What To Know About Pubic Bone Pain During Pregnancy

Many expectant parents will experience pubic bone pain during pregnancy. It can happen in early pregnancy but it's most common in later pregnancy, when the hormone relaxin causes the pelvis to loosen at the pubic bone, which helps prepare for delivery.

However, sometimes this loosening is exaggerated, causing pain that can even persist into the early postpartum period. The good news is there are things you can do to alleviate the discomfort. Here's everything you need to know about pubic bone pain during pregnancy, from causes to treatments.

What Pubic Bone Pain in Pregnancy Feels Like

When you have too much laxity in a joint, you can experience pain and instability. Most pubic pain during pregnancy is centered in the front of the pubic bone area above the mons pubis (below pubic hair), and it can feel like stabbing, wrenching pain.

Activities that can make pubic pain worse include:

• Getting out of bed
• Getting into the bathtub or car
• Putting on pants
• Sitting for long stretches
• Performing repetitive tasks

You may also note some swelling in the area of your pubic bone. You may subconsciously waddle when you walk or notice that your legs don't quite come together when you sit. You could feel or hear a clicking noise when moving your legs.

Risk Factors and Causes of Pubic Bone Pain in Pregnancy

The term for instability in the pelvic area is symphysis pubis dysfunction (SPD), sometimes referred to as pelvic girdle pain. Along with joint laxity that comes with pregnancy, the increased pressure on your pelvis and pubic bone as your baby grows can make the pubic pain worse.

You may be more likely to experience pubic bone pain if:

• This is not your first baby
• You are carrying multiples
• You have had previous pelvic or back trauma
  
• You have had SPD in a prior pregnancy
• You have excess weight or obesity
• You are carrying a very large baby

In rare cases, the pubic bone may widen farther than your body frame can support it—typically about 10 millimeters or greater. This widening can occur during pregnancy or the postpartum period and can result in a partial or total separation of the bones known as diastasis of the symphysis pubis (DSP).

How Pubic Bone Pain During Pregnancy Is Diagnosed 

Because X-rays are not recommended during pregnancy, your practitioner may order an ultrasound or MRI to visualize the space between the bones of the pelvis. It's more common, however, to make a diagnosis based on symptoms alone. If you have already had your baby and you are still having pain, an X-ray is the best diagnostic test available.

How To Relieve Pubic Bone Pain During Pregnancy

Most of the time, pregnancy-related pelvic pain dissipates once your baby is born. In the meantime, some treatments can help promote stability and lessen your discomfort. A health care provider can help you make a plan to minimize pain.

• Get low back and pelvis support: Use a pregnancy support belt or rebozo (traditional Mexican shawl) to stabilize your pelvis and help relieve pelvic pain and lower back pain. Studies suggest that a flexible belt or binder works better than a rigid one. Support belts can also help you prevent further injury related to having a less stable pelvis.
• Try acupuncture: While treatments can be time-intensive, research suggests that acupuncture can be helpful for pregnancy-related pain.
• Limit standing: Avoid standing for long periods of time. If you must stand, wear comfortable shoes and try to move around, even if this means you simply shift from foot to foot every so often. You can also use a small stool or box to prop one foot up as you stand.
• Modify your movement: Identify what movement causes the most pain and modify your movement to reduce pain. For example, if putting your pants on while standing triggers pain, try putting your pants on while sitting down.
• Exercise: Certain forms of exercise, including walking and gentle stretching, can help reduce pain. Ask your doctor, midwife, or physical therapist for safe moves you can do. The buoyancy involved in swimming, for example, can provide pain relief.
• Medication: Occasionally, pain medication is an appropriate treatment for pubic pain. Always consult a health care provider before taking medications, as some painkillers are not safe during certain trimesters of pregnancy and postpartum.