Part of Pregnancy back and pelvic pain
Pelvic girdle pain or contractions: when to call your midwife
Warning signs, and when to get help
When to call your midwife or maternity unit
Call them. That is the part to act on, and it holds whether this turns out to be your pelvic girdle pain, the start of labor, or something else entirely.
The NHS asks you to call your midwife or maternity unit urgently if your waters break, if you have vaginal bleeding, if your baby is moving less than usual, if you are less than 37 weeks pregnant and think you might be in labor, if any of your contractions last longer than 2 minutes, or if you are having 6 or more contractions every 10 minutes. It asks you to call for guidance if you think you are in labor or your contractions are regular and coming every 5 minutes or more often. And it says you can call if you are unsure or worried about anything, which is the line that covers the reason you are reading this. Do not wait until the next day, even in the middle of the night.
Before 37 weeks the list is wider and the threshold lower. The NHS names regular contractions or tightenings, period-type pains, a gush or trickle of fluid from the vagina, and backache that is not usual for you as signs to call about if you are under 37 weeks. Note what is on that list: backache, and period-type pains. Those are two of the things a woman with pelvic girdle pain has learned to put up with, which is exactly why they are written down here. The NHS also treats new back pain in the second or third trimester as a reason to contact your GP or midwife urgently, because it can be a sign of early labor, and that applies even when you are fairly sure it is the pain you already know.
One number is worth adding, because the figures above are UK service thresholds and they are not the lowest ones published. MedlinePlus, writing for readers in the United States, asks you to be seen right away before 37 weeks for more than 5 contractions in an hour, or contractions that are regular and painful, and it names contractions with lower back pain or pressure in your groin or thighs on the same list. Before 37 weeks, work to that lower figure rather than waiting for six in ten minutes.
If you cannot reach your midwife or maternity unit, call the hospital, birth center or clinic booked for your birth, or the out of hours number in your maternity notes. In the UK, call 111. Wherever you are, if you cannot reach anyone and you are worried, go to your maternity unit or an emergency department, and call emergency services if it is urgent.
Who you call depends on how far on you are. The NHS routes the first 12 weeks to a GP surgery or an early pregnancy unit, 12 to 19 weeks to a midwife or an early pregnancy unit, and 20 weeks or more to a midwife or maternity unit, with maternity assessment units handling urgent later problems such as changes in the baby's movements and signs of labor. Keep whichever number applies to you in your phone, tonight, while you are thinking about it.
Can pelvic girdle pain feel like contractions?
Yes, and anyone who tells you the two are easy to tell apart has not been woken at 3am by either. Both can be felt low in the back and low at the front of the pelvis, both come and go, and both can leave you walking around the bedroom wondering.
Pelvic girdle pain is pain in the joints of the pelvis, at the front, the back or both. The NHS describes it over the pubic bone at the front, across one or both sides of the lower back, between the vagina and anus, or spreading into the thighs, with some women noticing clicking or grinding, which POGP's booklet says you may hear or feel but which is not harmful in itself. One exception is worth stating, because clicking at the front also appears in the list of signs of a separated joint (Stolarczyk and colleagues, 2021): a click that arrived in the same moment as a sudden pubic pain, or that comes with not being able to stand on one leg, belongs with the warning line at the end of this page rather than with the reassurance here. Its signature is that it answers to what you do. The NHS and POGP both list walking, stairs, standing on one leg, turning over in bed and moving the legs apart among the things that set it off, so it usually arrives with a movement and eases off once the movement is over. The parent program page goes through that pattern in detail and what to do about it.
Contractions do not wait for you to do anything. They turn up on their own, in waves, and the NHS says they tend to become longer, stronger and more frequent as labor progresses.
Read that as two average patterns, not as a test you can run. Four things stop it being a test. Start with the biggest. A tightening pattern is not always one of these two things at all: the NHS says that when the placenta starts to come away from the wall of the womb, the pain can come and go like a contraction or can be constant, and that needs your maternity unit, or emergency services if the pain or bleeding is severe.
