Pelvic Girdle Pain in Pregnancy: A Complete Guide

Pelvic girdle pain, often called PGP, is one of the most common and most misunderstood causes of pregnancy pain in the UK. It affects roughly one in five pregnant women to some degree and can range from a mild ache when you walk to severe pain that makes everyday activities genuinely difficult. The good news is that PGP is well recognised, it is treatable, and with the right help most women can manage their symptoms and have a normal birth. This complete guide explains what pelvic girdle pain is, what causes it, how to recognise the symptoms, and the treatments and self-help measures that really make a difference.

What Pelvic Girdle Pain Is and Why It Happens

Pelvic girdle pain is the name for pain in the front or back of the pelvis that comes on during pregnancy. It used to be called symphysis pubis dysfunction, or SPD, but PGP is now the preferred term because it covers pain in any of the joints of the pelvis. The pain is caused by the joints of the pelvis moving unevenly -- usually because the hormone relaxin has loosened the ligaments more on one side than the other, or because one joint is stiff while another is too mobile.

The growing bump and the change in posture that comes with it put extra strain on already loosened pelvic joints. PGP can start as early as the first trimester or as late as the third, and it is more common in second and subsequent pregnancies, in women who have had PGP before, and in those with a history of lower back or pelvic pain.

Recognising the Symptoms of PGP

Pelvic girdle pain has a characteristic pattern. The most common symptom is pain over the pubic bone at the front of the pelvis, which may feel like a deep ache, a burning sensation or sharp twinges. Many women also feel pain across one or both buttocks, or in the lower back on either side. The pain is typically worse when walking, climbing stairs, standing on one leg (for example when getting dressed), turning over in bed, or moving the legs apart.

Some women describe a clicking or grinding sensation in the pelvis, and others find that their legs feel as if they are going to give way. If you have any of these symptoms, it is worth telling your midwife -- you do not need to wait until the pain is severe. PGP is a clinical diagnosis, which means it is identified from your symptoms and an examination rather than from a scan.

Self-Help Measures That Genuinely Help

There are several practical steps you can take straight away to reduce the strain on your pelvis. Keep your legs together -- when getting in and out of a car, sit on the seat first and then swing both legs in together. When getting dressed, sit down to put on trousers, socks and shoes. Avoid standing on one leg and activities that involve spreading the legs wide, such as breaststroke when swimming or wide squats.

Use a pregnancy support belt, which holds the pelvic joints together and can dramatically reduce pain when walking. Plan your day so you sit down for tasks where possible, and break up longer walks into shorter ones. Sleep on your side with a pillow between your knees to keep the pelvis aligned. Using a frozen or warm pack against the painful area for short spells can also ease the ache.

Treatment and When to Contact Your Midwife

If you think you have PGP, tell your midwife as early as possible. She can refer you to a physiotherapist who specialises in women health, which is available on the NHS in most areas. A physio can assess your pelvic joints, provide a properly fitted support belt, give you tailored exercises to strengthen the muscles that support the pelvis, and in some cases use gentle manual therapy to realign the joints.

With the right treatment, many women find their PGP improves dramatically. Your physio and midwife can also help you plan your labour -- keeping the legs together during birth, using a birth pool, and choosing positions that do not strain the pelvis. PGP is not something you just have to put up with, so if your pain is being dismissed, ask firmly for a physiotherapy referral.

Frequently Asked Questions

What is the difference between PGP and SPD?

PGP (pelvic girdle pain) is the current term and covers pain in any of the pelvic joints. SPD (symphysis pubis dysfunction) refers specifically to pain at the pubic joint at the front. PGP is now the preferred name because it is more accurate.

Does pelvic girdle pain go away after birth?

For most women, PGP eases soon after the birth as the pregnancy hormones leave your body and the pelvic joints return to their normal position. A few women continue to have pain and benefit from further physiotherapy.

Can I still have a normal birth with pelvic girdle pain?

Yes. Most women with PGP can have a normal vaginal birth. Your physio and midwife will help you choose positions that keep your legs together, and a water birth can be particularly helpful.

This information is for general guidance only and is not a substitute for professional medical advice. If you are worried about any symptom in pregnancy, always contact your midwife, GP or NHS 111.