle pain is now the preferred medical term.[2]

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“ Leslie is a fantastic chiropractor! He is incredibly skilled and knowledgeable, but what really sets him apart is how professional and welcoming he is. He maintains a highly respectful environment, so I always feel relaxed and in safe hands during my appointments. I highly recommend him. Thank you Leslie.”

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What is pelvic girdle pain?

Your pelvis is a ring of bone with three joints: the two sacroiliac joints at the back, where the spine meets the pelvis and the symphysis pubis at the front. In pregnancy, hormonal changes soften the ligaments supporting these joints while your posture, weight distribution and demands on your muscles change week by week. The result, for some women is that the pelvic joints become irritated and painful at the back, at the front or both.[2]

The older name symphysis pubis disorder (SPD) singled out the front joint, but the European guidelines recognised that the whole pelvic ring is involved which is why the umbrella term PGP replaced it.[2] PGP can start at any stage of pregnancy and for most women it resolves itself in the weeks and months after delivery.

a human pelvis showing the pelvic joints affected by pregnancy pelvic girdle pain

The bony landmarks and joints of the female pelvis in relation to pregnancy pelvic girdle pain

Explore our hip and pelvic guides

Hip and pelvic pain: the main guide

Hip and groin

Side of the hip and buttock

Pelvis and tailbone

Sacroiliac joint pain
Tailbone pain and coccydynia
Pelvic girdle pain in pregnancy (you are here)

Related guides

When hip or buttock pain starts in the back

When the problem shows up further down the leg

Wear and tear, bones and staying active

When sport or training is behind it

What causes it

There is no single cause to PGP but a recognisable combination of contributing factors. The hormone-driven softening of ligaments is universal in pregnancy and yet only some women develop pain. So, other factors are taken into account: a previous history of low back or pelvic pain, previous pelvic trauma, the physical demands of work and of caring for other children and how well the deep abdominal, pelvic floor and gluteal muscles are coping with their changing status. Asymmetry is a recurring theme, activities loading one side of the pelvis at a time, stairs, getting in and out of the car, carrying a toddler on one hip are the all classic aggravators.

None of this reflects anything you have done wrong. Some pelvises simply find pregnancy harder mechanical work than others. The same ligamentous laxity and altered pelvic loading that produce pelvic girdle pain can also leave the coccyx sore. So, any tailbone pain that you are also experiencing is worth mentioning at your appointment rather than treating as a separate problem.

a pregnant woman in a white top holding her bump inside the chiropractic clinic treatment room at Branksome Hill Road. She is signalling where she feels the PPGP at the front of the pelvis

Symptoms of pelvic girdle pain

Women describe pain over the pubic bone at the front or across one or both sacroiliac joints at the back or radiating into the groin and inner thigh. Turning in bed, single-leg standing to get dressed, walking up stairs and getting out of the car are the aggravators and some notice a clicking or grinding sensation at the front of the pelvis. Walking distance often declines through the day.

PGP sits within the wider family of hip and pelvic pain and overlaps with and is often confused with pregnancy low back pain and sacroiliac joint pain outside pregnancy. The distinguishing feature is the pattern: pelvic pain that is provoked by those specific asymmetric movements in pregnancy points to PGP. Careful chiropractic assessment separates these and will determine treatment.

How chiropractic care may help

In practice, care during pregnancy is gentle and adapted throughout the trimesters. It may include light mobilisation of the pelvic joints and lower back, soft tissue work through the gluteal and hip muscles and positioning that keeps you comfortable as your bump grows. Just as valuable is the practical advice: how to turn in bed, manage stairs, get out of the car keeping your knees together, pace your day and use simple supports where they offer help. I review progress visit by visit, because pregnancy changes weekly and your plan is adjusted with it, always alongside your midwife’s care.