The other three are simpler. A woman can have both at once, so a movement-related pain does not mean nothing else is happening. The NHS says contractions may feel like extreme period pains for some people, and period-type pains before 37 weeks are themselves on the call-straight-away list. And back pain is on both lists: the NHS names backache or a heavy, aching feeling as an early sign of labor, and backache that is not usual for you as a preterm sign.
One more thing belongs here, because this page is about pain that comes and goes. The womb is not the only thing in there that can hurt in waves. Appendicitis is the most common non-obstetric surgical problem in pregnancy, and gallbladder disease, pancreatitis and a blocked bowel sit on the same list, all of them harder to spot in pregnancy than outside it, because the growing uterus shifts the organs around and because sickness and tummy pain are common anyway (Alsadery and colleagues, 2023). A trapped groin hernia can do the same (NHS). You are not expected to work out which, and it changes nothing about who you call, but it is why the warning signs at the end of this page cover severe lower tummy or pelvic pain, pain that hurts when you move or touch the area, and a painful lump in your groin, alongside everything about labor.
So none of it is for deciding. It is for describing, and a good description is what gets you a fast answer on the phone.
What early labor feels like
The NHS calls the start of labor the latent phase, when the cervix becomes soft and thin and starts opening, and it says this can take hours or sometimes days. Most women are advised to stay at home during that time, which is a decision made with the maternity unit rather than instead of calling them.
The signs the NHS describes are contractions, which may feel like extreme period pains and tend to get longer, stronger and more frequent; backache or a heavy, aching feeling; an urge to go to the toilet, caused by your baby's head pressing on your bowel; a show, which is sticky, jelly-like pink mucus coming from the vagina, pink because it contains a small amount of blood; and the waters breaking, after which it is usual to go into labor within 24 hours. Heavier bleeding than a show is a reason to call straight away, not a variation of it.
The NHS also describes practice tightenings, which it calls Braxton Hicks: it says they may feel uncomfortable but are usually painless, and that they generally stay short, come only now and then, and do not grow stronger or closer together. You will meet that term, so be clear about what it is worth to you tonight. It describes a comparison you can make looking back, over hours, with someone qualified asking you questions. It is not a filter to apply to the tightening you had twenty minutes ago, and before 37 weeks regular tightenings go to your midwife or maternity unit whatever they feel like.
Pelvic girdle pain before labor, and during it
Pelvic girdle pain affects about 1 in 5 pregnant women, on the RCOG's figure, and in clinic it tends to cost more as pregnancy goes on, partly because the load grows and partly because sleep and pacing get harder to protect. A pain that has been building for weeks and is worse by evening is behaving like pelvic girdle pain.
That pain has its own threshold for getting help, separate from everything on this page about phoning in the night. POGP's is a timeframe: if symptoms do not improve within a week or two, or they interfere with your normal day to day life, ask for help from your midwife, GP or physiotherapist, and you should be seen by a specialist pelvic health physiotherapist. So the night-time call and the daytime referral are two different jobs, and doing one does not cover the other.
What we cannot tell you is whether it says anything about timing. We searched for studies on pelvic girdle pain and preterm birth or the onset of labor and found none we can cite, so there is no prediction to offer you. Women ask this constantly, and the only answer we can defend is that nobody knows. The things that genuinely do signal early labor are on the NHS lists at the top of this page, and they belong on a phone call.
During the birth itself, the main work happens before it. The NHS advises writing in your birth plan that you have pelvic girdle pain. The RCOG says staff will make sure your legs are supported and help you move and change position, that most women with pelvic pain in pregnancy can have a normal vaginal birth, and that all types of pain relief are possible, including an epidural. Add one line of your own to the plan: which movements hurt you most, and which positions you have found you can hold.
What do you tell them when you call?
This is the part that changes how the call goes, and hardly anyone has it ready. You are not being asked to diagnose anything. You are being asked to describe, and a clear description gets a faster decision.
