Pelvic girdle pain is common but it is not something you just have to put up with.

Ask your midwife for a referral to a physiotherapist as early as possible. The sooner it is treated, the better it can be managed. Read more about our approach.

Pelvic girdle pain in pregnancy: symptoms, self-help and treatment

What is pelvic girdle pain?

Pelvic girdle pain (PGP) is an umbrella term for pain in and around the joints of the pelvis during pregnancy. It was previously called symphysis pubis dysfunction (SPD), but the newer term PGP better reflects how widespread the pain can be.

PGP is common. Around 1 in 5 pregnant women experience it to some degree. It is not harmful to your baby. With the right support, most people manage it well, and it usually resolves after birth.

Symptoms

Pain at the front of the pelvis, over the pubic bone
Pain across one or both sides of the lower back
Pain in the hips, groin or inner thighs
Pain that shoots down the legs
A clicking or grinding sensation in the pelvis
Pain made worse by walking, climbing stairs, turning in bed, standing on one leg, or getting in and out of a car

Causes

Pregnancy hormones (particularly relaxin) cause the ligaments through your body to soften and stretch, preparing for birth. This increases the mobility of your pelvic joints, which can lead to uneven movement and pain. Newer research suggests the primary driver is an increase in nervous system sensitivity in the pelvis, rather than true instability.

Things that make PGP more likely

Previous PGP in an earlier pregnancy
A previous pelvic or back injury
Higher BMI before pregnancy
A history of lower back pain
Hypermobility conditions

Self-help tips

DO

Keep movements symmetrical, stepping up stairs one leg at a time
Sleep on your side with a pillow between your knees
Sit down to get dressed rather than standing on one leg
Use a small step stool when getting in and out of the car
Sit on a firm chair with your hips slightly higher than your knees
Apply a warm heat pad to the painful area
Wear flat, supportive footwear
Break up long periods of standing or sitting with short rests
Use a supermarket trolley for support when shopping
Carry shopping in two equal bags rather than one

AVOID

Standing on one leg (get dressed sitting down)
Sitting on the floor cross-legged
Pushing heavy laden trolleys one-handed
Carrying a toddler on one hip
Twisting at the waist when lifting
Long walks or extended standing without rest
High-impact exercise while symptomatic
Sitting in very low or very soft chairs

Gentle exercises to try

These exercises are suitable for most people with PGP, but if any exercise increases your pain, stop and seek advice from your physiotherapist.

Pelvic floor with gentle activation

Sit upright on a firm surface.
Gently draw up your pelvic floor as if stopping urine flow.
At the same time, draw your lower tummy muscles gently inwards.
Hold for 5 breaths, then release fully.
Repeat 8 to 10 times, 3 times a day.

Clam (side-lying hip strengthening)

Lie on your side with hips and knees bent to 45 degrees.
Keep your feet together and rotate the top knee upwards like a clamshell.
Only go as far as you can without your pelvis rolling back.
Hold 2 seconds, then lower slowly.
Repeat 10 times each side, once a day.

Sitting pelvic tilt (find neutral)

Sit upright on a firm chair with hands on your knees.
Gently arch your lower back (tilt pelvis forward), then flatten it.
Find the comfortable midpoint, which is your neutral pelvis.
Practise holding neutral during daily sitting and work.

Seated leg press (isometric squeeze)

Sit in a chair with a firm pillow or rolled towel between your knees.
Gently squeeze the pillow with your knees for 5 seconds, then release.
Repeat 10 times.
Activates inner thigh and pelvic floor muscles to support the joints.

Physiotherapy: the single most useful step

Ask your midwife or GP for a referral to an obstetric or pelvic health physiotherapist as soon as symptoms develop. You do not need to wait to see if it gets worse.

What physiotherapy offers

An individual assessment of which joints and muscles are affected
A tailored exercise programme
Advice on posture, movement and activity modification
Consideration of a pelvic support belt if appropriate
Guidance on birth positioning

Self-referral. Many NHS trusts now allow direct self-referral to pelvic health physiotherapy. Check your local trust website. The Pelvic, Obstetric and Gynaecological Physiotherapy group (POGP) maintains a directory of specialist physiotherapists across the UK, both NHS and private.

Pelvic support belts

A pelvic support belt (sometimes called a maternity support belt) can reduce pain for some people, particularly during activity. It is worn around the pelvis below the bump.

Belts are widely available from pharmacies and online. Ask your physiotherapist which type is most suitable for you before buying, as there are several styles with slightly different effects.

Planning your birth with PGP

Most people with PGP can have a vaginal birth. Tell your midwife and every birth team member about your PGP, and write it prominently in your birth plan.

Key considerations

Avoid putting your feet up on the midwife's hips or bed rails while pushing, which forces the legs far apart and can strain pelvic joints.
Positions that work well: kneeling, all fours and side-lying.
Avoid the lithotomy position (lying on back, legs in stirrups) unless clinically necessary.
If you need an epidural, tell the anaesthetist about your PGP so leg positioning can be managed carefully.
Ask for a note in your birth plan that the team should check your maximum comfortable hip abduction before any procedure.

After birth

PGP usually resolves within a few weeks of birth for most people. For some it can linger. If you are not feeling better by 6 to 8 weeks postnatally, ask your GP or health visitor to review and re-refer you to physiotherapy.

A small minority (around 7%) have ongoing symptoms needing longer physiotherapy input. Return to activity gradually, guided by symptoms, and wait until pain has fully resolved before high-impact exercise and heavy lifting.

Safe exercise during pregnancy→ Plan your birth with PGP in mind→ Other common pregnancy symptoms→ Your antenatal appointments→

A note from our team

This guide reflects NHS UK and Pelvic, Obstetric and Gynaecological Physiotherapy (POGP) guidance. A one-to-one assessment with a physiotherapist is always the best first step if you are in pain. Read more about us.

Frequently asked questions

What is the difference between PGP and SPD?

PGP (pelvic girdle pain) is the current umbrella term for pain in and around the pelvic joints in pregnancy. SPD (symphysis pubis dysfunction) was an older term referring to pain specifically at the pubic joint at the front. SPD is one type of PGP. Clinicians now use PGP because the pain is often wider than just the pubic bone.

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

Yes. Most people with PGP have a vaginal birth. Tell your midwife and write it prominently in your birth plan. Positions that usually work well are kneeling, all fours and side-lying. Avoid the lithotomy position (lying on your back with legs in stirrups) unless clinically necessary, and do not push your feet into the midwife's hips or the bed rails, as that forces the legs apart.

Is pelvic girdle pain harmful to my baby?

No. PGP is painful and frustrating for you, but it does not harm your baby in any way. It is a musculoskeletal condition of your pelvis, not a pregnancy complication.

When should I ask for a physiotherapy referral?

As soon as symptoms develop. Do not wait to see if it gets worse. Ask your midwife or GP for a referral to an obstetric or pelvic health physiotherapist. In many NHS trusts you can self-refer directly. The POGP website (thepogp.co.uk) lists qualified obstetric physiotherapists across the UK.

Will PGP come back in future pregnancies?

Yes, it often does, and can start earlier in subsequent pregnancies. The good news is you will know what to do. Ask for a physiotherapy referral early and resume the exercises and self-help strategies that helped last time.

What exercises should I avoid with PGP?

Avoid anything that involves wide-legged movements: breaststroke leg kick, deep squats, lunges, star jumps and high-impact activities like running. Swimming in general is good, but use a gentle front or back crawl rather than breaststroke. Cycling is usually fine on a static bike with a raised handlebar position.