Blog cover Causes of Pelvic Pain in the Third Trimester of Pregnancy

Common Causes of Pelvic Pain in the Third Trimester

It is an understatement to say that pregnancy dramatically affects a person’s body. If you are reading this you have likely experienced the many aches, pains, and changes to your body that pregnancy brings. In today’s post, we will unpack one of the lesser spoken about pains during pregnancy: pelvic pain during the third trimester. We’ll go over the causes, symptoms, and treatments for pelvic pain in the third trimester of pregnancy. Will will also share some exercises and remedies for pregnant people to alleviate discomfort and improve well-being.

Understanding Pelvic Pain in the Third Trimester

Pelvic pain corresponds to pain in the lowest part of the abdomen, roughly situated between the hip bones from left to right and between the navel and pubic bone (up to down). This is where a pregnant person’s uterus is situated, and where their fetus grows. 

Pelvic Pain’s Prevalence in the Third Trimester

As you may already know the third trimester can be quite uncomfortable, and even painful, as the fetus begins to grow in both size and weight. This dramatic growth of the fetus can cause pelvic pain in the third trimester of pregnancy to be particularly challenging to endure.

Let’s unpack this a bit further. 

  • Step onehello, hormones! Estrogen is six-times higher (!!!) than non-pregnancy baseline in the third trimester, peaking around 32 weeks. Estrogen is responsible for a cascade of physical and emotional changes, which leads us to …  
  • Step two – weight gain and pressure on the pelvis: Thanks to the flood of hormones, a pregnant person can experience significant weight gain in the third trimester. This can exert a lot of uncomfortable pressure on the pelvis, which in turn creates …. 
  • Step three – altered posture and movement patterns: The additional pressure and weight can alter a pregnant person’s posture and movement patterns. As the fetus grows, a pregnant person’s center of gravity changes. The pelvis gets pushed forward by the belly, and the lower back curves more than at non-pregnant baseline. 

Increased estrogen ➡️ Weight gain & pressure on pelvis ➡️ Altered posture & movement patterns  

Despite all of this, pregnant people’s aches and pains are often dismissed as something they’ll have to simply “deal with” as a part of pregnancy.  However, this is simply not true. While it is common to have pelvic pain in the third trimester of pregnancy, it is not normal, and can be managed.

Before we get into how to manage the pain, I would like to talk about what symptoms to look out for.

Symptoms of Pelvic Pain During Pregnancy

Pelvic pain during the third trimester of pregnancy may manifest in different ways for different pregnant people. Below we will go over what we often see with our pregnant patients seeking care at Optimize Pelvic Health.

What does pelvic pain feel like? 

Some people describe pelvic pain as being “sharp and crampy,” akin to what some people say menstrual cramps feel like. We often are told the pain “comes and goes.” Others describe their pelvic pain as a chronic, dull or throbbing sensation. 

Where or how might I feel pelvic pain symptoms?

You might think that pelvic pain manifests strictly in the pelvis, however it’s important to know that pain is often referred to other body regions. During the third trimester of pregnancy you may experience symptoms of:

  • Pain in the pelvic region, hips, and lower back – The pelvic region extends beyond the width of your hips and the distance between your navel and pubic bone. Pelvic pain may refer through a pregnant person’s entire front (anterior) and back (posterior) sides in the hips and pubic bone area. This includes the lower back … which means that a pregnant person in the third trimester could experience pelvic pain in their lower back also. Pain may not be exclusive to your pubic bone or hip areas. 
  • Difficulty walking or standing for long periods – Some pregnant people have difficulty standing or walking for long periods of time because of pelvic pain. Specifically, pain or discomfort in the pubic bone area (aka symphysis pubis dysfunction [SPD] or pregnancy-related pelvic girdle pain [PGP]). This is because because the pelvic joints are stiff and/or moving unevenly at the pelvis’s front or back side.  

Pain is the way your body provides feedback to the brain that something is awry or “off.” As such, it is critical that you heed this feedback accordingly – especially during the third trimester of pregnancy. 

No one should live in pain or discomfort unnecessarily, and there is relief available. 

At-Home Treatment

Despite what you may have been told, you do not have to live in pain or discomfort through the third trimester of pregnancy.

While some pharmacological interventions may be contraindicated due to pregnancy, there are at-home treatments for pelvic pain available and recommended by pelvic floor physical therapists. 

Rest and proper posture

A pregnant person is very likely to have their posture and movement patterns adversely affected due to a change in their center of gravity. Many pregnant people, especially those in the third trimester, tend to lean back. This causes a pull, and sometimes pain or tenderness, at the front of the pubic bone. This pulling sensation can aggravate pelvic pain.  