Have these ready, out loud or on a scrap of paper:
- how many weeks pregnant you are, and whether you have been told anything about your pregnancy that affects this, including a previous early birth
- when this started, and whether it is different from the pain you already know
- whether it comes in waves, how long a wave lasts, and how many you have had in the last hour, with times if you have them
- what you were doing when it started, and whether moving, resting or changing position makes any difference
- whether there has been any bleeding, or any fluid, however little
- whether your baby has been moving as usual today
- that you have pelvic girdle pain, and where yours normally sits
Timing matters more than it sounds. The NHS thresholds are built on frequency and length, so "about every four minutes, lasting most of a minute, for the last hour" is worth more than "quite often". If you can, note the clock time each wave starts rather than trying to remember afterwards.
One more thing, because it comes up in clinic. Being wrong is fine. Maternity units expect calls that turn out to be nothing, and would far rather have that call than the other kind. If you put the phone down unsure, call again.
Can pelvic girdle pain start labor early?
We found nothing in the literature we can cite showing that pelvic girdle pain brings labor on early, and we are not going to imply it either way from silence.
What has been studied is the treatment. In a controlled trial, 386 pregnant women with pelvic girdle pain were randomized to standard treatment, standard treatment plus acupuncture, or standard treatment plus stabilizing exercises for 6 weeks. There were no serious adverse events after any of the treatments, preterm delivery happened in 5.4 percent, 4.0 percent and 5.4 percent of the three groups, and the fetal heart rate recordings made in connection with acupuncture were all normal. The authors add their own limit, which matters more than the figures: the study was not large enough to exclude negative effects on preterm delivery (Elden and colleagues, 2008). So the usual physiotherapy for pelvic girdle pain was not followed by more early births in that trial, and that is as far as it goes.
The NHS and the RCOG both say pelvic girdle pain does not harm your baby. That statement is about the pain, not about a new symptom that arrives next to it, so it is not a reason to sit on tightenings, bleeding, fluid or a change in movements.
If you were given exercises by your own midwife, doctor or physio, theirs come first. And if any exercise brings on tightenings, stop and contact your maternity unit rather than finishing the set.
Pelvic girdle pain in labor and after the birth
The parent page covers labor and the weeks after it properly, including the birth plan, what staff do to help you move, and what usually happens to the pain: labor and after the birth on the main pelvic girdle pain page.
If you are reading this after the birth and the pain has stayed, that is a reason to ask for help rather than to wait it out. The postnatal core and pelvic floor program is the one written for that stage, and signs of a weak pelvic floor covers the symptoms women most often put up with afterwards.
Three sister pages deal with the questions that sit next to this one. How to sleep with pelvic girdle pain is the practical one for tonight, and pelvic girdle pain and SPD explains the two names you may have been given for the same problem. If what sent you here was a sudden, stabbing pain low in the pelvis rather than a tightening, lightning crotch and round ligament pain covers that, and the same warning list applies there as here.
Related exercise programs
Warning signs
Get emergency help now
- Emergency: anything that looks life threatening, at any stage of pregnancy. Call emergency services without stopping to work out which line below fits: 999 in the UK, 112 in the UK and anywhere in Europe, 911 in the United States and Canada, 000 in Australia, 111 in New Zealand. Say how many weeks pregnant you are, and say it again to each new person you speak to (NHS).
- Emergency: you think your baby is coming now and you have a strong urge to push. Call emergency services and ask for an ambulance.
- Emergency: heavy bleeding from your vagina, for example soaking a pad soon after you put it on, or any bleeding with severe pain in your tummy, pain in your shoulder, or feeling sick, faint or dizzy. Call emergency services straight away.
- Emergency: pelvic or pubic pain that has suddenly left you unable to stand, walk or put weight on one or both legs. Call emergency services if you cannot stand or walk at all, or you cannot get to a hospital safely. Until help reaches you, stay where you are rather than trying to get yourself up: lie on your side with your knees together and a pillow between them, and do not stand on one leg or let your legs come apart.
- Emergency: a very high or a very low temperature, shivering you cannot control, breathing very fast or finding it hard to breathe, being confused or slurring your speech, skin, lips or a tongue that look blue, gray, pale or blotchy (on brown or black skin this can be easier to see on the palms of the hands or soles of the feet), or a rash that does not fade when you press it. Call emergency services, as this can be sepsis.
