Expecting and experiencing pelvic pain? It could be symphysis pubis dysfunction. Here's what you need to know about this common but uncomfortable pregnancy condition, including what causes it and how to get some relief.

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Key Takeaways
  • SPD is a common hormone-related pregnancy condition. Symphysis pubis dysfunction (also called pelvic girdle pain) happens when the hormone relaxin loosens the ligaments that stabilize your pelvic bones. Some experts estimate that 1 in 4 pregnant women experience SPD.
  • Pain is usually triggered by movement and weight-bearing activities. SPD often causes sharp or wrenching pain in the pubic area that can radiate to the thighs or perineum, and it's typically worse during activities like walking, climbing stairs, getting dressed, turning in bed, or getting in and out of a car.
  • It's usually manageable and temporary. Treatment focuses on reducing discomfort — avoiding triggers, using heat or ice, wearing a pelvic support belt, doing targeted exercises, and considering physical therapy or pain relief if needed. Serious complications are rare, and symptoms usually resolve once relaxin levels drop after delivery.

What is SPD?

Symphysis pubis dysfunction (SPD), or pelvic girdle pain (PGP), happens when the ligaments that normally keep your pelvic bones aligned become too relaxed during pregnancy. While some loosening is normal as your body prepares for childbirth, too much flexibility too soon can make the pelvic joint (called the symphysis pubis) unstable, leading to pain and unusual sensations.

medical illustration of symphysis pubic dysfunction (SPD)

How common is SPD in pregnancy?

Diagnosed SPD affects about 1 in 300 pregnancies, though some experts believe it's significantly underdiagnosed. Some estimate that up to 25% of all pregnant women experience SPD.

Connect with other women suffering with SPD and get more expert advice and daily tips in the What to Expect app, where you can also keep track of your pregnancy journey through every stage.

What are the signs and symptoms of SPD?

The most common symptoms are difficulty when walking and sharp or wrenching pain (as though your pelvis is tearing apart). Typically, the pain is focused on the pubic area, but in some women it radiates to the upper thighs, groin, and perineum.

The pain can worsen when you're doing weight-bearing activities, particularly those that involve lifting one leg, such as:

  • Climbing stairs
  • Getting dressed
  • Getting in and out of a car
  • Turning over in bed

"I got SPD with my first," says What to Expect Community mom moonmaidenmother. "It was terrible and the weirdest movements would trigger so much pain. Stairs were awful."

What causes symphysis pubis dysfunction?

The culprit behind SPD is a hormone aptly named relaxin, which loosens your ligaments so your baby can ease his way into the world through your pelvis.

Sometimes relaxin does its job a little too well, loosening the ligaments around your pelvic bone earlier than needed and allowing excess movement in the pelvic joint, which can be painful.

What you need to know about SPD

In very rare cases, the pelvic joint may separate more than normal, a condition called diastasis symphysis pubis or symphyseal separation. This can cause more intense pain in your pelvis, groin, hips, and buttocks, and may require medical treatment. SPD can also worsen after delivery, but this is also rare.

For most moms, symptoms improve after birth, once relaxin levels drop and the pelvic ligaments regain stability.

"It's rough, I know, but it does go away so quick after delivery if that's any comfort at all," says What to Expect Community member pixelstyx.

Treating symphysis pubis dysfunction during pregnancy

While there's no instant cure, there are some things you can try to help ease discomfort:

  • Avoid triggers as much as you can. Sit down to get dressed, and avoid heavy lifting and pushing (which you should be steering clear of anyway!). Try to keep your legs together when you move (get out of bed or into the car, for example). "What helps me is to pretend I'm wearing a pencil skirt all the time — rolling over in bed, standing up, getting in and out of the car, etc.," says What to Expect Community mom lifesadance22. "Try to keep your legs together and your hips in a neutral position when possible."
  • Use heat or ice. Apply a heating pad or ice pack to the pubic area. If using heat, limit sessions to 20 minutes at a time to avoid raising your baby's temperature. "Heat compressions on tailbone, pubic bone, or hips at night help soooo much," says What to Expect Community member Cherries345.
  • Wear a pelvic support belt. These belts help stabilize the pelvic bones and are widely available online.
  • Do your Kegels and pelvic tilts. Regular practice helps strengthen the supportive muscles of the pelvis.
  • Ask about pain relief. If the pain is severe, ask your practitioner about safe pain relievers.
  • Consider physical therapy. A physical therapist trained in pregnancy-related pelvic pain can offer targeted exercises and movement guidance. "I had crippling SPD with my first two pregnancies and am mostly pain free this time because of physical therapy!" says What to Expect Community mom stupidforgetfulmichael.

Most importantly, remember that SPD is usually temporary and often resolves after your baby is born. If you're struggling, don't hesitate to reach out to your provider. Help is available, and you don't have to power through the pain alone.