Pregnancy – Pelvic girdle pain and pubic symphysis diastases (PSD)

In pregnancy there is a natural increase in the mobility of the pelvis due to hormones softening the tissues. The main joints of the pelvis are the Sacro-iliac joints (SIJ) that sit at either side of your low back and the symphysis pubis, the joint at the front of your low stomach. For many women these changes do not result in any discomfort but some can experience severe pain and can start as early as the first trimester. Saying this the most common time to experience these symptoms is in the last/third trimester.

What are the symptoms?

The symptoms are pain which can be on-going or more sudden felt in the pubis, groin, inside of the thighs or the low back. Not all pain is associated with pelvic girdle pain or PSD as movements from the baby kicking repetitively and stretching of the uterine ligaments can both cause similar pains. PSD and pelvic girdle pain is often a very specific pain and can feel like a burning pain.

What can make it worse?

Activities that open the hips i.e. turning from side to side in bed, breast stroke swimming, getting out of the car, squatting and sometimes walking can all aggravate it. Pain in the early stages may not be immediate but come on later and thus sometimes not associated with these activities. It is also sometimes associated with clicking or grinding which may be audible and can be felt.  N.B sometimes a urinary tract infection can give rise to a burning pain but this tends to be felt more deeply.

What should I do?

If you think that you have pelvic girdle pain or PSD or other similar pains in the first instance you should contact your midwife. They can examine you and advise if this is the diagnosis.

Physiotherapy can be very useful to help manage the symptoms. Techniques include gentle soft tissue work, specific exercises to support the pelvis, advice on how to avoid aggravating the symptoms and support belts can be prescribed.

It is important to remember that pelvic girdle pain and PSD can happen in one pregnancy and not the next. It does not affect your baby but you should ensure that when you are in labour it is known if you have had pelvic girdle pain/PSD to help manage your birthing position to avoid any aggravation of symptoms. In most circumstances the pain resolves after the birth with no need for further treatment.


N.B this advice is designed as general information only. If you are experiencing pain you should contact your midwife to be assessed and advised on the best course of action.


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