- Emergency: you suddenly become short of breath, you get chest pain or pain in your upper back that may be worse when you breathe in, you cough up blood, your heart is beating very fast, or you faint. Call emergency services straight away, even if your leg looks normal. These can be signs of a blood clot in the lungs (pulmonary embolism).
- Emergency: numbness, tingling or altered feeling around or under your genitals, between your inner thighs, or around your bottom (anus), for example it feels different when you wipe after using the toilet. Call emergency services or go to an emergency department straight away. This can be a sign of pressure on the bundle of nerves at the base of the spine (cauda equina syndrome), which needs emergency treatment.
- Emergency: you find it hard to start peeing, cannot pee, cannot feel yourself peeing or cannot control when you pee, or you do not notice when you need to poo or cannot control when you poo, and this is not normal for you. The same applies to a new change in how your genitals feel during sex, or new trouble getting an erection or ejaculating. Call emergency services or go to an emergency department straight away. These can also be signs of cauda equina syndrome.
- Emergency: sciatica in both legs, or pain, tingling, numbness or weakness in both legs. The same applies if you lose feeling in one leg. Call emergency services or go to an emergency department straight away.
- Emergency: pain in your lower tummy or pelvis that is severe, is getting worse, or hurts when you move or touch the area, or that comes with feeling faint, dizzy or lightheaded, passing out, pain at the tip of your shoulder, trouble breathing, heavy bleeding from the vagina, or sudden confusion. Call emergency services or go to an emergency department straight away. Tell them if there is any chance you are pregnant.
- Emergency: hip or groin pain on one side that suddenly becomes much worse, or a leg that will not take your weight at all. Go to an emergency department straight away, and say you are pregnant and that the top of the thighbone may be involved, because pregnancy can weaken the bone there and weakened bone can crack. Call emergency services if you cannot stand or walk at all, or cannot get there safely.
- Emergency: you have a lump in your groin and the pain in it is severe or came on suddenly, you cannot poo or pass wind at all, you are vomiting blood or your vomit looks like coffee grounds, or you have suddenly become confused. Call emergency services or go to an emergency department straight away, and do not try to push the lump back in yourself. A hernia that has become trapped can block the bowel or cut off the blood supply to whatever is caught in it (NHS).
- Emergency: you have had cancer, now or in the past, and your back or neck pain feels like a tight band around your body, or comes with pain spreading down an arm or leg, weakness, numbness or pins and needles in your arms or legs, trouble walking, or trouble controlling your bladder or bowels. Call your cancer team's emergency number straight away, or go to an emergency department if you do not have one or cannot get through. This can be cancer pressing on the spinal cord (metastatic spinal cord compression), which needs treatment straight away.
- Emergency: you have thoughts of ending your life or of harming yourself or your baby and feel you might act on them, you have already harmed yourself, or you do not feel you can keep yourself or your baby safe. Call emergency services or go to an emergency department straight away.
Get help now, day or night
- Who to call for every line below that says to contact your midwife or maternity unit: call them straight away, day or night, on the number in your maternity notes. In the first 12 weeks, before your first midwife appointment, the NHS routes these calls to a GP surgery or an early pregnancy unit, and from 12 to 19 weeks to a midwife or an early pregnancy unit, so you do not need a maternity unit of your own yet to be seen. Outside the UK, call your obstetrician, or the maternity or labor and delivery unit where your birth is booked. If you cannot reach anyone and you are worried, call NHS 111 in the UK, and anywhere, go to your maternity unit or an emergency department rather than waiting at home (NHS).
- Any of your contractions or tightenings last longer than 2 minutes, or you are having 6 or more in every 10 minutes, at any stage of pregnancy. Contact your midwife or maternity unit straight away. The NHS also says to call them for guidance once contractions are regular and coming every 5 minutes or more often. Before 37 weeks do not wait for those numbers: US guidance (MedlinePlus) asks to be seen right away for more than 5 contractions in an hour, or contractions that are regular and painful. Do not wait until the next day, and call even in the middle of the night. If you cannot reach your midwife or maternity unit, call the hospital, birth center or clinic booked for your birth, or the out of hours number in your maternity notes. In the UK, call 111. Wherever you are, if you cannot reach anyone and you are worried, go to your maternity unit or an emergency department, and call emergency services if it is urgent.
