Pelvic pain during pregnancy: Best sleeping position and what to do for relief

With all the research presented to us with regard to adopting a side-sleeping position as opposed to sleeping on your back or your tummy, it is safe to assume that all pregnant mums will be snoozing on their sides. But some women suffer from chronic pelvic pain during pregnancy – Symphysis pubis dysfunction (SPD) or pelvic girdle pain (PGP) – making it very difficult to get comfortable and to sleep on their sides in particular.

Sleeping on your side can be lifesaving and can lower your risks of experiencing a stillbirth. According to research, women who suffered a stillbirth after 28 weeks gestation were 2.3 times more likely to have slept on their backs than on their sides, the night before the stillbirth occurred. 

With such compelling evidence to support sleeping on your side during pregnancy, what can be done to help mothers who are afflicted with pelvic girdle pain? 

You may be wondering what this condition is and how to relieve pelvic pain during pregnancy. Furthermore, how can you make sleeping on your side through the night an easier task?

Pelvic pain during pregnancy

Symphysis pubis dysfunction (SPD), or pelvic girdle pain (PGP)

SPD is an uncomfortable pregnancy condition that affects 1 in 300 pregnancies. Pregnancy comes with a host of uncomfortable aches and pains, and pelvic pain that involves your symphysis pubis joint, which is located in front of the pubic bone, is a common complaint.

Prior to delivery, your ligaments are supposed to stretch and relax. This is your body’s response in conjunction with getting ready for the birth of your child.

SPD occurs when the ligaments that normally keep your pelvic bone aligned during pregnancy, relax and stretch well before your due date, leading to making the pelvic joint, that is the symphysis pubis, unstable. The painful condition causes pain in your pelvis, a sensation that the two sides of your pubic bone are sliding up and down against each other, as well as a few other uncomfortable symptoms that we will read about. 

It is estimated that up to 60% of women experience pain in their symphysis pubis while pregnant, according to Dr. Sheila Hill, an OB-Gynaecologist in the hospitalist division of Texas Children’s Pavilion for Women.

In its most severe form, SPD can lead to actual separation of the pubic bone, with women experiencing extremely painful pelvic and hip pain in this case. However, Dr. Hill notes that pubic bone separation is uncommon, occurring in less than 1 percent of pregnancies.

SPD or PGP is different from lightening crotch, which is pelvic pain during pregnancy in the third trimester.

Symptoms of SPD in Pregnancy

SPD is a debilitating condition that affects around 60% of pregnant women. Photo: iStock

SPD pain is characterized as a focused pain in the pubic and groin area, but in some cases, it radiates to the upper thighs and perineum. 

The most common symptoms are difficulty when walking, and a wrenching pain that feels like your pelvis is tearing apart. 

You may also suffer from the following:

• Back and/or hip pain, and pain at the back of your pelvis or hip 
• Pain together with a grinding or clicking sensation in your pubic area
• Inner thigh pain or pain between your legs
• Pain that worsens when you part your legs, walking, perform weight-bearing activities, take the stairs or move around in bed
• Pain that worsens at nighttime and disrupts your sleep. The pain sometimes makes going to the bathroom in between sleep, extremely painful

The condition can occur at any time during your pregnancy or after giving birth, and you may notice it for the first time during the second trimester of your pregnancy.

How to relieve pelvic pain during pregnancy

There are many ways how to ease pelvic pain during pregnancy. Some of these are physiotherapy, exercise, massage, and acupuncture. 

Physiotherapy is the best treatment for SPD. Aside from minimizing your pain, it can also help improve muscle function and help stabilize your pelvic joint and its position.

You can also wear a belly band, or a pregnancy support band to support the pelvic bones and help maintain correct alignment, thereby reducing pain.

Meanwhile, there are a lot of exercises for pelvic pain during pregnancy. These include exercises in the water, which will help take the stress away from your joints so you can move better. You can also try Pilates, which focuses on posture control and core support. 

Other exercises for pelvic pain during pregnancy that you can try are pelvic titles, pelvic circles, inner thigh stretch, and child’s pose stretch. 

Furthermore, we all know that a prenatal massage has many benefits. How about getting a massage for pelvic pain in pregnancy? 

A 2020 study showed that massage for pelvic pain in pregnancy can play a part in managing the condition and providing relief. 

When it comes to how to ease pelvic pain during pregnancy, here are some things you should avoid:

• Pushing and carrying heavy objects, including your toddler
• Standing on one leg
• Bending or twisting to carry something
• Sitting or standing for a long period of time
• Crossing your legs
• Vacuuming 

How to sleep with pelvic pain during pregnancy 

Sleeping with a pillow in between your knees will help alleviate SPD. Photo: iStock

There are a few steps you can take to ensure sleeping on your side is a little easier if you suffer from SPD. 

• Sleep with a pillow in between your knees. This will help keep your pelvis aligned and will take the stretch off your hip and pelvic muscles when lying on your side by slightly elevating your top leg. A regular extra pillow may be used for this purpose, or you may want to invest in a specialized pregnancy pillow, a body pillow, or a leg spacer.
• Prop a pillow under your belly when sleeping to lift your stomach. This also takes the pressure off your low back and improves your spinal and pelvic alignment
• Swap your regular cotton nightwear with silk or satin pajamas as you can slide around in bed, rather than having to pick yourself up to turn over
• Continue wearing your belly band even when sleeping

However, if none of this works and you are very uncomfortable sleeping on your side, try sleeping at an incline position. You can also try sleeping in a recliner chair or on the couch propped up with pillows.

We hope these tips answer your question about how to sleep with pelvic pain during pregnancy.

Remember, talk to your doctor about safe pain relief medication if your pain is too severe. It is important to know the difference between SPD/PGP and lightning crotch, which is pelvic pain during pregnancy in the third trimester. 

Pregnancy is a long journey that can sometimes be made difficult by conditions such as these. We hope you hang in their mamas, and that our tips help you.

Updates by Romy Pena Cruz