It usually begins as a faint twinge—a nagging discomfort in the lower part of your abdomen or hips. Rina, a 32-year-old expectant mother from Pune, first noticed it while trying to get out of bed. By evening, she felt a deep, pulling pain in her pelvis while climbing stairs. Her mother-in-law dismissed it as "normal" and her prenatal class never mentioned it. Yet, the discomfort persisted, growing stronger with each passing week. She began to wonder, "Is something wrong? Or is this just how pregnancy is supposed to feel?"
Pelvic pain during pregnancy is common—but it is rarely talked about in detail. Many Indian women are left confused, concerned, and unsure about when to speak up. This comprehensive guide breaks down why pelvic pain happens at different stages of pregnancy, what exactly is going on in your body, and what you can do—practically and effectively—to feel better.
Table of Contents
Understanding Pelvic Pain in Pregnancy
Pelvic pain refers to discomfort or aching felt in the lower abdominal region, hips, buttocks, or inner thighs. The sensation can vary from a mild heaviness to sharp, shooting pain, depending on the underlying cause. This discomfort can begin early in pregnancy and may intensify as the baby grows.
In a 2022 study published in the Journal of Obstetrics and Gynaecology of India, over 60% of Indian pregnant women reported pelvic pain at some stage, yet fewer than 25% sought clinical attention for it. The reasons for this include social conditioning, lack of awareness, and limited antenatal education on musculoskeletal symptoms.
Pelvic Pain in the First Trimester
Physiological Reasons
In the first 12 weeks of pregnancy, the body undergoes significant hormonal and structural changes, even if the bump isn’t yet visible. These changes contribute to early pelvic pain:
Uterine Expansion:
As the uterus begins to grow, it puts pressure on the surrounding pelvic structures. This can cause cramp-like sensations similar to menstrual cramps, which many women find concerning.
Round Ligament Stretching:
The round ligaments, which anchor the uterus to the pelvis, begin stretching to accommodate its growing size. This can lead to sudden, sharp pain—especially during movement, coughing, or turning in bed.
Hormonal Impact:
High levels of progesterone and relaxin soften the connective tissue in the pelvic area. While this is necessary for the baby’s eventual passage through the birth canal, it leads to increased pelvic laxity and pain.
Practical Measures
1. Controlled Movement:
Get out of bed by rolling to your side first, then pushing yourself up slowly. Avoid jerky movements which can irritate ligaments further.
2. Warm Compresses:
A warm (not hot) water bag applied to the lower abdomen for 10–15 minutes can relax strained muscles and ease tension.
3. Safe Exercises:
Gentle prenatal stretches such as Butterfly Pose (Baddha Konasana) help open the pelvis and support better blood flow. These must be performed under expert supervision, especially in the first trimester.
4. Fluid and Electrolyte Balance:
Adequate hydration reduces uterine cramping. In warm Indian climates, supplementing with coconut water or homemade electrolyte solutions is often beneficial.
Pelvic Pain in the Second Trimester
Why It Becomes More Noticeable
Between weeks 13 and 27, the uterus continues its rapid growth. At this stage, pelvic pain may shift from general discomfort to more localised joint pain. The following factors contribute:
Symphysis Pubis Dysfunction (SPD):
This condition occurs when the ligaments supporting the pelvic bones loosen excessively due to hormonal changes. The pubic symphysis, which is the joint at the front of the pelvis, may become unstable, leading to pain in the groin, hips, or lower back.
Postural Changes and Load Distribution:
As the centre of gravity shifts forward due to the enlarging uterus, muscles and joints in the pelvic region bear uneven weight. For women who sit cross-legged on the floor or spend time squatting during chores, this imbalance may worsen.
Fetal Growth and Pressure:
As the fetus grows, pressure on pelvic nerves, the bladder, and the pelvic floor muscles increases. This leads to heaviness, sharp pain while moving, or even a tingling sensation in the thighs.
Symptoms to Watch For
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Difficulty lifting one leg while dressing
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Pain that worsens with walking or stair-climbing
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Clicking or grinding sensation in the pubic area
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Pain that increases after long hours of sitting in one position
Strategies for Relief
1. Maternity Support Belts:
These belts are designed to cradle the abdomen and stabilise the pelvis. When worn correctly, they reduce pressure on the pelvic joints and improve posture.
2. Optimised Sleeping Posture:
Sleep on your side with a firm pillow between your knees and another under your belly. This helps align the hips and reduces ligament strain.