- Before 37 weeks, you have regular tightenings or contractions, period-type pains, or backache that is not usual for you. Contact your midwife or maternity unit straight away, as this can be a sign of early (premature) labor.
- New back pain in the second or third trimester (from 13 weeks), even if you think it is PGP or ordinary backache. Contact your midwife or maternity unit straight away, as it can be a sign of early labor. Once they have checked it, follow their advice about when to call again.
- Your waters break, or you have a gush or trickle of fluid from your vagina, at any stage of pregnancy. Contact your midwife or maternity unit straight away.
- Any bleeding or spotting from your vagina, even if it is light and you have no pain. Contact your midwife or maternity unit straight away.
- Your baby is moving less than usual, you cannot feel your baby moving anymore, or the usual pattern of movements has changed. Contact your midwife or maternity unit straight away, even in the middle of the night. Do not wait until the next day, and do not use a home heartbeat monitor to check.
- A severe headache that does not go away with simple painkillers, problems with your vision such as blurring or flashing lights, pain just below your ribs, sudden swelling of your face, hands or feet, being sick (vomiting), heartburn that does not go away with heartburn medicines, or feeling very unwell. Contact your maternity unit straight away, as these can be signs of pre-eclampsia, which needs checking and treating quickly. The same applies to a headache after an epidural or spinal anesthetic that gets worse when you sit or stand up and eases when you lie down. Call emergency services if you have a fit (seizure), or a headache that came on suddenly and is very severe. Call emergency services too if you have a headache with a stiff neck and either a high temperature or bright light hurting your eyes, as this can be meningitis.
- Tummy pain that does not go away after you have rested for 30 to 60 minutes, or that comes with lower back pain, vaginal discharge that is unusual for you, regular cramping or tightenings, pain when you pee, or needing to pee suddenly or more often than usual (NHS). The same applies to back or pelvic pain that comes on suddenly, is getting worse quickly or is much worse than your usual pain. Contact your maternity unit straight away. Call emergency services if the tummy pain is severe, any pain comes with bleeding from your vagina, or tummy pain comes with pain in your shoulder or feeling sick, faint or dizzy.
- Pelvic or pubic pain that came on in a single moment, for example during the birth, a fall or a wide step, with a crack, pop or tearing feeling over your pubic bone. Contact your maternity unit straight away, and ask them to check the joint at the front of your pelvis. While you wait, keep off it rather than walking it off: lie on your side with your knees together and a pillow between them, get help to move if there is someone with you, and do not stand on one leg or let your legs come apart. If you cannot stand or walk at all, or you cannot get to a hospital safely, call emergency services. Separation of that joint (pubic symphysis diastasis) is uncommon, is not the same as the pelvic girdle pain this page is about, is confirmed on a scan rather than by how much it hurts, and is first treated with a pelvic support belt and side lying, so ask about a belt at that appointment (Stolarczyk 2021). Pain that has built up over days or weeks, even when it is severe, is the usual pattern of pelvic girdle pain.
- Back pain with a high temperature (38C or above), feeling hotter than usual or shivery, pain or burning when you pee, pee that looks cloudy, pink, red or brown, or pain in one or both sides of your back just under the ribs. Contact your midwife, maternity unit or doctor straight away, as this can be a urine or kidney infection, which is usually treated easily once someone has seen you (NHS). Call emergency services instead if you have any of the signs of sepsis in the emergency warnings above.
- You fall, or your bump is knocked or hit, for example in a car accident, even if you feel fine. Contact your maternity unit straight away so you and your baby can be checked.
- You are out of breath when you lie down, or breathlessness comes with dizziness. Contact your maternity unit straight away. If you are severely short of breath when you are resting, or so breathless that you are gasping or cannot get your words out, call emergency services. Feeling a little more out of breath as your baby grows is common, but this pattern needs checking.