Research has been carried out and a Cochrane review of interventions for pelvic and back pain in pregnancy found that exercise and some manual approaches may help reduce pain and disability, while grading the underlying evidence as low quality.[3] The European guidelines similarly recommend individualised exercise and advice as the core of management.[2] So, the Cochrane review saying that chiropractic “may help” is the right phrase, but in my opinion, it is still a very worthwhile “may” because many women get meaningful relief from the combination of gentle treatment and the right advice.

If pelvic pain during your pregnancy (PGP) is getting in the way of things you would rather be doing, come and talk it through. I offer a free 15-minute consultation, you can come in for a short no-obligation chat with no examination or treatment.

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red flags

PGP itself is a mechanical, musculoskeletal problem and is not dangerous to you or your baby. For the mechanical pattern described above, a chiropractic assessment is appropriate and your maternity team remains part of the picture throughout.

Speak to your midwife, GP or maternity unit first if pain is accompanied by bleeding, fluid loss, fever, changes in your baby’s movements, pain or burning passing urine or any symptom that simply worries you. Sudden severe abdominal pain always warrants urgent maternity advice.

your first visit to Bournemouth Chiropractic

At your first chiropractic appointment visit I take a full history including that of your pregnancy so far, then gently assess your pelvic joints, lower back and hips using tests appropriate to pregnancy. I explain what I find and we agree a plan together, including liaison with your midwife or GP whenever that is the right course. Our FAQ’s page should be useful answering common questions in advance of booking in too.

If PGP is making everyday movement a struggle, I would be glad to help you through the remaining months of your pregnancy more comfortably.

Frequently Asked Questions

Is pelvic girdle pain harmful to my baby?

No, pelvic girdle pain is not harmful to your baby. PGP is a mechanical problem of the pelvic joints and muscles, uncomfortable for you but posing no danger to your pregnancy. Any pain that comes with bleeding, fever or changes in your baby’s movements is a different matter and you need to contact your maternity team.

Can a chiropractor help with pelvic girdle pain in pregnancy?

A chiropractor may help with pelvic girdle pain in pregnancy through gentle, pregnancy-adapted treatment and practical advice on movement and daily activities. The research evidence is points in the encouraging direction and care always sits alongside your midwife’s advice. See our FAQ page for answers to commonly asked questions.

Will my pelvic girdle pain go away after birth?

For most women, pelvic girdle pain does go away after birth, usually settling within weeks to a few months as hormones and load return to normal. A minority have symptoms that persist longer and those are worth assessing properly rather than waiting because ongoing pelvic pain after delivery is treatable too.

Is SPD the same as pelvic girdle pain?

Yes, SPD and pelvic girdle pain describe the same condition. Symphysis pubis dysfunction (SPD) is the older name, focused on the joint at the front of the pelvis and pelvic girdle pain is the current term because the sacroiliac joints at the back are usually involved as well. If you were told you have SPD, the information on this page is for you.

What can I do at home to ease pelvic girdle pain?

To ease pelvic girdle pain at home, keep your knees placed together for the provocative movements, turning in bed, getting out of the car and take stairs one at a time. Pace your daily activity rather than pushing through, sleep with a pillow between your knees and keep gently active within comfort rather than resting completely.

Whatever's behind your pelvic pain in pregnancy, come and find out

Pelvic girdle pain in pregnancy, felt around the pubic bone, the hips or the base of the back, can make walking, turning in bed and getting dressed a struggle and it is natural to want a clear idea of what is going on and what might ease it. I'd happily see you first for a free 15 minute consultation, a short, no-obligation chat to talk through what's going on, not an examination or treatment. I'll answer your questions and tell you whether chiropractic may help and you can then choose whether to book a full visit for examination and treatment.

Pelvic girdle pain in pregnancy is a common reason expectant mums book in to see me at my clinic in Bournemouth.

In many of the cases I see, chiropractic care is a gentle, well-tolerated option worth considering during pregnancy and I'll explain clearly whether it's likely to help in your particular case. If I think you'd be better served by your midwife, GP, a women's health physiotherapist or another practitioner, I'll say so and help point you in the right direction.

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