Pregnancy

What are common causes of pelvic pain during pregnancy?

From relaxed pelvic joints to pressure from your growing baby's weight, here are the common culprits of benign pelvic pain during pregnancy. If the pain you're experiencing doesn't go away, or if you have symptoms such as bleeding, an unusual discharge, or strong cramping, call your ob-gyn.

Accommodation pain

From 8 to 12 weeks of pregnancy, you may experience cramp-like pain that feels like your period is coming on. As long as there's no bleeding, it's probably just your uterus expanding. You're less likely to feel this in your first pregnancy than in subsequent pregnancies, Dr. Greenspan says.

Ovarian cysts

Functional ovarian cysts, which form due to changes in the way your ovaries make or release eggs, are very common, noncancerous, and generally harmless. They can grow larger during pregnancy, and the pressure that your growing uterus puts on your ovaries can cause persistent pain. If the cyst ruptures, the pain may suddenly get worse. Be sure to tell your ob-gyn if you have a history of ovarian cysts, or if you think you've developed them during your pregnancy. She can do an ultrasound to help ensure that the cysts haven't grown too large.

In rare cases, a cyst can twist (called torsion)--a serious condition that usually happens after sudden or rigorous activity such as running to catch a bus or having intercourse. "A patient with torsion is usually inconsolable," Dr. Greenspan says. "The pain is very sharp, severe, and constant, and there may be nausea, vomiting, and sweating." If you suspect that you are experiencing torsion, call your ob-gyn right away.

Round ligament pain

As you start your second trimester, you may begin to feel pain in your side as the ligament that goes from the top of the uterus down to the groin stretches. "Women tend to feel this when they're walking or getting up from a chair," says Suzanne Merrill-Nach, M.D., an obstetrician in San Diego. "The uterus tilts and pulls on the ligament." Lying down on the side that's bothering you can make the pain disappear--and it should disappear for good by about 24 weeks.

Pressure from your baby's weight

Once you're in your third trimester, you may start to experience pressure in your pelvic region as the weight of your rapidly growing fetus presses down on the nerves that run from your vagina into your legs. "This pain typically occurs with movement, such as when you walk or ride in a car, because the baby bounces," Dr. Merrill-Nach says. To help relieve the discomfort, lie down on one side and rest.

Braxton Hicks contractions

Pressure or tightening in the pelvis that comes and goes could be contractions, but if they're sporadic and generally not painful, they're most likely practice contractions, called Braxton Hicks, instead of true labor contractions. These "practice" contractions tend to occur at around 20 weeks and can be triggered by dehydration, so be sure to drink plenty of water. (You'll know it's a contraction if you lie down and feel your belly; your uterus will become hard, and then relax.) They should disappear on their own but if you have more than four contractions an hour for two hours, call your doctor. "When we are talking about preterm labor generally before 37 weeks, we are looking for contractions every 15 minutes or closer that persist over two hours even if the patient has an empty bladder and is lying down," Dr. Merrill-Nach says.

Relaxed pelvic joints

Toward the end of your pregnancy you'll experience a surge in the hormone relaxin, which helps your ligaments become stretchy for childbirth. Relaxin can also loosen your pelvic joint, and even cause it to separate a bit. It's common to feel pain near your pubic bone, and you may also feel like your legs are unstable. Some women like to use pelvic support belts, which can help stabilize the area.

Constipation

Constipation, a common complaint during pregnancy, can cause some pelvic pain or discomfort. (Hormones slow down the digestive tract, as do the iron supplements your ob-gyn may recommend.) Drink plenty of water, and eat fiber-rich foods such as raw fruits and vegetables. If that doesn't help, ask your ob-gyn if you can try a stool softener or a glycerin suppository, Dr. Greenspan suggests.

Urinary Tract Infection (UTI)

Up to 10 percent of expectant moms will get a UTI at some point during their pregnancy, according to the March of Dimes. Typical symptoms include a sudden urge to urinate, pain or burning with urination, and bloody urination--but some patients with a UTI also experience abdominal pain, Dr. Chambliss says. "The concern with UTIs during pregnancy is that they can progress to an infection in your kidneys that will increase your risk of preterm labor," she adds. That's one reason why your ob-gyn tests your urine every visit, to check for the signs of bacteria that can lead to a UTI. The good news is that if a UTI is caught early it should be easy to treat with antibiotics.