- A calf or thigh that is newly swollen or getting more swollen, warm, tender, red or darker than usual, has swollen veins that are sore to touch, or has a throbbing or cramping pain that does not fit your injury or condition, or that feels different from normal muscle soreness after exercise. This can be a sign of a blood clot (deep vein thrombosis), especially after surgery, an injury, time in a cast or boot, a long trip or a spell of being much less mobile than usual. Get medical advice the same day. If you are also short of breath or have chest pain, call emergency services. Pregnancy and the first 6 weeks after giving birth also make a clot more likely, so if you are pregnant or gave birth in the last 6 weeks, contact your maternity unit, midwife or GP straight away.
- Lower tummy or pelvic pain and you are pregnant or think you might be. Contact your midwife or maternity unit straight away if you are pregnant, or get medical advice the same day if you might be. Pain low in the tummy early in pregnancy needs checking, because a pregnancy can grow outside the womb (ectopic pregnancy).
Get help today
- Same day: a lump in your groin that becomes painful, hard or red, that you cannot push back in, or that comes with a bloated tummy, feeling or being sick, constipation or a high temperature. Get medical help the same day, in person rather than by phone, for example at urgent care or an emergency department, as these can mean a hernia has become trapped (NHS). Do not try to push the lump back in yourself.
- Same day: dizziness, lightheadedness or feeling faint while you are exercising, or the room seems to spin. Stop, and sit down or lie on your side until it passes. Contact your midwife or maternity unit the same day, and do not exercise again until you have been checked, as dizziness is one of the signs to stop exercising in pregnancy. If you faint, it does not settle within a few minutes of keeping still, or you cannot stand or walk steadily, call emergency services.
- Same day: a leg or foot that is getting weaker, for example your foot drags, catches on the ground or slaps down when you walk (foot drop). Get medical advice the same day. If the weakness is getting worse by the hour, go to an emergency department.
- Same day: new back pain and you have had cancer, now or in the past. Get medical advice the same day and mention your cancer history. If you are being treated for cancer now, contact your cancer team the same day.
- Thoughts of suicide or of harming yourself or your baby, even if you do not plan to act on them. Get urgent help the same day from your GP, midwife or health visitor, or NHS 111 in the UK. In the UK, you can also talk to Samaritans on 116 123.
Book an appointment
- Within a few days: hip or groin pain, usually on one side, that is worse when you put weight on that leg, that makes you limp or need a stick or crutch, or that has not eased with position changes and pacing. Ask your midwife or doctor for a review, and say the pain is in your hip rather than only your pelvis. While you wait, take the weight off that leg where you can: lean on a crutch, a stick, a shopping cart or a stroller, use the rail and one step at a time on stairs, sit down for jobs you would do standing on one leg, and do not push through pain you have to limp on. Pregnancy and the weeks after the birth can cause a temporary weakening of the bone at the top of the thighbone, which is uncommon, is often read as pelvic girdle pain for weeks, and shows up on an MRI scan, which is the test to ask about when hip pain has no other explanation (Morton 2024). If the pain suddenly becomes much worse, or that leg will not take your weight at all, do not wait for the review: go to an emergency department straight away, as the emergency warnings above say.
- Within a few days: a new lump or swelling in your groin, especially one that gets bigger when you cough, sneeze or stand and smaller when you lie down. Tell your midwife or doctor, because a lump there needs examining rather than explaining, and an ultrasound scan is what separates swollen veins alongside the round ligament from a hernia (Yeo 2021). Do not try to push the lump back in yourself, and use the same day line above instead if the lump becomes painful, hard or red or you cannot push it back in.
- Low mood, anxiety or stress that is affecting your day to day life, or pain that is causing you considerable distress. Tell your midwife or doctor and ask what support is available, because this is part of what gets treated rather than something to put up with (NHS; RCOG; POGP).
Common questions
Can pelvic girdle pain feel like contractions?
