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Back Pain in Pregnancy and After Birth

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By Mr Ahmed-Ramadan Sadek, Neurosurgeon · 9 min read

🎧 Listen to this guideAudio version coming soon. Narrated in Mr Sadek’s voice using AI voice technology, from a script he has reviewed.

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Key points

  • Back and pelvic pain are very common in pregnancy. Estimates range from about 45% to more than two-thirds of pregnant women, depending on the study.
  • Pelvic girdle pain (PGP), once called symphysis pubis dysfunction (SPD), is a separate problem that affects about 1 in 5 pregnant women. It is not harmful to your baby.
  • Staying active and exercising, on land or in water, may help. A specialist pelvic health physiotherapist can assess and treat you at any stage of pregnancy.
  • Check with your midwife, GP or pharmacist before taking any painkiller, as some are not suitable in pregnancy.
  • Research has not found that epidurals in labour cause long-term back pain.

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Get help straight away if you are pregnant or have recently had a baby and you have back pain with:

  • Loss of feeling in one or both legs, your bottom or your genitals: call 999 or go to A&E.[1]
  • Pain or numbness in both legs at the same time, difficulty passing urine, bowel leakage you cannot control, or numbness around the vagina or back passage: go to A&E or call 999 straight away. These can be signs of pressure on the nerves at the bottom of the spine (cauda equina syndrome).[4]
  • A fever, bleeding from your vagina or pain when you pee: contact your GP or midwife urgently.[1]
  • Pain in one or both sides, under your ribs: contact your GP or midwife urgently.[1]
  • Back pain in the second or third trimester, especially with tightenings or contractions: this could be a sign of early labour.[1][12]

For anything to do with your pregnancy, such as contractions, bleeding or reduced baby movements, call your midwife or maternity unit (often called maternity triage) straight away. Do not wait for your next appointment.

How common is it?

The NHS describes back pain in pregnancy as very common.[1] The figures vary because studies define and measure pain in different ways:

  • A Cochrane review (Liddle and Pennick, 2015) reports that more than two-thirds of pregnant women have low back pain and almost one-fifth have pelvic pain.[5]
  • A large review by Wu and colleagues (2004) estimated that about 45% of pregnant women have pelvic girdle pain, low back pain or both.[6]
  • The Pelvic, Obstetric and Gynaecological Physiotherapy group (POGP) says pain in the lower back or back of the pelvis affects about 50% of pregnant women, and pelvic girdle pain about 20%.[4]
  • The NHS and the Royal College of Obstetricians and Gynaecologists (RCOG) both put pelvic girdle pain at up to 1 in 5 pregnant women.[2][3]

Most of this pain is a nuisance rather than a danger, but it can be hard going. Wu and colleagues found that about 25% of women have serious pain during pregnancy, and about 8% have severe difficulty with daily activities.[6]

Why does it happen?

Several changes come together in pregnancy:

  • Hormones and ligaments. The ligaments in your body naturally become softer and stretch to prepare for labour. This can strain the joints of the lower back and pelvis.[1] POGP notes that hormones are the main cause for only a small number of women.[4]
  • Weight and posture. As your baby grows, the extra weight and the change in the way you sit and stand put more strain on your pelvis.[3]
  • Muscles and joints. The joints of the pelvis can start to move unevenly, and the tummy, buttock, inner thigh and pelvic floor muscles can weaken, putting more load on the joints.[3][4]
  • Your history. Pain is more likely if you have had back or pelvic pain before, a previous pelvic injury, a physically demanding job, or if you are overweight or gain a lot of weight in pregnancy.[2][4][6] RCOG adds hypermobility (joints that stretch more than usual).[3]

Pelvic girdle pain or low back pain?

