Maybe it started as a twinge getting out of the car. Now it's a sharp catch at the front of your pubic bone when you roll over in bed, or a deep ache across the back of your pelvis after a walk that used to feel easy. Putting weight on one leg to pull on pants has started to feel like a small negotiation with your own body.
If this sounds familiar, you're describing something physiotherapists call pregnancy-related pelvic girdle pain. It's a common experience, not a rare complication, and it doesn't mean your pelvis is broken or that you did something wrong. That said, common doesn't mean it has to be ignored, and there's a real difference between pain you can work around and pain that's worth having assessed.
This post walks through what's actually happening in the pelvis during pregnancy, what the current evidence says about managing the pain, and where the evidence runs out and clinical judgment takes over. It also covers when it's worth bringing this to your care provider or a pelvic health physiotherapist, and when it's reasonable to simply adjust and carry on.
What pelvic girdle pain in pregnancy actually feels like
Pelvic girdle pain describes discomfort felt in and around the pelvic ring. This can be at the joint at the front where the two pubic bones meet (the pubic symphysis), at the joints at the back on either side of the sacrum (the sacroiliac joints), or at both at once. Some people notice it as a sharp, localized pain right at the pubic bone. This pattern is sometimes called symphysis pubis dysfunction, though it's really one presentation of the broader pelvic girdle pain picture rather than a separate condition.
Others feel a duller ache lower down on one or both sides of the back, sometimes radiating into the buttock or the back of the thigh. It tends to show up with specific movements: turning over in bed, climbing stairs, standing on one leg while dressing, getting in and out of a car or bathtub, or walking for longer than usual. Many people also notice it's worse toward the end of the day, after being on their feet.
The intensity and pattern vary a great deal from person to person, and there's no single "textbook" version of it. Some people have mild, occasional discomfort; others find it genuinely limits how they move through a day. Both experiences fall within the range of what pregnancy can involve.
Why pregnancy puts extra load through the pelvis
There isn't one single cause, and the research on this has moved past the old explanation that it's purely a hormone problem. The hormone relaxin does increase during pregnancy and is associated with some increase in ligament laxity around the pelvis. Studies have not found a strong or consistent relationship, though, between relaxin levels and who actually develops pain. Hormones and laxity do not seem to be the main contributors to pelvic girdle pain.
A more useful way to think about it is load and control together. As pregnancy progresses, your centre of gravity shifts and your abdominal wall lengthens and changes how it works. The muscles that usually help control movement through the pelvis and low back are being asked to do that job under different mechanical conditions. For some people, that combination is enough to provoke pain in the pelvic joints, particularly with asymmetrical movements like single-leg standing or twisting.
Some research shows that a previous history of low back or pelvic girdle pain, having had a previous pregnancy, higher pre-pregnancy body weight, physically demanding work, and higher levels of stress or low mood may be associated with pelvic girdle pain. None of these factors mean pain will definitely develop, and plenty of people with none of these factors still experience pelvic girdle pain.
How common is this, and does it mean something is wrong?
Pelvic girdle pain during pregnancy is common enough that most physiotherapists who work with pregnant clients see it regularly. Anywhere from 1 in 3 to 1 in 6 pregnant women may experience low back pain, pelvic girdle pain or both together at some point during pregnancy.
This is worth sitting with, because a lot of the fear around this kind of pain comes from language that's no longer considered accurate. Terms like "unstable pelvis" or the idea that the pelvic bones have "shifted out of place" aren't supported by current understanding of the condition. Imaging studies in people with pregnancy-related pelvic girdle pain generally don't show structural damage or true instability. The pain is real, and it can be significant, but it reflects how the pelvis is being loaded and controlled in the moment, not permanent structural harm.
That distinction matters for how you approach it. Pain that comes and goes with certain movements and eases with rest or position changes is a common variation of what pregnancy can involve. It becomes worth a closer look when it's severe enough to significantly limit walking or daily tasks, or when it's accompanied by other symptoms such as numbness, weakness, or pain that wakes you from sleep. It's also worth a look when the pain doesn't ease at all with rest. Any of those would be reasonable to bring up with your midwife, obstetrician, or family doctor, alongside considering a physiotherapy assessment.