It can, and women tell us so often enough that it is worth saying plainly rather than reassuring you out of it. Both can be felt low in the back and low at the front, both can come and go, and a pelvis that has been sore all day does not announce which of the two is happening at 2am. The patterns are different on average. Pelvic girdle pain is usually brought on by what you do, and the NHS and POGP both describe it getting worse with walking, stairs, standing on one leg, turning over in bed and moving the legs apart, which means it tends to arrive with a movement and settle when you stop. Contractions do not need you to do anything, and the NHS says they tend to become longer, stronger and more frequent as labor progresses. An average pattern is not a test. Before 37 weeks the NHS names regular tightenings, period-type pains and backache that is not usual for you as reasons to contact your midwife or maternity unit straight away, and that holds whether or not the pain also behaves like your usual pelvic girdle pain.
Can pelvic girdle pain cause contractions?
No source we could read says it does, and we looked rather than guessing. Pelvic girdle pain is pain in the joints of the pelvis, and nothing we found links it to the muscle of the uterus tightening. What is in the sources is the other way round: both can be felt in the same part of the body, which is a reason to get the tightenings checked rather than filed under your pelvis. The NHS and the RCOG both say pelvic girdle pain does not harm your baby. That is about the pain itself, not about a symptom that happens to arrive alongside it, so a new tightening pattern still goes to your maternity unit.
Is pelvic girdle pain a sign of early labor?
Nobody can answer that for you from a web page, and the honest position is that we found no study we can cite showing pelvic girdle pain predicts when labor will start. What matters more is the other direction. Before 37 weeks the NHS treats backache that is not usual for you, regular tightenings or contractions, period-type pains, and a gush or trickle of fluid as reasons to call your midwife or maternity unit straight away, and from 13 weeks it treats new back pain as a reason to contact your GP or midwife urgently because it can be a sign of early labor. So the question to act on is not whether your pelvic girdle pain means anything. It is whether anything is new, and new goes on the phone.
When should I call the midwife about contractions?
Sooner than most people do. The NHS says to call your midwife or maternity unit for guidance if you think you are in labor, or if your contractions are regular and coming every 5 minutes or more often, and to call urgently if any contraction lasts longer than 2 minutes, if you are having 6 or more every 10 minutes, if your waters break, if you have vaginal bleeding, if your baby is moving less than usual, or if you are less than 37 weeks pregnant and think you might be in labor. It also says you can call if you are unsure or worried about anything, which covers the situation this page is about. Before 37 weeks the threshold is lower: MedlinePlus, writing for readers in the United States, asks you to be seen right away for more than 5 contractions in an hour, or contractions that are regular and painful. Do not wait until the next day, even in the middle of the night. If you cannot reach your midwife or maternity unit, call the hospital, birth center or clinic booked for your birth, or the out of hours number in your maternity notes, and in the UK call 111. If you cannot reach anyone and you are worried, go to your maternity unit or an emergency department. Call emergency services if you think your baby is coming now and you have a strong urge to push.
What happens to pelvic girdle pain in labor?
The people looking after you work around it, and the main thing you can do in advance is tell them it is there. The NHS advises writing in your birth plan that you have pelvic girdle pain, so the team caring for you in labor knows. The RCOG says staff will make sure your legs are supported and will help you move and change position, that most women with pelvic pain in pregnancy can have a normal vaginal birth, that a caesarean section is not normally needed for pelvic girdle pain, and that all types of pain relief are possible, including an epidural. It is also worth telling them which movements hurt you most, because a position that is comfortable for one woman with pelvic girdle pain is the sore one for the next.
