Pelvic pain during pregnancy is one of the most commonly reported but least widely discussed physical experiences of pregnancy. Pelvic girdle pain (PGP) affects a significant proportion of pregnant women and can range from mild discomfort to significant pain that affects mobility and daily functioning. For women pregnant after 35, understanding this experience and the evidence around supportive care can be genuinely useful.
The pelvis during pregnancy undergoes considerable changes. Hormonal shifts — particularly increased levels of relaxin — cause ligaments throughout the pelvis to become more flexible in preparation for childbirth. While this is a functional adaptation, it can also lead to increased stress on the pelvic joints. This is part of the broader physical landscape of physical changes during pregnancy after 35.
What Research Shows About Pelvic Girdle Pain in Pregnancy
Research published through the National Institutes of Health suggests that pelvic girdle pain affects between 20% and 30% of pregnant women to varying degrees. The condition tends to develop most commonly in the second and third trimesters but can begin as early as the first trimester in some women. Severity varies considerably — some women experience mild aching that is manageable with activity modification; others experience significant pain with walking, climbing stairs, or turning in bed.
Common Experiences of Pelvic Girdle Pain
Symphysis Pubis Pain
Pain at the front of the pelvis, in the area of the symphysis pubis, is one of the hallmarks of PGP. This is often described as a sharp, burning, or aching pain that can radiate into the groin, inner thighs, or hips. Activities that involve loading one leg at a time — such as climbing stairs, getting in and out of a car, or walking — tend to aggravate this type of pain.
Sacroiliac Joint Pain
Pain at the back of the pelvis, in the sacroiliac joint area, is also common and may occur alongside or independently of anterior pelvic pain. This is sometimes experienced as deep buttock pain or pain that radiates into the hips or thighs. Prolonged sitting or standing may worsen this type of pain.
Pain With Movement Transitions
Many women with PGP report that pain is particularly noticeable with certain movement transitions — turning over in bed, getting up from a chair, or moving from sitting to standing. These “transition movements” that involve asymmetrical loading of the pelvis are often cited as particularly challenging.
Supportive Approaches — What the Evidence Suggests
Several approaches are studied in the context of managing pelvic girdle pain during pregnancy. What helps one person may not help another, and a personalized evaluation by a physiotherapist — ideally one with experience in women’s health or pelvic floor physiotherapy — is generally the most useful starting point.
Pelvic support belts are commonly recommended and some women report them helpful, though research results are mixed. Pelvic floor physiotherapy — which may include manual therapy, exercise prescription, and education about activity modification — is among the more evidence-supported approaches. Avoiding activities that consistently provoke pain and modifying how movements are performed may also support comfort.
When to Seek Assessment
Pelvic pain during pregnancy does not need to be simply endured. If pelvic pain is significantly affecting your mobility, sleep, or daily functioning, discussing it with your OB/GYN or midwife is appropriate. A referral to a physiotherapist with experience in pregnancy-related pelvic pain can provide a more detailed assessment and individualized recommendations. Understanding managing physical discomfort during pregnancy after 35 involves knowing which professionals can help.
Very severe PGP — particularly if there is a sensation of something clicking or giving way in the pelvis, or if pain is accompanied by neurological symptoms — warrants prompt discussion with a healthcare provider.
Frequently Asked Questions
Is pelvic girdle pain normal during pregnancy?
Pelvic discomfort is common during pregnancy and affects a significant proportion of pregnant women. Pelvic girdle pain that affects daily functioning is worth discussing with your healthcare provider, who can assess whether referral to a physiotherapist or other support is appropriate.
Does PGP affect the ability to give birth?
In most cases, pelvic girdle pain during pregnancy does not preclude vaginal birth. Discussing birth positioning and movement options with your midwife or OB is helpful — positions that avoid wide leg abduction are often more comfortable for women with PGP. Your birth team should be aware of your PGP.
Will pelvic girdle pain go away after pregnancy?
For most women, pelvic girdle pain improves significantly after birth as hormone levels normalize. However, some women experience ongoing pelvic pain postpartum, and postnatal physiotherapy assessment may be helpful if symptoms persist beyond a few months after delivery.
Can anything prevent pelvic girdle pain during pregnancy?
Research has not identified interventions that reliably prevent pelvic girdle pain in all women. Maintaining core and pelvic floor strength before and during pregnancy is generally considered beneficial for pelvic health broadly. Early physiotherapy assessment when symptoms begin may help manage the condition more effectively.
Key Takeaways
- Pelvic girdle pain affects approximately 20–30% of pregnant women and can involve pain at the front or back of the pelvis, often worsened by asymmetrical movements or prolonged activity.
- The condition results from hormonal changes that affect ligament laxity in the pelvis, combined with the mechanical demands of pregnancy.
- Pelvic floor physiotherapy is among the more evidence-supported approaches for managing PGP and can provide individualized assessment and recommendations.
- PGP does not need to be simply endured — discussing it with your OB/GYN or midwife and seeking physiotherapy referral is appropriate if symptoms significantly affect daily life.
- For most women, PGP improves after birth, though postnatal assessment may be helpful if symptoms persist.
Medical Disclaimer
This content is for informational purposes only and does not constitute medical advice. Individual health situations vary significantly. Always consult a qualified healthcare provider before making decisions related to your health, fertility, or pregnancy.
About the Author
Emily Carter is a women’s health writer focused on fertility, pregnancy after 35, and sleep changes in midlife. She writes research-informed, non-alarmist content to help women navigate reproductive and hormonal transitions with clarity and confidence.