If getting out of the car has started to hurt, if you climb stairs one leg at a time because the other way is unbearable, or if rolling over in bed wakes you, that is not a vague pregnancy ache. It is a specific, named, treatable condition — and its main clinical problem is that it gets filed under "back pain in pregnancy" and shrugged at.
The short answer: pelvic girdle pain is pain in the pubic joint and the sacroiliac joints, provoked by asymmetrical movements — stairs, cars, rolling over, standing on one leg. It is common, it is a musculoskeletal problem rather than damage, and physiotherapy treats it. Ask for a referral or self-refer if your area allows it. Move symmetrically, keep the knees together turning in bed, and take stairs one step at a time with both feet.
Why it happens
The pelvis is three bones joined by two sacroiliac joints and the pubic symphysis at the front, and those joints are held by ligaments rather than locked together. Relaxin and progesterone soften those ligaments in pregnancy so the pelvis can accommodate birth. Softer ligaments mean more movement between the bones, and if the two sides move unevenly the joints become painful and inflamed.
That is why the triggers are asymmetrical. Walking, stairs and getting out of a car all move one side of the pelvis relative to the other. Doing the same tasks symmetrically is not a workaround — it is the mechanical logic of the condition.
What is normal
| Pelvic girdle pain | Ring about it | |
|---|---|---|
| Where | Pubic bone, groin, hips, back of the pelvis | One side, high near the kidney, with fever |
| Trigger | Specific movements — stairs, car, turning in bed | Comes in regular waves regardless of movement |
| Character | Sharp, sometimes with clicking or grinding | Severe and constant, or with vaginal bleeding |
| Walking | Slower, waddling | Unable to weight-bear at all |
| With it | Nothing | Fever, bleeding, fluid loss, or reduced movements |
The important overlap: rhythmic pelvic pain arriving in regular waves before 37 weeks is assessed as possible preterm labour, not as PGP. PGP is provoked by what you do; contractions are not.
What actually helps
🦴 Daily management
- Get a physiotherapy referral. This is the treatment. Ask your midwife, or self-refer if your area allows it. Earlier is better.
- Stairs one step at a time, both feet onto each step, leading with the less painful leg.
- Keep your knees together turning in bed and getting out of a car — swivel as one unit, and a plastic bag on the car seat genuinely helps you slide.
- Sit down to dress. Standing on one leg to put on trousers is one of the most reliable provocations there is.
- Smaller, more frequent walks rather than one long one, and no long periods sitting still either.
- Ask about a pelvic support belt or crutches if walking is limited. Neither is an admission of anything.
- Note it in your birth plan, including how far apart you can comfortably take your legs.
Call the same day if: the pain becomes severe and constant rather than movement-related; you cannot bear weight at all; you have a fever; there is vaginal bleeding or a loss of fluid; you notice reduced movements; or the pelvic pain is arriving in regular waves before 37 weeks, which is assessed as possible preterm labour.
Pelvic girdle pain in pregnancy — at a glance
Relaxin and progesterone soften the ligaments holding the pubic symphysis and the sacroiliac joints, allowing more movement between the pelvic bones; when the two sides move unevenly the joints become painful. That is why the provocations are asymmetrical — walking, stairs one leg per step, getting in and out of a car, rolling over in bed, standing on one leg to dress — and why the pain is sharp and specific rather than a broad ache, sometimes with clicking or grinding. PGP is common and treatable, and physiotherapy is the mainstay: manual therapy, deep stabilising exercises, movement advice and where needed a support belt or crutches, with a Cochrane review supporting exercise and multimodal approaches. Practical management is symmetry — both feet onto each step, knees together turning in bed, sitting down to dress, shorter walks more often. It does not prevent a vaginal birth but belongs in the birth plan alongside your comfortable leg range. Regular waves of pelvic pain before 37 weeks are assessed as preterm labour rather than PGP.
Inside Baby Novum: the daily check-in records pain alongside activity, which turns the referral conversation into specifics — sharp, on stairs and getting out of the car, since week 22 — rather than the adjective that gets it dismissed. Encrypted on the device, no account, no server copy.
Frequently Asked Questions
What is pelvic girdle pain?
Pain in the joints of the pelvis — the pubic joint at the front and the sacroiliac joints either side at the back — during pregnancy. It was previously called symphysis pubis dysfunction or SPD. It is common, it is a musculoskeletal problem rather than damage, and it is treated with physiotherapy. It is not a normal, unavoidable part of pregnancy that has to be endured.
How do I know it is PGP and not back pain?
By what provokes it. PGP is triggered by asymmetrical movements — walking, climbing stairs one leg at a time, getting in or out of a car, rolling over in bed, standing on one leg to dress. The pain is sharp and specific rather than a broad ache, and it is felt in the pubic bone, the groin, the hips or the back of the pelvis. Some people hear or feel a clicking or grinding.
What treatment is there for PGP?
Physiotherapy is the mainstay, and in many places you can be referred by your midwife or self-refer. It typically covers manual therapy, exercises for the deep stabilising muscles, advice on movement, and sometimes a pelvic support belt or crutches. The evidence supports treating it — a Cochrane review of interventions for pelvic and back pain in pregnancy found benefit from exercise and multimodal approaches — and the earlier it starts the better it tends to go.
What makes pelvic girdle pain worse?
Anything that separates the legs or loads one side at a time: climbing stairs one foot per step, standing on one leg, wide steps, sitting cross-legged, vacuuming, carrying a toddler on one hip, and breaststroke. Sitting still for long periods also stiffens it. Most of the practical management is about doing the same tasks symmetrically and in smaller amounts.
Will PGP affect my labour?
It does not prevent a vaginal birth, and most people with PGP give birth normally. It is worth noting in your birth plan, along with your comfortable range for separating your legs, so positions can be chosen accordingly — supported side-lying and all-fours are often more comfortable than stirrups. Say it before labour rather than during it.