Pelvic girdle pain in pregnancy: what helps, is a belt worth it
What pelvic girdle pain is, how to get physio for it on the NHS, the everyday changes and exercises that help, how to sleep with it, and an honest answer on belts
It started as a click when you turned over in bed. Now it's the stairs, getting out of the car, and standing on one leg to get your leggings on. Someone's told you it's SPD, someone else says PGP, and the next midwife appointment isn't for a fortnight.
Pelvic girdle pain is common, it's real, and it isn't you doing something wrong. About 1 in 5 pregnant women get it. It's also one of the few pregnancy aches with a proper treatment on the NHS, so the most useful bit of this page is the part about getting referred.
Quick answer: PGP is pain from the joints of your pelvis, front or back. About 1 in 5 pregnant women get it. Tell your midwife early and ask for physio: that's the treatment. Until then, knees together in and out of the car and turning in bed, sit down to dress, a pillow between your knees at night, and a belt for the hours you're on your feet.
- About 1 in 5 pregnant women get PGP, and the NHS says it isn't harmful to your baby.
- It's more common later in pregnancy, but it can start in the first trimester, and some people only get it in the last few days before labour.
- The NHS says call your midwife or GP if it's hard to move around, it hurts to get out of a car or turn over in bed, or stairs are painful.
- Physiotherapy is the treatment. Equipment such as crutches or a pelvic support belt comes after that, if you need it.
- It usually improves after the birth. Around 1 in 10 women have ongoing pain, according to the Royal College of Obstetricians and Gynaecologists.
What is pelvic girdle pain, and why now?
Your pelvis is a ring of bone with a joint at the front (the pubic symphysis, just above where your legs meet) and one either side at the back (the sacroiliac joints, at the base of your spine).
In pregnancy the ligaments holding those joints soften and stretch to get you ready for labour. The NHS describes PGP as a collection of symptoms caused by stiffness in those joints, or the joints moving unevenly at the front or the back of the pelvis.
The old name is SPD, symphysis pubis dysfunction. You'll still hear it from your mum and from half the internet. Same thing. PGP is the name the NHS uses now.
It's more common later on, when the bump is heavier, but it can start in the first trimester and some people only get it in the last few days. If you had it in a previous pregnancy, or you've had pelvic or back pain before, you're more likely to get it.
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How do I know if I have PGP?
The NHS list of symptoms reads like a diary of the third trimester:
- pain over the pubic bone at the front, roughly level with your hips
- pain across one or both sides of your lower back
- pain in the perineum, the bit between your vagina and your back passage
- pain spreading to your thighs
- a clicking or grinding feeling in the pelvis
It's worse when you walk, do the stairs, stand on one leg (getting dressed, getting into the bath) or turn over in bed. Walking downstairs holding a toddler's hand is the classic.
"Pelvic pain at 30 weeks" is what a lot of people type into Google. But there's no set week. It arrives when it arrives.
When to call your midwife
The NHS says call your midwife or GP if you have pelvic pain and it's hard to move around, it hurts to get out of a car or turn over in bed, or it's painful going up or down stairs. Don't wait for the next booked appointment. This is the call that gets you the physio referral, and the earlier it goes in, the better.
What actually helps with pelvic girdle pain
Physio, and how to get it
Physiotherapy is the treatment, and on the NHS you can be referred to a service that specialises in pregnancy pelvic joint problems. Ask your midwife or GP.
What the physio can offer, according to the NHS and the Royal College of Obstetricians and Gynaecologists: hands-on treatment for the joints, exercises for your pelvic floor, tummy, back and hips, advice on how to move, and equipment if you need it, such as crutches or a pelvic support belt.
If the first answer you get is "it's normal in pregnancy", ask again. Common isn't the same as nothing to be done.
The everyday changes that do the most
Most of this is the NHS list. The belt line and the shopping tip are ours. None of it is glamorous. All of it adds up.
| The moment it hurts | What to do instead |
|---|---|
| Turning over in bed | Knees together, a pillow between them, roll shoulders and hips as one piece |
| Getting in and out of the car | Sit on the edge of the seat with your knees together and swing both legs round together |
| Getting dressed | Sit down for knickers, leggings, socks and shoes. Standing on one leg is one of the things that sets it off |
| Stairs | One at a time, hold the rail, and cut down how often you go up and down |
| Standing: queues, cooking, the school gate | Equal weight on both feet, supportive flat shoes, and don't stand for long stretches |
| Shopping and lifting | Don't carry heavy bags. Get the shop delivered or split it into small ones |
| Sitting for a long time | Get up and move every so often. Long stretches of sitting stiffen it up |
| The walking hours | A support belt under the bump for those hours, and off again when you sit |
The NHS line is to keep active but avoid what makes the pain worse, and rest when you can. With PGP, that's the rule that matters most. Pushing through it doesn't build anything. It just costs you tomorrow.
Pelvic girdle pain exercises
The ones that matter are the ones your physio gives you, because they'll be set for how your pelvis is moving. Until you've been seen, the NHS pregnancy exercise page has three general ones that work the muscles holding the pelvis together:
- Pelvic floor squeezes. Squeeze and lift the muscles around your back passage and vagina as if you're stopping yourself weeing, then let go. Quick ones first, then slow ones held for a count of up to 10. The NHS suggests three sets of eight a day.
