Tailbone pain during pregnancy

By trimester

Weeks 1–13

1st trimester

Tailbone pain is uncommon this early, since pain from pregnancy-related ligament loosening more typically shows up as pregnancy progresses and the uterus grows. If your tailbone hurts in the first trimester, it's more likely from an unrelated fall, cycling, or an old injury than from pregnancy hormones.

Weeks 14–27

2nd trimester

Relaxin rises substantially during this stage, loosening the ligaments around the pelvis and spine, which can make longer stretches of sitting or reclining uncomfortable on the tailbone. A cushion with a cutout under the coccyx and shifting position often can help.

Weeks 28–birth

3rd trimester

This is when tailbone pain is most likely to show up or get worse, as added weight and a forward-shifted center of gravity change how pressure lands on the coccyx while sitting. The tailbone can also be injured during delivery itself, so pain that continues or starts after birth is its own separate, common experience.

What does the evidence show for tailbone pain?

• Relaxin increases roughly tenfold during pregnancy, loosening the ligaments around the sacroiliac joints, pelvis, and spine, which researchers propose as one contributor to generalized pregnancy back and pelvic discomfort, though the link between relaxin levels and pain severity isn't fully settled. 1
• Childbirth is a documented cause of coccyx injury, including fractures described as obstetric fractures caused by forced extension of the tailbone during labor. 2
• Conservative care for coccyx pain, including cushions with a cutout beneath the tailbone, activity changes, and physical therapy, succeeds in an estimated 90% of cases, with more serious causes like infection or a growth investigated when the cause is unclear or pain doesn't improve. 2
• A case report describes labor injuring the coccyx enough to cause inflammatory changes at the tailbone even without a clean fracture or dislocation, with pain severe enough that the person could not sit, significantly limiting postpartum recovery. 3
• Tailbone pain can persist for months after an uncomplicated vaginal delivery with no episiotomy, and in at least one documented case, the actual source turned out to be referred pain from the lower back rather than the coccyx itself, which is why pain that doesn't respond to typical coccyx-focused care is worth a second look. 4

When should I call my provider about tailbone pain?

Sudden, severe tailbone pain after a fall or hard landing can signal a coccyx fracture or dislocation, which is worth having evaluated rather than managed as ordinary pregnancy discomfort. Pain accompanied by fever, redness, or swelling over the area points toward a possible infection rather than routine mechanical pain, and any cause that stays unclear or doesn't respond to conservative care deserves a closer look from your provider. Given how effective standard measures usually are, pain that isn't easing after a couple of weeks of cushioning and position changes is also reasonable to bring up at your next visit. 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.