Pelvic Girdle Pain
Pelvic girdle pain (PGP) is a collection of conditions causing pain in the pelvic joints — including symphysis pubis dysfunction (SPD). It affects up to 20% of pregnant women and can range from mild discomfort to severe disability.
What "Moderate" Means Here
A "moderate" rating means this symptom is common but is more likely to benefit from your provider’s input — either to confirm it’s within the normal range for you, to rule out an underlying cause, or to get a treatment recommendation beyond basic home remedies. It doesn’t necessarily mean something is wrong; many moderate symptoms are simply worth mentioning at your next appointment so your provider has full visibility into how your pregnancy is progressing. If it escalates in intensity or frequency, that’s a good reason to reach out sooner rather than waiting for your next scheduled visit. Providers generally appreciate patients flagging moderate symptoms proactively rather than waiting to see if they resolve, since the same symptom can mean different things depending on your individual health history, prior pregnancies, and how far along you are.
Timing During Pregnancy
This symptom is most often reported later in pregnancy. Third-trimester symptoms are frequently related to the growing uterus placing more pressure on nearby organs, joints, or blood vessels, or to the body preparing for labor. Because late-pregnancy symptoms can occasionally overlap with signs of labor or other conditions specific to the third trimester, it’s worth reviewing the "when to call your doctor" guidance below a bit more closely as your due date approaches. Many providers also schedule more frequent visits in the third trimester specifically so that new or worsening symptoms can be caught and addressed quickly.
Common Causes
- Relaxin hormone loosens pelvic ligaments more than necessary, causing instability
- Asymmetrical movement or loading of the sacroiliac and pubic symphysis joints
- Pelvic floor muscle weakness or imbalance
- Previous pelvic injury or trauma
- Prior pregnancy with PGP increases risk of recurrence
Remedies That May Help
Pelvic Physiotherapy
A pelvic floor physiotherapist is the most effective treatment provider — manual therapy, exercises, and joint-specific techniques provide significant relief.
Pelvic Support Belt (SI Belt)
A sacroiliac belt worn around the hips (not the belly) compresses and stabilizes the pelvic joints.
Move Symmetrically
Keep knees together when turning over in bed, getting in and out of cars, and getting dressed. Avoid asymmetrical movements that load one side of the pelvis.
Avoid Aggravating Activities
Avoid stairs where possible, avoid breaststroke swimming, avoid heavy lifting, and minimize prolonged walking or standing.
Crutches (Severe Cases)
In severe cases, crutches can reduce pelvic loading. Discuss with your physiotherapist.
When to Call Your Doctor
- PGP is so severe you cannot walk or bear weight
- You hear or feel a clicking or grinding at the front of your pelvis (pubic symphysis)
- Pain extends into the thighs or is accompanied by leg weakness
- Pain after delivery is not improving within 6–8 weeks postpartum
Warning Signs That Always Warrant Immediate Care
Regardless of the specific symptom you’re looking up, general ACOG and CDC guidance is to seek immediate medical attention — call your provider’s urgent line, go to labor and delivery, or go to the ER — if you experience any of the following:
- Vaginal bleeding that is heavy, bright red, or accompanied by pain
- Severe or persistent abdominal or pelvic pain
- A severe headache that doesn’t improve with rest, water, or over-the-counter pain relief
- Sudden swelling of the face, hands, or feet, especially paired with a headache or vision changes
- Vision changes such as blurring, seeing spots, or temporary vision loss
- A noticeable decrease in your baby’s movement compared to their usual pattern
- Fever of 100.4°F (38°C) or higher
- Fluid leaking or gushing from the vagina
- Regular, painful contractions before 37 weeks
- Difficulty breathing, chest pain, or a rapid heartbeat
- Persistent vomiting that keeps you from keeping down fluids
- Severe itching, especially on the palms and soles, which can sometimes indicate a liver-related condition
This list reflects general warning signs recognized across pregnancy, not just for this specific symptom — when in doubt, it’s always appropriate to call your provider and describe what you’re experiencing rather than waiting to see if it resolves.
General Tips for Managing Pregnancy Symptoms
Alongside any symptom-specific remedies above, a handful of general habits tend to help with a wide range of pregnancy symptoms and are worth keeping in mind throughout your pregnancy:
- Stay consistently hydrated — many pregnancy symptoms, from headaches to fatigue to constipation, are worsened by even mild dehydration.
- Keep taking your prenatal vitamin as directed, since nutrient gaps (particularly iron, calcium, and vitamin D) can compound certain symptoms.
- Prioritize rest and sleep where you can, including resting on your side in later pregnancy, which supports circulation to the uterus.
- Stay gently active if your provider has cleared you for exercise — light movement like walking or prenatal yoga can ease many common complaints.
- Eat smaller, more frequent meals rather than three large ones, which can help with digestive symptoms and blood sugar swings.
- Keep a running list of questions between appointments so nothing gets forgotten when you do see your provider.
None of these general habits replace medical evaluation for a specific concerning symptom, but they’re a reasonable baseline to maintain throughout pregnancy regardless of what you’re experiencing.
Frequently Asked Questions
What is the difference between PGP and SPD?
Pelvic girdle pain (PGP) is an umbrella term for pain involving any pelvic joint (sacroiliac joints, pubic symphysis). SPD (symphysis pubis dysfunction) is pain specifically at the pubic symphysis — the joint at the front of the pelvis.
Will PGP affect my birth options?
Most women with PGP can have a vaginal birth. Your physiotherapist and midwife/OB will work with you on positions that minimize pelvic strain during labor. Having an epidural is generally safe.
Does pelvic girdle pain mean something is wrong with my baby?
No — PGP is entirely a maternal condition affecting the pelvic joints. It has no effect on the baby.
Can PGP be prevented?
There is no guaranteed prevention, but maintaining pelvic floor strength before pregnancy and avoiding asymmetrical movements reduces risk and severity.
Does PGP resolve after birth?
Most women experience significant improvement or resolution within weeks to months after delivery. Postpartum physiotherapy accelerates recovery.
How do I know if a pregnancy symptom needs medical attention?
As a general rule, contact your provider if a symptom is severe, sudden, rapidly worsening, or paired with other concerning symptoms like fever, vision changes, or reduced fetal movement — even if it doesn’t appear on a specific warning-signs list. You know your body best, and providers consistently say they’d rather field a call about something that turns out to be normal than have a patient wait through something that wasn’t.
Should I track this symptom before my next appointment?
It’s a good habit to jot down when a symptom started, how often it occurs, roughly how intense it feels, and anything that seems to make it better or worse. This kind of record is genuinely useful to your provider — it turns a vague "I’ve been having some discomfort" into something they can actually assess for patterns, and it can help you notice on your own whether a symptom is improving, staying steady, or getting worse over time.
Is it normal for pregnancy symptoms to come and go?
Yes — many pregnancy symptoms fluctuate day to day or even hour to hour, influenced by things like hydration, activity level, meal timing, and simple positional changes. Fluctuation on its own usually isn’t a red flag. What’s more worth flagging to your provider is a symptom that is steadily trending worse over days or weeks, or one that suddenly becomes much more intense than your usual pattern.