Pelvic Instability is the name that describes a group of conditions that cause pelvic girdle pain in pregnancy. It is a reasonably common problem, varying in severity and, for that reason, can be overlooked by both the medical practitioner and the woman  and undertreated in pregnancy.

After delivery it can take several months to settle, with a few women continuing to experience significant and disabling problems.

It is thought to be related to an increase in the hormone relaxin circulating in pregnant women and/or a change in the symmetry of pregnant women.

The scenario can often be a woman who begins to notice some pain in the 2nd trimester around her sacro iliac joints (pelvis), aggravated by lifting objects, rolling over at night and walking stairs. Pain can be felt in the lower back, groin & hip area. In severe cases women may not be able to walk very far without significant pain and it can be severely limiting in their daily life. Unfortunately in these cases women often require physiotherapy assistance and may need to use crutches or a frame to help them through this time.

For most women who experience this problem far more conservative treatment is effective. Early consultation to a specialist physiotherapist is often recommended.  Women often benefit from a range of pelvic floor exercises, strapping of the hips and lower back and simple analgesia, such as paracetamol if required.  Women are often encouraged to limit walking activities and heavy lifting.  It is important to purposely think about keeping your knees together, such as when getting in and out of bed or the car.

It is important that women suffering with this debilitating problem inform their midwife on arrival to their health facility for delivery. Midwives can then plan care for delivery, including avoiding having legs apart for longer than necessary during labour and delivery and reducing the amount of rolling and turning that may be required.