These are two different problems, although some women have both. In the Wu review, about half of women with pain had pelvic girdle pain, a third had low back pain, and a sixth had both.[6]

Pelvic girdle pain comes from the joints of the pelvis: the pubic joint at the front and the sacroiliac joints at the back. You may feel pain:[2][3]

  • Over the pubic bone at the front, or across one or both sides of the lower back.
  • In the area between the vagina and anus, or spreading into the groin and thighs.
  • When walking, going up or down stairs, standing on one leg to get dressed, turning over in bed, or moving your legs apart, for example getting out of a car.

Some women feel or hear clicking or grinding in the pelvis.[2] Pregnancy-related low back pain is felt higher up, in the lower back itself. If you are not sure which you have, a physiotherapist can tell the difference, which matters because the two may respond to different treatments.[5] You can read more about the joint at the back of the pelvis in our guide to sacroiliac joint pain.

What helps

Everyday changes

  • Bend your knees and keep your back straight when you pick something up, and avoid heavy lifting.[1]
  • Move your feet when you turn, rather than twisting your spine. Wear flat, supportive shoes.[1][2]
  • Split shopping between two bags, and sit with your back well supported.[1]
  • Change position often. RCOG suggests not sitting for more than 30 minutes at a time.[3]
  • Sit down to get dressed, stand with your weight even on both legs, and keep your knees together when getting in and out of a car or turning in bed.[2][3]
  • Sleep with a pillow between your legs, and rest when you can, particularly later in pregnancy.[1][2]

Exercise and physiotherapy

The Cochrane review of 34 trials and 5,121 pregnant women found low-quality evidence that exercise, on land or in water, may reduce pregnancy-related low back pain. There was moderate-quality evidence that an exercise programme of 8 to 12 weeks reduced the number of women reporting back and pelvic pain, and that exercise reduced time off work. For pelvic girdle pain on its own, exercise was not clearly better than usual antenatal care.[5] The NHS suggests antenatal yoga or aquanatal classes (gentle exercise in water) with a qualified instructor.[1]

If pain is getting in the way, ask your midwife or GP about a referral to a physiotherapist who specialises in pregnancy and pelvic health.[1][4] Treatment may include advice on movement and pacing, exercises for the tummy, pelvic floor, back and hip muscles, hands-on therapy and, if needed, walking aids such as crutches. RCOG is clear that PGP is not something you just have to put up with, and that treatment is safe at any stage of pregnancy.[3]

Water exercise

In one trial in the Cochrane review, water exercise classes reduced time off work because of back pain, although the evidence was low quality.[5] Water also takes weight off your joints, and RCOG lists hydrotherapy among the treatments for PGP.[3]

Support belts

Support belts are sometimes sold for pregnancy back and pelvic pain, but the evidence that they help is weak, coming mainly from one small, low-quality trial.[5] NICE’s back pain guideline advises against belts or corsets for low back pain.[13] Exercise, advice and specialist physiotherapy are the better-supported options.

Acupuncture

RCOG lists acupuncture as one option for PGP.[3] In the Cochrane review, single studies suggested acupuncture eased evening pelvic pain more than usual care or stabilising exercises, but another found no clear difference in pain relief compared with sham (pretend) acupuncture. Side effects were minor and short-lived.[5] NICE NG59 advises against acupuncture for low back pain in adults generally.[13] If you are thinking about it, discuss it with your midwife and choose a practitioner experienced in treating pregnant women.

Medicines

Always check with your midwife, GP or pharmacist before taking any painkiller in pregnancy or while breastfeeding. Some common painkillers, such as certain anti-inflammatory medicines, should be avoided in pregnancy unless a doctor or pharmacist advises otherwise.[11] If pain is severe, your doctor will talk through what is safe for you.[3]

Labour, epidurals and back pain

Most women with PGP can have a vaginal birth. Let your midwife know, and write it in your birth plan, so that your team can help you find comfortable positions. A birthing pool can take weight off your joints, and all types of pain relief, including an epidural, are possible.[2][3]

Many women worry that an epidural will cause back pain for years afterwards. The evidence is reassuring:

