Pelvic bone pain during pregnancy is most often caused by a condition called pelvic girdle pain (PGP), which affects roughly 1 in 5 pregnant women at any given point during pregnancy and up to 28% at some point before delivery. The pain stems from hormonal changes that loosen the joints and ligaments holding your pelvis together, making the area less stable and more prone to discomfort. It can range from mild achiness to sharp, shooting pain, and while it’s not dangerous, it can make everyday activities surprisingly difficult.
What Causes the Pain
During pregnancy, your body produces a hormone called relaxin. Its job is to loosen the muscles, joints, and ligaments around your pelvis so your body can eventually accommodate delivery. The trade-off is that this loosening can make your pelvic joints feel unstable and painful, especially at the front where the two halves of your pelvis meet (a joint called the symphysis pubis) and at the back near your sacroiliac joints.
Most people don’t notice the effects of relaxin at all. But when the loosening is uneven or excessive, the pelvic joints start to move in ways they normally wouldn’t, creating friction and inflammation. The muscles around your pelvis then have to work harder to compensate for the lost stability, which can lead to fatigue and spasm on top of the joint pain itself. As your baby grows and your center of gravity shifts, the load on these already-stressed joints increases further.
What It Feels Like
PGP doesn’t always present the same way. Some women feel a mild, dull ache across the front of the pelvis at hip level. Others experience sudden shooting pain from the front or back of the pelvis, or a steady pain that radiates into the lower abdomen, groin, inner thighs, or perineum. Tingling, burning, stabbing, or throbbing sensations are all common variations.
One distinctive feature is a sensation that your pelvis feels loose or wobbly, almost like the bones aren’t quite holding together. Some women hear or feel a clicking or grinding sound coming from the pelvis when they walk, roll over in bed, or stand on one leg. Pain typically flares with activities that load one side of the pelvis at a time: climbing stairs, getting in and out of a car, rolling over at night, or standing on one foot while dressing.
Who Is More Likely to Get It
Certain factors raise your chances of developing pelvic pain during pregnancy. A history of pelvic or lower back pain (whether from a previous pregnancy or not) is one of the strongest predictors, as is a history of trauma to the back or pelvis. Having had multiple pregnancies, a higher BMI, physically demanding work, emotional distress, and smoking also increase risk.
Interestingly, your age, height, weight alone (as distinct from BMI), use of hormonal contraceptives before pregnancy, and the time gap since your last pregnancy do not appear to affect your risk.
Exercises That Help
Gentle strengthening and stretching exercises can both manage existing pain and help prevent it from worsening. The key principle is that none of these should hurt. Hold each stretch for 5 to 10 seconds and repeat 4 to 5 times. If something feels uncomfortable, go more gently, don’t stretch as far, and don’t hold as long.
Pelvic tilts are a good starting point. Sit on a chair or birthing ball and alternate between sitting as tall as you can (emphasizing the curve in your lower back) and slouching back onto your tailbone. Pelvic circles, where you sit on a birthing ball and circle it beneath you in one direction and then the other, help keep the joints mobile without loading them heavily.
The cat-cow stretch is useful for the whole pelvic-spinal chain. On all fours, round your shoulders and push the middle of your back toward the ceiling, then slowly lift your head and arch your back the opposite way. Child’s pose, where you kneel and stretch your hands forward while keeping your bottom on your heels (widening your knees to make space for your bump), stretches the lower back and hips. Adding a side reach in child’s pose targets each side individually.
A lower tummy exercise also builds core stability to support the pelvis. Place your hands on your lower belly below the belly button, breathe in normally, then breathe out while gently pulling your tummy muscles in and away from your hands. Hold for 10 seconds while continuing to breathe. This trains the deep abdominal muscles that act as a natural pelvic brace.
Sleep and Daily Movement Tips
Nighttime is often the worst for pelvic pain because rolling over loads the joints unevenly. Sleeping on your side with a pillow between your knees keeps the pelvis aligned. As your pregnancy progresses, placing an extra pillow or rolled-up towel under your bump reduces strain on the hips and lower back. If your hips ache at night despite good pillow positioning, your mattress may be too firm. Lying on a single duvet folded in half, or adding a mattress topper, can soften the pressure points.
How you move in bed matters as much as how you lie in it. When turning over, bend your knees up, tighten your tummy muscles, and keep your knees together. Turn your shoulder and hip as a single unit rather than twisting. To get out of bed, roll onto your side, drop your legs over the edge, and push yourself up with your elbow and hands. Reverse the sequence to get back in. These small changes reduce the shearing force across the pubic joint that causes those sharp, catching pains.
During the day, try to avoid activities that load one leg at a time. Take stairs one step at a time, sit down to get dressed, and keep your knees together when getting in and out of a car (swivel on your seat rather than stepping one leg out first).
How It Affects Labor and Delivery
PGP does not mean you need a cesarean section. According to the Royal College of Obstetricians and Gynaecologists, there is no evidence that a C-section helps women with PGP, and it may actually slow recovery. The important thing is to make sure your birth team knows about your pelvic pain beforehand. They’ll support your legs during labor, help you change positions, and avoid pushing your legs apart beyond a comfortable range.
Many women with PGP find that a birthing pool helps significantly during labor, since the water takes weight off the joints and makes it easier to move freely. Upright or side-lying positions tend to be more comfortable than lying flat on your back.
Recovery After Birth
For most women, pelvic pain improves significantly within the first few months after delivery as relaxin levels drop and the joints tighten back up. Research from the University of Utah found that many first-time mothers saw pelvic floor symptoms improve substantially within a year of vaginal delivery. However, some women continue to experience symptoms for longer, and if you’re still dealing with bothersome pain three to six months after giving birth, working with a pelvic floor specialist can help identify whether the joints haven’t fully restabilized or whether surrounding muscles need targeted rehabilitation.