Should Pain be Expected when Expecting?

Pregnancy by definition is a span of about 9 months in which a woman’s body undergoes many, many changes-- some changes being more comfortable than others.

Although we often picture pregnancy as a blissful and wonderful expectation as we grow a new life, the physical changes a woman’s body goes through can feel anything but miraculous. Over 50% of pregnant women report their biggest complaint during pregnancy is low back pain, sometimes lasting over 3 months! Additionally, up to three-fourths of women will experience low back pain at some point during their pregnancy.(1,2)

Add to this pelvic girdle pain (pelvic pain, SI joint pain, pubic symphysis dysfunction), which is experienced by up to 20% of women at some point during pregnancy,(3), and it’s no wonder that pregnancy can be physically exhausting!

Although pain is usually experienced sometime between the 5th and 7th months of pregnancy, it can begin as soon as eight to twelve weeks after becoming pregnant.(2).This was Dr. Kristen’s experience. What she has also noticed with pregnancy is that any past injuries tend to resurface during pregnancy.

Why we Experience Pain during Pregnancy

But why? Well for starters a woman's body begins releasing a hormone necessary for pregnancy called Relaxin-- and it does just that--Relaxes the ligaments and smooth muscles of a woman's abdomen and pelvis so that your body can grow with the baby. Then the uterus and fetus begin to expand and grow. This growth makes a woman’s center of gravity change to accommodate--shifting forward to accommodate for the growth of the baby. The abdomen stretches, and the woman’s belly moves forward and out accordingly to increase in the baby’s weight and development. This shift in gravity of a woman’s weight (3) adds pressure and weight on her low back, pelvis, knees, ankles, and feet.

In fact, the thoracic (mid-back) and lumbar (low back) spine curvature can change during pregnancy, causing an increase in pain in the low back and pelvic regions. This can also cause changes to a woman's balance and gait patterns (i.e the way you walk).(3)Think of the pregnant “waddle” that some women do while walking, and you have an idea as to the changes that take place in the abdomen, low back, pelvis, and sacrum!

This can, and often does, place additional stress and strain on the joints in the low back and posterior pelvis, known as the lumbar and sacroiliac areas. Expansion of the pelvis and abdomen stretch a ligament used to hold the uterus called the round ligament and many women will experience pain in the front lower abdomen and pubic regions. These postural changes lead to increased pain, muscle tightness, tenderness, and discomfort.(2)

Low back and pelvic pain can also be major deterrents in a woman who could, and would, be otherwise motivated to continue working and taking care of both herself and her home. Pain has shown to influence pregnant women’s daily lives in the challenges they encounter concerning their physiological, psychological, occupational, and social functions.(4)

And it doesn’t always stop there. Sometimes women can experience low back and pelvic region pain the year after birth, and even up to three years after labor and delivery. (1,5) Pregnancy-related low back and pelvic pain, as well as post-partum mechanical spinal disorders, are not only common, but they can impede recovery, nursing, and caregiving – three very important components in taking care of the newborn after labor and delivery.(5)

How will a pregnant woman know if her pain is being caused by her pregnancy?

What is pregnancy pain like? Some women describe it as a deep discomfort. Others describe it as stabbing, continuous, recurrent, and intense.(6) The discomfort can also vary in intensity; some days can be more difficult than others, and there may be times when the pregnant woman feels like even basic tasks are difficult to do.

Where might pregnancy-related pain be felt on the body?

For some, the pain in the front, by the pubic bone. Others may feel discomfort directly at the low back above the gluteal area – sort of around the beltline. And for others still, the pain also occurs between the hip bones.