  • A London study of 450 women (Russell and colleagues, BMJ, 1996) found no difference in new long-term backache between women who did and did not have an epidural. The only factor linked to backache after birth was having back pain before or during pregnancy.[7]
  • A randomised trial of 369 women at an NHS hospital, followed up for about two years, found no difference in long-term low back pain, disability or back movement between the epidural and non-epidural groups.[8]
  • A Cochrane review (2018) of epidurals in labour found no difference in long-term backache, based on two trials with 814 women.[9]

After the birth

For many women the pain eases after the baby is born, but not for everyone. Wu and colleagues estimated that about 25% of women have pelvic girdle or low back pain after pregnancy.[6] In the London study, 34% of women reported backache 3 months after birth, although for most this was not new.[7] RCOG says around 1 in 10 women have ongoing pelvic girdle pain.[3]

Feeding, lifting and carrying your baby and their equipment can put a lot of strain on your back and pelvis.[4] The NHS suggests:[10]

  • When feeding, sit with your back well supported, with a small cushion behind your waist and your feet reaching the floor. A feeding pillow can help.[4][10]
  • Kneel or squat, rather than bending your back, for jobs near the floor such as bathing your baby.
  • Change nappies on a raised surface, for example kneeling next to a bed or sofa, and never leave your baby alone on a raised surface.
  • Keep your back straight and bend your knees when lifting, and keep your back straight when pushing a pram, or use a well-fitting sling.

Your tummy muscles may separate during pregnancy. The gap usually closes by the time your baby is 8 weeks old. If it is still obvious at 8 weeks, contact your GP, as you may be at risk of back problems and a physiotherapist can help.[10] Your postnatal check at around 6 to 8 weeks is a good time to mention any back or pelvic pain.[10] If pelvic pain does not settle, your GP may refer you to look for other causes, such as a hip problem or hypermobility.[3]

When to see your midwife or GP

  • Your back pain is very painful. You may be referred to an obstetric physiotherapist.[1]
  • It is hard to move around, or it hurts to get out of a car, turn over in bed or use the stairs. These can be signs of PGP.[2]
  • Pain is affecting your sleep or daily activities, or not improving with the advice here.[4]
  • The pain is causing you a lot of distress.[2]
  • Pain carries on after the birth. You can ask a GP or health visitor for help at any time.[10]

Frequently asked questions

Is back pain normal in early pregnancy?

Yes, it is very common. The NHS says backache is common in pregnancy, especially in the early stages, as the ligaments soften to prepare for labour.[1] Estimates range from about 45% of pregnant women having back or pelvic girdle pain[6] to more than two-thirds having low back pain.[5] Contact your GP or midwife urgently if back pain comes with a fever, bleeding, pain when you pee, or pain in your sides under your ribs.[1]

Can back pain be a sign of labour?

Yes, it can. Backache is one of the signs that labour may be starting, along with contractions, a show and your waters breaking.[12] The NHS advises contacting your GP or midwife urgently if you have back pain in your second or third trimester, as it could be a sign of early labour.[1] If you think you are in labour, or you are unsure or worried, call your midwife or maternity unit.[12]

Can pelvic girdle pain (SPD) harm my baby?

No. Pelvic girdle pain can be very painful for you, but it will not harm your baby.[2][3] Most women with PGP can have a vaginal birth, and RCOG says a caesarean section is not normally needed for PGP and may slow down recovery.[3] Tell your midwife and write it in your birth plan, so the team can help you find comfortable positions in labour.[2]

What painkillers can I take for back pain while pregnant?

Ask before you take anything. Your midwife, GP or pharmacist can tell you what is suitable for you. Some common painkillers, such as certain anti-inflammatory medicines, should be avoided in pregnancy unless a doctor or pharmacist advises otherwise, and you should also check before taking them while breastfeeding.[11] If your pain is severe and you need stronger pain relief, RCOG says your doctor will discuss this with you.[3]

Does a pregnancy support belt help back pain?

The evidence is weak. One small trial suggested a soft pelvic belt might ease pelvic pain, but it was low quality.[5] NICE advises against belts or corsets for low back pain.[13] Exercise, advice and specialist pelvic health physiotherapy are the better-supported options, so ask your midwife or GP about a referral.