3. Physiotherapy and Pelvic Stabilisation Exercises:
A certified physiotherapist can guide you through pelvic tilts, gentle core activation, and strengthening movements that reduce instability without harming the baby.
4. Activity Modification:
Avoid asymmetrical activities such as lifting heavy bags on one side or standing on one leg. Use both hands and balance your weight evenly.
Pelvic Pain in the Third Trimester
The Final Stretch and Its Challenges
From week 28 onwards, the body begins preparing for labour. This stage brings new sources of pelvic pain, often more intense and consistent.
Engagement of the Baby’s Head:
In preparation for birth, the baby's head descends into the pelvis. This engagement, while important, increases pressure on the bladder, pelvic joints, and nerves. It can cause throbbing pelvic pain and a sense of heaviness or fullness.
Hormonal Peak of Relaxin:
Relaxin reaches its highest levels in the final trimester. Its role is to loosen joints and muscles, but this increased flexibility can destabilise the pelvis and lead to pain during daily activities.
Braxton Hicks Contractions:
These are intermittent, often painless contractions, but when felt in the pelvis, they can mimic cramping or deep pressure.
Digestive Slowdown and Constipation:
Iron supplements, along with traditional diets rich in ghee and sweets, can lead to constipation. This worsens pelvic pressure and causes rectal and lower abdominal discomfort.
Management Techniques
1. Sitz Baths:
Soaking the lower half of your body in warm water (with Epsom or rock salt) relaxes pelvic muscles and improves circulation. This is especially helpful after long hours of standing.
2. Prenatal Massage Therapy:
Gentle massages, preferably by a certified prenatal therapist, can reduce tightness in pelvic and lower back muscles. Avoid massages that stimulate pressure points.
3. Cushioned Seating:
Pregnancy doughnut cushions or wedge pillows redistribute weight and prevent direct pressure on the tailbone or pubic area. This is particularly useful during long commutes or desk work.
4. Dietary Adjustments:
Include high-fibre foods such as soaked raisins, papaya (in moderation), and whole grains. Maintain fluid intake with jeera water, sabja seed drinks, and tender coconut.
Pelvic Floor Dysfunction and Prevention
The pelvic floor is a sling of muscles supporting the uterus, bladder, and bowel. During pregnancy, the weight of the growing uterus can weaken these muscles, especially in women who are sedentary, overweight, or carrying twins.
Common Signs
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Leaking urine while coughing or laughing
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Vaginal pressure or bulging sensation
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Pain during intercourse or difficulty initiating urination
Strengthening Techniques
Kegel Exercises:
Tighten the pelvic floor muscles as if stopping urine flow, hold for five seconds, and release. Begin with 10 repetitions, twice a day.
Breathing Coordination:
Sync deep exhalation with pelvic floor activation. Never hold your breath during these exercises.
Preventing Strain:
Avoid straining during bowel movements. Use natural remedies like isabgol husk or triphala under medical guidance.
Cultural and Practical Adjustments for Indian Households
Sitting Posture Awareness:
Avoid long durations of floor sitting, especially during rituals or cooking. Use low stools with back support.
Footwear Modifications:
Replace hard chappals with cushioned slippers that offer arch support. Brands offering orthopaedic designs are now available across Indian online platforms.
Modified Squatting Practices:
Deep squatting should be limited in the third trimester. Use a footstool with western-style toilets to maintain pelvic alignment.
Handling Festival Workload:
Indian households often expect pregnant women to participate in rituals or extended family functions. Pre-plan for breaks, delegate tasks, and avoid prolonged fasting. Fasting without hydration, especially during hot seasons or festivals like Navratri, can aggravate cramping and fatigue.
When to Consult a Medical Professional
You should seek immediate medical attention if you experience:
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Severe, persistent, or one-sided pelvic pain
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Pain accompanied by bleeding or abnormal vaginal discharge
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Inability to walk due to pelvic discomfort
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Fever or signs of infection
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Sudden decrease in fetal movement
Final Thoughts
Pelvic pain during pregnancy is not a sign of weakness or something to be silently endured. It is a complex but manageable symptom of the body’s adaptation to growing life. With the right support system, including access to informed antenatal care, physiotherapy, and practical lifestyle changes, every Indian mother can journey through her pregnancy with greater awareness and physical ease.
Listening to your body, respecting its signals, and responding with knowledge is the foundation of a healthy and empowered pregnancy. Have you experienced pelvic pain in pregnancy mommy? Do share your experience in the comments and share this article with another mom it might help!
