Pregnancy changes how your body moves and supports your weight. For some people, these changes can lead to pain where the two sides of the pelvis meet at the front of the body. This is called symphysis pubis dysfunction (SPD).
SPD can cause pain in the pubic area, groin, hips or lower back. The pain may be worse when you’re walking, climbing stairs, getting in and out of a car or turning over in bed.
At Banner Health, our maternity care team can evaluate your pelvic pain and connect you with physical therapy or other support to help you move more comfortably during your pregnancy and after your delivery.
The pubic symphysis is the joint at the front of the pelvis where the left and right pelvic bones meet.
During pregnancy, hormonal changes, posture, weight and movement can put more stress on the joints and muscles that support the pelvis. When your pelvic joints do not move comfortably or evenly, you may experience pain around the pubic symphysis and other parts of your pelvic area.
Pain can range from mild to severe and may continue after delivery. Symptoms can make it hard to walk, sleep and do everyday activities. Treatment can help reduce pain so you can function better.
You may also hear SPD called:
SPD pain usually affects the front of the pelvis but may also spread to nearby areas.
Symptoms may include:
SPD can begin at different stages of pregnancy. Some people notice symptoms earlier, while others develop pain as pregnancy progresses.
Symptoms may:
SPD can be painful but pelvic pain does not automatically mean there is a problem with the baby or the pregnancy.
You should contact your maternity care team about new, severe or unusual pelvic pain because other pregnancy conditions can also cause pain.
There is usually not one single cause of SPD. These pregnancy-related changes may play a role:
Anyone can develop pregnancy-related pelvic pain. You may be at higher risk if you:
Pain during pregnancy can come from muscles, joints, nerves and internal organs. The location and pattern of your pain can help your provider understand what might be causing it.
Round ligament pain more often causes brief, sharp pain in the lower abdomen or groin, especially when you move suddenly.
Sciatica is nerve pain that often travels from the lower back or buttock down the leg. It may also cause numbness or tingling.
It’s common to feel general soreness and pressure during pregnancy. Get checked if you have pain that limits your walking, sleep, stair climbing or daily activity.
SPD is a musculoskeletal condition. It does not cause labor contractions, vaginal bleeding or leaking fluid. Contact your maternity care team if you have pelvic pain along with symptoms that could be signs of labor or another pregnancy concern.
There is no single test that diagnoses SPD.
Your maternity care provider or physical therapist may ask:
The evaluation may also include:
Most people don’t need imaging but your provider may consider it if your symptoms are severe, unusual or do not fit the expected pattern.
Treatment focuses on reducing pain, improving movement and helping you stay as active and comfortable as possible.
Pelvic health physical therapy may help by:
Small changes may reduce stress on the pelvis. Your care team may recommend:
A pelvic support belt or brace may help support your pelvis when you move. It should fit correctly. It’s best to use one with guidance from a maternity care provider or physical therapist.
Talk with your maternity care provider before taking medication for pain during pregnancy.
Your care team can explain which options may be safe based on your stage of pregnancy, health history and other medications.
Complete rest is usually not the goal. Your care team may recommend that you reduce movements that trigger pain while staying active within comfortable limits.
Many people with SPD can stay active but you may need to make these adjustments to your exercise:
Exercise needs vary. What feels comfortable for one person may not work for another.
SPD may add pain to delivery but it doesn’t mean the delivery will be more difficult. SPD does not automatically mean you need a cesarean birth. Many people with SPD can still have a vaginal delivery.
Your maternity care team can help you find positions that are comfortable and don’t place too much stress on the pelvis.
Before labor:
Get urgent care or contact your maternity care team right away if pelvic pain happens with:
SPD often gets better after pregnancy but recovery can take time. You may still have:
Talk to your provider if your symptoms:
It’s important to get care for ongoing SPD. Over time, untreated SPD may contribute to pelvic issues like urinary incontinence, pelvic organ prolapse, chronic pelvic pain, abdominal muscle separation and low back or hip pain.
At Banner Health, we offer maternity care throughout pregnancy and after delivery. Our teams can help evaluate pelvic pain, rule out other concerns and connect you with the support you need.
Find a maternity care provider or maternity care location.
Symphysis pubis dysfunction (SPD) is pregnancy-related pelvic pain that affects the joint at the front of the pelvis and nearby muscles and joints. It may cause pain in the pubic area, groin, hips or lower back.
SPD may cause aching, sharp, stabbing or pulling pain. Pain may worsen when walking, climbing stairs, standing on one leg, turning over in bed or getting in and out of a car.
These movements can place uneven pressure on the pelvis. When the pelvic joints and supporting muscles are irritated or not moving comfortably together, actions that shift weight from one side to the other may trigger pain.
SPD does not automatically mean you need a cesarean birth. Many people can have a vaginal delivery. Tell your maternity care team about your symptoms so they can help you choose positions that are comfortable for your pelvis.
Many people improve after delivery but symptoms may continue for weeks or longer. Pelvic health physical therapy and other treatments may help if pain continues postpartum.
Talk to your maternity care provider if pelvic pain is severe, getting worse or affecting walking, sleep, climbing stairs or daily activities. Get urgent care for pain with bleeding, leaking fluid, contractions, fever or other concerning symptoms.
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