Pelvic girdle pain (SPD) during pregnancy

By trimester

Weeks 1–13

1st trimester

Pelvic girdle pain is less common this early, but it can show up sooner if you've had low-back or pelvic pain before, pelvic girdle pain in an earlier pregnancy, or a pelvic injury. Mention any of that history at your first prenatal visit so your provider has context before symptoms build.

Weeks 14–27

2nd trimester

This is when pelvic girdle pain most often starts or gets worse, as the hormone relaxin loosens your joints and your growing uterus shifts how weight moves through your pelvis. Starting a support belt and physical therapy early, rather than waiting until pain gets severe, tends to work best.

Weeks 28–birth

3rd trimester

Symptoms usually peak now, as your baby's weight, your changed gait, and joint looseness all reach their highest point. A support belt, continued physical therapy, and movement changes like log-rolling out of bed, keeping your knees together, and avoiding wide single-leg positions become daily habits for many people. Call your provider the same day if pain becomes severe enough to stop you from walking or bearing weight.

What does the evidence show for pelvic girdle pain?

• Pelvic girdle pain is a recognized group of conditions that cause pain in the pelvic joints during pregnancy, and it's often overlooked or brushed off as an ordinary ache rather than recognized as its own condition needing attention. 1
• Roughly one in five pregnant women experience pelvic girdle pain. Prior low-back pain and pelvic trauma are the strongest known risk factors, and doctors can confirm it with a few simple hands-on exam moves, like the active straight leg raise, instead of X-rays or invasive testing. 2
• A support belt for the sacroiliac joint showed immediate, measurable improvement on a standard pelvic-stability exam in a 2022 study, and 82 percent of participants felt meaningfully better after four weeks of wearing one, leading researchers to conclude these belts are a safe, well-tolerated option for pregnancy-related pelvic girdle pain. 3
• A small randomized study compared two pelvic support belt designs and found both eased pain and improved function within three weeks, with the more flexible belt better tolerated and showing a slight edge for pain relief, though researchers said a larger trial is needed to confirm that difference. 4
• One trial compared exercise and activity advice alone against the same plan plus a support belt, and both groups improved about the same, suggesting that targeted exercises and guidance on daily movement matter more than the belt by itself, though many clinicians still recommend a belt for comfort. 5
• Preterm labor between 20 and 36 weeks is signalled by contractions every 10 minutes or more often, a low dull backache, a feeling of pressure in the pelvis, cramps that feel like menstrual cramps, abdominal cramps with or without diarrhea, and a change in vaginal discharge such as leaking fluid or bleeding, and NICHD advises calling a doctor or going to the hospital to be evaluated. 6

When should I call my provider about pelvic girdle pain?

Pelvic girdle pain has a mechanical signature. It flares with walking, stairs, rolling over in bed, and standing on one leg, and it settles when you stop loading the joint. The pattern that needs a call instead is pelvic pressure or a low dull backache arriving rhythmically, cramps that feel like a period, or contractions every 10 minutes or more often, because those are the preterm labor signs NICHD lists from 20 weeks on. Add any change in vaginal discharge, fluid leaking, or bleeding, and go in to be evaluated rather than holding it for the next appointment. Whatever the pattern, any symptom that feels beyond your usual range is a reason to call: obstetric teams expect these questions and would rather hear early than late.