Pelvic pain in pregnancy

Gjestland, 2013Kovacs, 2012Owe, 2016Shiri, 2018Vleeming, 2008

Pelvic pain experienced in the area of the sacroiliac joints and the pubic symphysis is reported by 10 to 65% of people during pregnancy, especially in people with high concentrations of relaxin. This pain may occur early in pregnancy. Investigations for pelvic pain in pregnancy are not usually required.

Prepregnancy exercises do not reduce the incidence of pelvic pain during pregnancy. However, appropriately graded strengthening and stabilising exercises, such as the use of a fit ball or water-based exercise, can reduce the severity of pelvic pain during pregnancy and should be encouragedDavenport, 2019. Sacroiliac joint compression via belts or compression garments may be prescribed by physiotherapists to reduce pain.

If exercise is insufficient to control pelvic pain in pregnancy, use:

Changes in pubic symphysis width probably occur in most pregnant people, with a gap of up to 1 cm being considered normal. Rupture of the pubic symphysis (diastasis) can occur; especially in association with rapid labour, cephalopelvic disproportion, pre-existing pelvic abnormality or excessive thigh abduction that can occur during delivery under epidural anaesthesia. The reported incidence of this condition is lessening as the number of forceps deliveries decreases. Pubic diastasis can be associated with severe suprapubic pain and may take months to several years to resolve.