What tends to help day to day
The honest answer here is that the research on specific treatments is a mix of encouraging and genuinely uncertain, and it's worth being upfront about that rather than overstating what any one approach can do. The best treatment for pelvic girdle pain during pregnancy is usually a combination of approaches rather than one specific exercise or technique. Research suggests that education, activity modification, and an individualized exercise program provide the greatest benefit. This may include learning how to move in ways that place less stress on the pelvis, modifying activities that worsen symptoms, and gradually building strength and stability in a way that matches your body's needs. A pelvic support belt may also help some people, particularly during activities such as walking or climbing stairs. Hands-on treatment and acupuncture may provide additional short-term relief for some individuals, but they appear to be most effective when combined with exercise and education rather than used on their own. Because pelvic girdle pain can present differently from person to person, an assessment by a healthcare professional can help determine which combination of treatments is most likely to be effective.
In practical terms, many people find a few adjustments make a meaningful difference even without a formal treatment plan. Keeping the knees together when turning over in bed or getting in and out of a car reduces the asymmetrical load through the front of the pelvis. Sitting to get dressed rather than standing on one leg avoids one of the more provocative positions. Breaking up long periods of standing or walking, and avoiding activities that involve a wide stance for extended periods, can reduce how often the pain gets triggered. Some people find a maternity support belt genuinely helpful; others find it makes little difference, and that variability is consistent with the evidence, not a sign anyone is doing it wrong. Sleep is worth a specific mention, since disrupted sleep tends to make everything else feel harder. Lying on your side with a pillow between the knees and another under the belly can reduce the strain of turning over, and moving your whole body as one unit when you do roll, rather than twisting at the hips, tends to be more comfortable for many people.
Gentle movement is generally encouraged rather than complete rest, since prolonged inactivity has its own downsides in pregnancy. The specific type and amount of movement that helps is individual, though, which is where an assessment becomes more useful than a generic list of exercises.
What a physiotherapy assessment can add
A pelvic health physiotherapist can look at how you're moving, which positions and activities are provoking your symptoms, and how the muscles around your pelvis, hips, and abdomen are working together. From there, the plan is usually built around your specific pattern: some people benefit from manual therapy to reduce muscle guarding, others from a graded, individualized exercise approach, others mostly from movement and activity modification advice. This is one evidence-informed option among several; it doesn't resolve pain for every person who tries it, and it's reasonable to combine it with the self-management strategies above rather than choosing one or the other.
For families in Victoria, the Cowichan Valley, North Vancouver, or West Vancouver, an in-home assessment can be particularly practical here. Travelling to a clinic is a real barrier when getting in and out of a car is itself painful. Seeing how you actually move around your own home, up your own stairs, and in and out of your own bed can also be more useful than a clinic-based assessment alone.
Pelvic girdle pain and labour
If you're managing pelvic girdle pain later in pregnancy, it's worth mentioning to whoever is supporting your birth, since some positions place more strain on the pubic symphysis than others. Positions that involve wide hip abduction held for a long stretch, such as certain stirrup positions, tend to be more provocative for some people. Side-lying or hands-and-knees positions are often more comfortable instead, though this varies from person to person and depends on the specifics of the birth. This is a conversation for your obstetrician, midwife, or a pelvic health physiotherapist ahead of time, rather than something to figure out in the moment. It doesn't mean your options are limited, only that it's useful information for your care team to have.
What happens after birth
For many people, pelvic girdle pain eases considerably in the weeks after birth as the body's load and mechanics shift again. For others, some discomfort persists longer, and postpartum-specific clinical practice guidelines exist precisely because this is a recognized, if less commonly discussed, part of recovery for some. If pain is still limiting your activity by a few months postpartum, that's a reasonable point to seek an assessment rather than assuming it's simply something to wait out.
Where this leaves you
Pelvic girdle pain in pregnancy is common, and it is likely more related to load and movement control rather than structural damage or hormones like relaxin. The evidence for managing it is mixed but a combination of approaches individualized to you and your body rather than one specific exercise or technique is likely best. Simple movement adjustments help many people day to day, and there's no single right approach that suits every person the same way.
If your pain is manageable with the strategies above, there's no requirement to seek treatment for it. If it's limiting how you move through your day, disrupting your sleep, or simply worrying you, an assessment with a pelvic health physiotherapist is one option available to you. Your midwife, obstetrician, or family doctor is another good place to start that conversation.