Round Ligament Pain (RLP) is a common discomfort felt in the lower abdomen or groin during pregnancy. This sensation typically manifests as a sharp, sudden jab or a prolonged dull ache, most often noticed beginning in the second trimester. While RLP is a normal physiological sign of the body adjusting to a growing fetus, it can cause concern. Many individuals who have been pregnant before wonder if this discomfort intensifies with each subsequent pregnancy.
The Anatomy Behind the Pain
The sensation of RLP is directly related to the two round ligaments, which are rope-like bands of tissue located on either side of the uterus. These ligaments originate near the top of the uterus and extend down into the groin area, connecting to the labia majora. They function as supportive structures, helping to keep the uterus anchored within the pelvis.
As the uterus expands rapidly to accommodate the developing baby, the round ligaments are pulled, stretched, and thickened. This constant tension can lead to an ache, but the characteristic sharp pain occurs when the ligaments contract or spasm quickly. Sudden movements—like coughing, sneezing, laughing, or quickly changing positions—cause the ligaments to stretch faster than they can adapt. This results in a brief, stabbing spasm, often occurring on one or both sides of the lower abdomen, indicating strain from the growing pressure.
Does RLP Worsen With Subsequent Pregnancies
Many individuals report that Round Ligament Pain begins earlier and feels more intense with their second or third pregnancy, an observation supported by anecdotal evidence. This perceived increase in severity is often attributed to the prior stretching and loosening of the ligaments from previous pregnancies. Having already been stretched, these ligaments may be slightly less rigid and therefore allow the uterus to shift or tilt more easily.
This increased mobility can lead to the ligaments being engaged or pulled more quickly during movements, causing a sudden spasm that feels more severe than in a first pregnancy. The uterus also tends to grow at an accelerated rate in subsequent pregnancies, placing immediate and greater tension on the supportive structures sooner. Additionally, a person who has already carried a baby may be more attuned to the sensation, noticing the pain earlier in the second trimester than they did the first time.
The pain is often more noticeable, but it remains a benign condition related to the physical accommodation of the growing fetus. Although the experience may be more abrupt or intense in subsequent pregnancies, the underlying mechanism is the same physiological stretching of the supportive uterine structures. The perception of worsening pain should still be discussed with a healthcare provider to ensure the diagnosis is RLP and not another issue.
Immediate Relief Strategies
When the sharp, stabbing pain of RLP occurs, slowing down movement can offer immediate relief, as the pain is a reaction to the sudden stretch. Resting comfortably should help ease the symptoms. Many find relief by changing their position slowly or by flexing the hips. Pulling the knees toward the abdomen shortens the round ligaments, which may reduce tension and stop the spasm.
Applying gentle warmth with a warm (not hot) heating pad or taking a warm bath can help relax the muscles and ligaments involved. Wearing a maternity support garment, or belly band, is a practical strategy, as it provides external support to the abdomen and reduces strain on the round ligaments. To prevent painful spasms caused by sudden increases in abdominal pressure, lean forward and support the lower abdomen with your hands before coughing, sneezing, or laughing.
Signs That Require Medical Attention
While RLP is a common and harmless part of pregnancy, abdominal pain can sometimes signal a more serious underlying condition, making RLP a diagnosis of exclusion. It is important to contact a healthcare provider immediately if the pain is constant, unrelenting, or severe, and does not resolve after a short rest or change in position.
The pain should not be accompanied by other concerning symptoms, such as fever, chills, or pain or burning during urination, which could indicate an infection. RLP is typically a sharp, fleeting sensation, so any rhythmic pain, like contractions, or persistent cramping needs medical evaluation. Additionally, the presence of vaginal bleeding, spotting, or an unusual discharge alongside the pain requires immediate consultation to rule out complications.