Telling a pregnant person to have proper posture is easier said than done. We’ve provided some basic tips and prompts to help:

Proper Posture While Standing

Imagine a straight line cutting through you, from the top of your head all the way down to your feet. This will help you remind yourself to not slump or slouch. When standing, avoid locking your knees, maintain your feet slightly apart from each other, and keep your pelvis tucked in. If possible, avoid standing for long periods of time. (source)

Proper Posture While Sitting

Again, avoid slumping or slouching, just like while standing. It can also be helpful to use a chair that has lumbar support, and tilt your pelvis forward. A chair with soft armrests will allow your shoulders to relax. If possible, get up every hour to walk around – a good tip for everyone, regardless of pregnancy status. 

Use A Maternity Belt or Support

Many pregnant people find additional support during their third trimester by wearing maternity belts or supports, both during exercise and during everyday life. OPH staff’s favorites include Fitsplint and Bao Bei. Maternity belts/supports function by decreasing the additional pressure and weight placed on ligaments and joints, while still allowing a pregnant person’s core muscles to engage properly. 

When Resting

When resting, the pregnant person has more opportunity to literally put their feet up, which can help decrease the added weight and pressure on the pelvis. During rest, a pregnant person may find the most relief when incorporating pillows for support, including behind their head and back and between their legs. Some pregnant people find a lot of comfort from using a pregnancy pillow or a large body pillow. 

Safe exercises to alleviate pelvic pain

In addition to the aforementioned non-medical treatments for pelvic pain, there are several gentle exercises for pregnant people, especially those in the third trimester, that could help them to manage or alleviate pelvic pain.

An important reminder: when performing any of these gentle exercises, they should feel comfortable and not at all painful. If they feel painful, gently stop, and share your experience with your provider.

Exercise 1 – Child’s pose:

  • Step 1: Sit on the ground, with both legs tucked under your knees so you are sitting on your shins.
  • Step 2: Put both hands on the ground
  • Step 3: Gently and slowly reach your arms forward, above your head, while keeping your back flat. Your forehead should be on the ground, and your belly will rest between your thighs and forehead.
Dr. Janet from Optimize Pelvic Health demonstrating Child’s Pose

Exercise 2 – Cat-Cow Stretch:

  • Step 1: Get on all fours, keeping your hands shoulder-width apart, with your knees directly below your hips.
  • Step 2: Inhale deeply through your nose while curving your lower back and bringing your head up to look at the ceiling, while tilting your pelvis up like a “cow.”
  • Step 3: Do the opposite of step 2. Exhale deeply through your mouth. Simultaneously bring your abdomen in and arch your spine in the opposite direction as before.
  • Step 4: Bring your head down to look at the floor, and move your pelvis downward like a “cat.”
Dr. Janet from Optimize Pelvic Health demonstrating Cat-Cow stretch

Exercise 3 – Prenatal Yoga Poses:

  • Consider prenatal yoga, which is a specialized form of gentle and safe yoga for pregnant people. There are many offerings available online and locally. 

Pelvic Floor Physical Therapy Treatment for Pelvic Pain in the Third Trimester

Pelvic floor physical therapy treatment can help improve or eliminate pelvic pain in the third trimester in a variety of ways. A pelvic floor physical therapist can help by:

  • Guiding you through the process of finding maternity/support belts that best fit, meet your goals, and desired use/wear. 
  • Utilizing hands-on treatment methods to areas such as your hips, back, and other areas which affect pelvic nerves. 
  • Providing hands-on treatment directly to your pelvis to help you find relief from pelvic pain during the third trimester. 

Connect with a Pelvic Floor Physical Therapist Today

Many pregnant people are told that pelvic pain during the third trimester of pregnancy is simply “business as usual.” At Optimize Pelvic Health our pelvic floor physical therapists maintain quite the opposite. You do not have to be in pain during pregnancy. 

If you have pelvic pain – even in the absence of other symptoms – pelvic floor physical therapy can be helpful. At Optimize Pelvic Health we work closely with pregnant people experiencing pelvic pain. We carefully consider your lived experiences, symptoms, and goals to develop an individualized action plan that makes sense for you. Our pelvic floor physical therapists treat everything from symphysis pubis dysfunction, pelvic girdle pain, to generalized pelvic pain.

If you are experiencing pelvic pain during the third trimester of pregnancy, please reach out so we can help minimize and eliminate your pain together. 

You do not have to needlessly suffer; we can help. 

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