Is it safe to exercise with back pain in pregnancy?

For most women, yes, and it may help. A Cochrane review found low-quality evidence that exercise on land or in water may reduce pregnancy-related low back pain, and moderate-quality evidence that it reduces time off work.[5] The NHS suggests antenatal yoga or aquanatal classes with a qualified instructor.[1] If you have pelvic girdle pain, keep active but avoid things that make the pain worse.[2] Ask your midwife if you have any pregnancy complications.

Will an epidural give me back pain later?

The evidence says no. A London study of 450 women found no increase in new long-term backache after an epidural; back pain before or during pregnancy was the main link with backache after birth.[7] A randomised trial following women for around two years found no difference in back pain, disability or movement.[8] A Cochrane review also found no difference in long-term backache between women who did and did not have an epidural.[9]

How long does back pain last after giving birth?

It often eases after the birth, but not always. Estimates vary: about 25% of women have pelvic girdle or low back pain after pregnancy in one large review,[6] 34% reported backache 3 months after birth in a London study,[7] and RCOG says about 1 in 10 women have ongoing pelvic girdle pain.[3] Mention it at your 6 to 8 week postnatal check, or ask your GP or health visitor at any time.[10]

When should I worry about back pain in pregnancy?

Call 999 or go to A&E if you lose feeling in one or both legs, your bottom or your genitals.[1] Go to A&E or call 999 straight away if you have pain or numbness in both legs, difficulty passing urine, bowel leakage you cannot control, or numbness around the vagina or back passage.[4] Contact your GP or midwife urgently if you have a fever, bleeding, pain when you pee, pain under your ribs, or back pain in the second or third trimester that could be labour.[1]

Further reading

References

  1. NHS. Back pain in pregnancy. NHS website; page last reviewed 10 January 2024. Link
  2. NHS. Pelvic pain in pregnancy. NHS website; page last reviewed 12 December 2022. Link
  3. Royal College of Obstetricians and Gynaecologists. Pelvic girdle pain and pregnancy. RCOG patient information; published June 2015. Link
  4. Pelvic, Obstetric and Gynaecological Physiotherapy (POGP). Pregnancy related pelvic girdle pain and low back pain during pregnancy and after having a baby. POGP patient information. Link
  5. Liddle SD, Pennick V. Interventions for preventing and treating low-back and pelvic pain during pregnancy. Cochrane Database Syst Rev. 2015;(9):CD001139. Link
  6. Wu WH, Meijer OG, Uegaki K, et al. Pregnancy-related pelvic girdle pain (PPP), I: terminology, clinical presentation, and prevalence. Eur Spine J. 2004;13(7):575-589. Link
  7. Russell R, Dundas R, Reynolds F. Long term backache after childbirth: prospective search for causative factors. BMJ. 1996;312(7043):1384-1388. Link
  8. Howell CJ, Dean T, Lucking L, et al. Randomised study of long term outcome after epidural versus non-epidural analgesia during labour. BMJ. 2002;325(7360):357. Link
  9. Anim-Somuah M, Smyth RM, Cyna AM, Cuthbert A. Epidural versus non-epidural or no analgesia for pain management in labour. Cochrane Database Syst Rev. 2018;5(5):CD000331. Link
  10. NHS. Your post-pregnancy body. NHS website; page last reviewed 20 July 2026. Link
  11. NHS. Pregnancy, breastfeeding and fertility while taking ibuprofen. NHS website; page last reviewed 27 August 2025. Link
  12. NHS. Signs that labour has begun. NHS website; page last reviewed 9 November 2023. Link
  13. National Institute for Health and Care Excellence. Low back pain and sciatica in over 16s: assessment and management (NG59). NICE; 2016, last updated 29 July 2026. Link

This article is general information and is not a substitute for advice about your own situation. Please speak to your GP or specialist before making any change to your treatment.

Last checked: October 2026