- Pelvic tilts against a wall. Stand with your shoulders and bottom against a wall, knees soft. Pull your belly button towards your spine so your lower back flattens into the wall, hold for four seconds, release. Up to 10.
- Box position tummy strengthener. On all fours with your back flat, pull your tummy in and curve your back up towards the ceiling. Hold a few seconds, come back to flat. Don't let your back dip. Up to 10, slowly.
The full instructions are on the NHS exercise in pregnancy page. Stop anything that hurts.
Exercises to avoid with PGP
Anything that takes your legs wide apart or loads one leg at a time: breaststroke, lunges, deep squats, big strides. Lying flat on your back for exercise is out after 16 weeks anyway, on NHS advice. Long brisk walks tend to stir it up too. Short walks on the flat are fine if they don't hurt.
A birthing ball is a gentle way to keep the pelvis moving without loading it: sit with your hips above your knees and do slow circles. If you've got one, the easy pregnancy ball exercises post has the rest. Stop if anything clicks or hurts.
Is a pelvic support belt worth it for PGP?
For the walking about hours, usually yes. For fixing it, no.
A pelvic support belt goes under the bump and lifts it, so less of the weight is dragging on the joints that hurt. That's why the NHS lists pelvic support belts among the equipment a physio may suggest, and why our belt reviews talk about pelvic pain more than anything except back pain.
One reviewer wrote: "It has helped on busy days later in pregnancy. It has made longer periods on my feet much more manageable."
The limits, so you're not disappointed. It doesn't stabilise the joints the way physio does. It's for two or three hours at a time, on your feet, then off. It shouldn't go anywhere near your bed. And if it makes the pain worse, it's sitting too high, it's too tight, or PGP isn't what you've got. Take it off and tell your physio.
The pregnancy support belt post covers how to put one on, when to start and what size to order.
BABYGO® Pregnancy Support Belt
Under the bump, for the hours you're on your feet with PGP. Three pieces, velcro guaranteed for a year. Sizes S to XXL by your pre-pregnancy dress size.
£30
How to sleep with PGP
Night is when PGP is at its most annoying, because every turn is a manoeuvre.
Start with the NHS side-sleeping advice. From 28 weeks, go to sleep on your side, left or right: the NHS says research suggests falling asleep on your back after 28 weeks doubles the risk of stillbirth, and that if you wake up on your back you should just turn over, not panic. The same NHS page suggests pillows to support the bump and one between your knees.
For PGP the one between the knees is the important one. Lying on your side, your top leg drops forward and twists the pelvis. A pillow between the knees keeps your hips stacked, and squeezing it as you turn keeps your knees together so the pelvis moves as one piece.
A long pregnancy pillow does the bump, the back and the knees in one go and doesn't slide off in the night. One reviewer wrote: "It supports my bump and hips without taking over the whole bed."
Getting up: roll onto your side first, push up with your arms, swing both legs down together.
BABYGO® Moon Pregnancy Pillow
Bump, lower back and knees supported at once, so your top leg stops dropping forward. One size, with a washable bamboo and cotton cover. It carries on as a feeding pillow after the birth.
£49
PGP in labour and after the birth
Most women with PGP can have a normal vaginal birth, and a caesarean won't normally be needed for PGP on its own. That's the RCOG line.
Tell the midwife looking after you in labour that you have it: they'll keep your legs supported and help you change position. A birthing pool can help because the water takes the weight off the joints. Put it in your birth plan so nobody has to ask.
After the birth it usually improves. RCOG says around 1 in 10 women have ongoing pain, so if you're still sore at your postnatal check, say so and ask to carry on with physio. Lifting a car seat, a buggy and a baby all day is a lot to ask of a pelvis that's still settling.
Questions we get asked
Is PGP the same as SPD?
Yes. SPD (symphysis pubis dysfunction) is the older name. The NHS calls it pelvic girdle pain now.
Can pelvic girdle pain start at 12 weeks?
It can. It's more common later in pregnancy, but some people get it in the first trimester. The advice is the same whenever it starts: tell your midwife and ask for physio.
Will pelvic girdle pain go away after the birth?
Usually, yes. Around 1 in 10 women have ongoing pain, according to RCOG, so keep up the exercises, and if it lingers, say so at your postnatal check and ask for physio again.
Does pelvic girdle pain mean I'll need a c-section?
No. Most women with PGP have a normal vaginal birth, and a caesarean isn't normally needed for PGP alone. Tell the labour team you have it so they can support your legs and help you change position.
Can I still exercise with PGP?
Yes, within what doesn't hurt. Walking on the flat, the NHS pelvic floor and pelvic tilt exercises, and gentle circles on a birthing ball. Skip breaststroke, lunges, wide-leg stretches and anything on one leg.
Does a pregnancy pillow help with pelvic girdle pain?
At night, yes. A pillow between your knees keeps the pelvis level when you're on your side, and squeezing it as you turn keeps your knees together. A full-length pillow supports the bump and back at the same time.
If it's the daytime hours you need help with, the bump support collection has the belt, and the size guide takes a minute before you order.
Filed under Pregnancy