References
- NHS. Signs that labour has begun. Page last reviewed 9 November 2023. https://www.nhs.uk/pregnancy/labour-and-birth/signs-that-labour-has-begun/
- NHS. Premature labour and birth. Page last reviewed 10 January 2024. https://www.nhs.uk/pregnancy/labour-and-birth/premature-labour-and-birth/
- NHS. Back pain in pregnancy. Page last reviewed 10 January 2024. https://www.nhs.uk/pregnancy/common-symptoms/back-pain/
- NHS. Pelvic pain in pregnancy. Page last reviewed 12 December 2022. https://www.nhs.uk/pregnancy/common-symptoms/pelvic-pain/
- NHS. Pregnancy symptoms you need to get help for. Page last reviewed 24 June 2026. https://www.nhs.uk/pregnancy/common-symptoms/pregnancy-symptoms-you-need-to-get-help-for/
- NHS. Your baby's movements. Page last reviewed 8 July 2024. https://www.nhs.uk/pregnancy/keeping-well/your-babys-movements/
- NHS. Vaginal bleeding in pregnancy. Page last reviewed 17 February 2026. https://www.nhs.uk/pregnancy/common-symptoms/vaginal-bleeding/
- NHS. Stomach pain in pregnancy. Page last reviewed 18 November 2024. https://www.nhs.uk/pregnancy/common-symptoms/stomach-pain/
- NHS. Pre-eclampsia. Page last reviewed 23 March 2026. https://www.nhs.uk/conditions/pre-eclampsia/
- MedlinePlus. Preterm labor. US National Library of Medicine. Review date 29 May 2026. https://medlineplus.gov/ency/patientinstructions/000486.htm
- Royal College of Obstetricians and Gynaecologists (RCOG). Pelvic girdle pain and pregnancy. Patient information leaflet. June 2015. https://www.rcog.org.uk/for-the-public/browse-our-patient-information/pelvic-girdle-pain-and-pregnancy/
- Pelvic, Obstetric and Gynaecological Physiotherapy (POGP). Pregnancy related pelvic girdle pain and low back pain during pregnancy and after having a baby. https://thepogp.co.uk/patient_information/womens_health/pregnancy_pgp_lbp.aspx
- Pelvic, Obstetric and Gynaecological Physiotherapy (POGP). Pregnancy related pelvic girdle pain and other common conditions in pregnancy. Booklet. 23 March 2023. https://thepogp.co.uk/Resources/112/pregnancy_related_pelvic_girdle_pain_and_other_common_conditions_in_pregnancy/
- Elden H, Ostgaard HC, Fagevik-Olsen M, Ladfors L, Hagberg H. Treatments of pelvic girdle pain in pregnant women: adverse effects of standard treatment, acupuncture and stabilising exercises on the pregnancy, mother, delivery and the fetus/neonate. BMC Complementary and Alternative Medicine. 2008;8:34. https://doi.org/10.1186/1472-6882-8-34
- Kanakaris NK, Roberts CS, Giannoudis PV. Pregnancy-related pelvic girdle pain: an update. BMC Medicine. 2011;9:15. https://doi.org/10.1186/1741-7015-9-15
- Stolarczyk A, Stepinski P, Sasinowski L, Czarnocki T, Debinski M, Maciag B. Peripartum pubic symphysis diastasis, practical guidelines. Journal of Clinical Medicine. 2021;10(11):2443. https://doi.org/10.3390/jcm10112443
- Morton A, Savard-Heppel J. Transient osteoporosis of the hip in pregnancy. Obstetric Medicine. 2024;17(4):188-193. https://doi.org/10.1177/1753495X241236222
- NHS. Ectopic pregnancy. Page last reviewed 23 August 2022. https://www.nhs.uk/conditions/ectopic-pregnancy/
- NHS. Hernia. Page last reviewed 19 May 2026. https://www.nhs.uk/conditions/hernia/
- NHS. Inguinal hernia repair. Page last reviewed 28 February 2025. https://www.nhs.uk/tests-and-treatments/inguinal-hernia-repair/
- Yeo JHL, Tashi S. A rare but noteworthy diagnosis for lumps in the groin during pregnancy: round ligament varices. American Journal of Case Reports. 2021;22:e934313. https://doi.org/10.12659/AJCR.934313
- Alsadery HA, Bamalan OA, Aljubran HJ, Albaish LJ, Al Ghanim BZ. Non-obstetric acute abdomen in pregnancy: a review of literature. Medical Archives. 2023;77(4):293-298. https://doi.org/10.5455/medarh.2023.77.293-298
Written and checked by the PocketPhysio editorial team. Last updated 2026-10-23.
This page is general education, not a diagnosis or a personal treatment plan. See a physiotherapist or doctor for advice about your own situation.