There are plenty of things nobody warns you about before you get hapū. Pelvic girdle pain is one of them. For some people it starts as a dull ache in the lower back or hips. For others it’s a sharp, catching pain that makes walking upstairs or rolling over in bed feel like a serious undertaking. Either way, it’s more common than most people realise, and more treatable than most people know.
Here’s what you need to know about pelvic girdle pain in pregnancy, including what causes it, what helps, and where to find support in Aotearoa.
What Is Pelvic Girdle Pain?
Pelvic girdle pain (PGP) is a term used to describe pain in the joints of the pelvis during pregnancy. You might also hear it called SPD, which stands for symphysis pubis dysfunction. SPD is an older name for the same condition, and the two terms are used interchangeably by many health professionals, midwives, and māmā themselves. Both are completely valid ways to describe what you’re experiencing.
The pelvic girdle is the ring of bones at the base of your spine. It’s made up of three joints that normally work together as a stable unit: the symphysis pubis at the front, and the two sacroiliac joints at the back. PGP happens when those joints start moving unevenly or become less stable, which can cause pain anywhere in the pelvis, hips, groin, inner thighs, or lower back.
Importantly, PGP does not harm your baby. It can, however, significantly affect your day-to-day life, and that’s reason enough to take it seriously and get support.
How Common Is It?
PGP affects up to one in five pregnant women. That’s a lot of māmā quietly limping through the supermarket, wincing when they get in and out of the car, and wondering if this is just something they have to put up with.
It isn’t. PGP is common, but it’s not something you simply have to accept. Early assessment and the right support can make a real difference to how manageable it feels throughout your pregnancy.
What Causes It?
During pregnancy, your body produces a hormone called relaxin. Its job is to loosen the ligaments in your pelvis to help prepare your body for birth. That’s completely normal and necessary. The issue is that when ligaments become more relaxed, the pelvic joints can lose some of their usual stability, which can lead to uneven movement and pain.
It’s not just hormones though. Muscle weakness around the pelvis, postural changes as your bump grows, and the shifting of your centre of gravity can all contribute to how your pelvis copes with the extra load.
Who Is More Likely to Experience PGP?
Anyone can develop pelvic girdle pain, but you may be at a higher risk if you:
- Had PGP or lower back pain in a previous pregnancy
- Have a history of lower back or pelvic pain outside of pregnancy
- Have hypermobility or a history of joint instability
- Have had a previous injury or trauma to the pelvis
- Have weaker core or pelvic floor muscles at the start of pregnancy
PGP can start at any point during pregnancy, though it becomes more common as the bump grows and the load on the pelvis increases.
What Does PGP Feel Like?
The symptoms vary quite a bit from person to person. Some people experience mild discomfort that comes and goes; for others, it can be quite limiting. Common signs include:
- Pain deep in the pubic area, lower back, hips, groin, or inner thighs
- Pain that gets worse when walking, particularly on uneven ground
- Pain when climbing stairs or stepping over things
- Difficulty turning over in bed or getting up from a seated position
- Pain when getting in and out of the car
- A clicking, grinding, or popping sensation in the pelvis
- Pain when standing on one leg, for example when getting dressed
If any of these sound familiar, it’s worth mentioning it to your LMC or midwife at your next appointment. The sooner PGP is identified and assessed, the better it can usually be managed.
How Is PGP Treated?
The most effective starting point for most people is a referral to a pelvic health physiotherapist. Physiotherapists with training in women’s health can assess how your pelvis is moving, identify any muscle imbalances or joint issues, and put together a plan that actually fits where you’re at in your pregnancy.
Treatment is safe at any stage of pregnancy and may include a combination of:
Targeted Exercise
Strengthening the muscles that support the pelvis, particularly the glutes, hip muscles, and pelvic floor, can help improve stability and reduce pain. A physio will be able to prescribe exercises that are safe and appropriate for your stage of pregnancy, and adjust them as your bump changes.
Manual Therapy
Hands-on treatment such as soft tissue release, joint mobilisation, or muscle energy techniques can help address asymmetries in the pelvis and ease muscle tension around the hips and lower back.
Pelvic Support Belts
A pregnancy support belt worn around the pelvis can provide compression and help stabilise the joints during activity. In New Zealand, there are some well-regarded options designed specifically with pregnancy in mind, including the Leto Belt, which was developed by NZ women’s health physiotherapists. SRC pregnancy shorts and tights are another popular option that some māmā find easier to wear day-to-day. Your physio can recommend the most suitable option for your specific situation.
Activity Modification and Practical Advice
A lot of PGP management comes down to small adjustments to how you move through your day. Your physio or LMC may suggest things like:
- Sitting down to get dressed rather than standing on one leg
- Keeping your knees together when getting in and out of the car
- Taking smaller steps when walking
- Using a pillow between your knees at night
- Avoiding activities that involve standing on one leg for extended periods
- Moving your legs together when turning over in bed
None of these are glamorous tips, but they can make a meaningful difference to how much pain you’re carrying through the day.
Osteopathy and Chiropractic Care
Some people find osteopathic or chiropractic treatment helpful for PGP during pregnancy. If you’re exploring these options, look for a practitioner with specific experience in pregnancy care, and let your LMC or midwife know what you’re doing so your whole care team is across it.
Finding a Pelvic Health Physiotherapist in New Zealand
New Zealand has a growing number of physiotherapists who specialise in pelvic health and women’s health. The Pelvic Health Directory NZ is a useful starting point for finding a practitioner near you, and many general physiotherapy clinics also offer antenatal pelvic health services.
You can self-refer to a physiotherapist, or ask your LMC or midwife to refer you. Physiotherapy for pregnancy-related PGP is generally privately funded, as ACC does not cover conditions that arise as a natural part of pregnancy. If your PGP was caused or significantly worsened by a specific accident such as a fall, it may be worth discussing an ACC claim with your GP, but for most people this will be a private cost. It’s worth checking your health insurance policy too, as some cover physiotherapy.
What About After the Baby Is Born?
For most people, PGP improves significantly in the weeks after birth as hormone levels settle and the joints restabilise. Some māmā find it resolves fairly quickly; for others, it can take a few months. A small number of people experience symptoms that persist beyond the early postpartum period, and in those cases ongoing physiotherapy is worth pursuing.
If you had PGP in this pregnancy, it’s worth flagging it at the start of any future pregnancy so you can get support in place early.
It’s Okay to Ask for Help
Living with pelvic pain through pregnancy is genuinely hard. It can affect your sleep, your ability to work, your confidence about birth, and just the everyday stuff like carrying the groceries or playing with older kids. It’s also the kind of pain that can quietly wear on your mental wellbeing, especially when it doesn’t seem to be taken seriously.
If that’s where you’re at, please mention it to your LMC, midwife, or GP. You don’t have to just push through it. There is support available, and getting the right help early is genuinely one of the best things you can do for yourself and your pregnancy.
Hey Māmā’s directory includes a range of pelvic health and pregnancy support providers across Aotearoa. Search by location or type of support to find someone near you.
Disclaimer: The information in this article is general in nature and is not a substitute for professional medical advice. Every pregnancy is different. Please speak with your LMC, midwife, or GP about any pain or discomfort you’re experiencing.