Sleeping with pelvic girdle pain in pregnancy

What it is

Pelvic girdle pain — also called SPD — is pain in the pubic bone, groin, lower back, hips or the joints at the back of the pelvis, caused by the pelvic joints moving unevenly under the effects of pregnancy hormones and increasing weight.

It affects a large minority of pregnancies and can start at any stage. It is not dangerous to the baby.

Typical signs: pain on walking, climbing stairs, standing on one leg, getting in and out of a car, and — the worst one — turning over in bed. Some women describe a clicking or grinding.

It usually improves after the birth, and it should not simply be endured until then. Physiotherapy genuinely works and is the main treatment.

Being told it is normal and to put up with it is the standard experience and it is poor advice.

Nights

The pillow between the knees is the essential one — a firm pillow, thick enough to keep the knees roughly hip-width apart so the pelvis is not twisted.

Add a pillow under the bump and one behind the back. Full-length support on both sides stops the pelvis rotating during the night.

Keep the knees together when turning over. Move as one block — this is the single most useful technique and it makes the worst moment of the night manageable. Some women find turning easier with a silk or satin sheet, which reduces friction.

Getting in and out of bed: sit on the edge, keep the knees together, and swing both legs at once while lowering the upper body.

A softer surface or a mattress topper reduces hip pain from side-lying.

And keep the legs supported when sitting up in bed, rather than letting them fall apart.

Days, and treatment

Ask for a referral to a physiotherapist, ideally one with obstetric experience. This is the actual treatment: exercises for the deep abdominal and pelvic floor muscles, advice on movement, and sometimes a support belt.

A pelvic support belt helps many women and needs fitting properly to be useful.

Avoid: standing on one leg to dress, carrying a toddler on one hip, crossing legs, wide steps, breaststroke swimming, vacuuming, and squatting deeply. Sit down to dress.

Take stairs one at a time, leading with the less painful leg.

Keep moving within the limits of pain — complete rest makes it worse — and stop before pain rather than pushing through it.

Paracetamol is generally considered safe in pregnancy and your doctor can advise on dose. Avoid ibuprofen and other anti-inflammatories in pregnancy unless specifically prescribed.

Tell whoever will be at your birth. Severe pelvic girdle pain affects positions in labour, and there is a safe range of hip abduction that should be respected — worth writing into a birth plan.

When to see a doctor

Ask for a physiotherapy referral rather than accepting that it is just part of pregnancy.

See a doctor urgently for: severe pain that came on suddenly, pain with fever, pain with bleeding, or pain that is rhythmic and coming in waves before 37 weeks — which may be labour.

Also urgently for: numbness in the groin or inner thighs, difficulty passing urine or loss of bladder or bowel control, or weakness in a leg. These need same-day assessment.

And for calf pain, swelling, redness or breathlessness, which need urgent assessment for a clot.

This article is general information, not medical advice, and has not been reviewed by a clinician.

This article is general information, not medical advice, and is no substitute for personal medical advice. For any decision about your or your child's health, please consult your doctor.

Frequently asked questions

Q: Will it harm the baby? — No. It is a musculoskeletal problem and it does not affect the baby.

Q: Will it go away after the birth? — For most women it improves substantially within weeks. Physiotherapy afterwards helps where it does not.

Q: Can I still exercise? — Yes, within pain limits. A physiotherapist can advise what suits you; avoid anything that separates the legs widely.

Q: Do I need a caesarean? — Usually not. Most women with pelvic girdle pain have a vaginal birth, with attention to positions that do not force the legs apart.