Postpartum Pelvic Pain: What’s Normal & When to Get Help
Postpartum Pelvic Pain: What’s Normal & When to Get Help
Did you know that because of the stress that pregnancy places on the body, women who are pregnant can undergo a range of postpartum physical conditions? (Postpartum refers to occurring in, or during the period following childbirth). Indeed, as our Pain Doctors regularly explain to patients, after childbirth: “around 1 in 4 women have some pelvic pain at 3 months after having a baby. That’s common. And as many causes of these pains naturally improve, 1 in 10 women still have pain [in their pelvic joints, nerves and muscles] by 8 months after the birth” [1]. And this is the time to get help by booking an in-person or online appointment with a Pain Consultant. They will devise a Holistic Personalised Treatment Plan that may include a range of different types of treatments, therapies and injectables.
The aforementioned pain scenario is brought about via:
- The necessary stretching of the pelvic floor muscles and nerves as the baby moves through the canal
- Pressure on the pelvic floor owing to the stress of carrying a baby during pregnancy, and
- Irritated pelvic nerves (after a c-section) [1]
Moreover, in addition to the aforementioned, our Pain Consultants also inform patients that over 27% of women suffer from what is known as ‘late dyspareunia,’ that is to say, painful intercourse 12 months post-delivery [1].
Causes of Post-Pregnancy Pelvic Pain
Here at the London Pain Clinic, we understand that: “pregnancy and birth involve a wide variety of changes to your body, posture, pelvis, vagina and hormones. These changes are both essential to life and challenging, especially for some women. Pelvic pain from muscles, ligaments or joints (pelvic girdle pain) is common during pregnancy. Sometimes pelvic girdle pain persists after delivering your baby, or begins after having a baby” [1]
Of note, our Pain Doctors are very mindful that many women have slight postural imbalances (in relation to the way they stand and sit), right from an early age. Prior to becoming pregnant, such imbalances would have only caused slight issues. However, due to carrying the immense weight of a baby in the womb, the pressure and laxer ligaments of pregnancy, and the process of giving birth, such postural imbalances can become provoked [1].
Vaginal Elasticity, the Birth Process & Vaginal Prolapse
Throughout a woman’s pregnancy (which is subject to physical and hormonal changes); and particularly when giving birth via the vagina, the tissues in the vagina stretch considerably in order to prep and ready the body to give birth. For those who have delivered their baby via the vagina, there will have been some transformations as to the way in which their organs and tissues are positioned within the pelvis [1].
And whilst some new mothers do not suffer any symptoms, others may experience symptoms on a scale from mild to extremely troublesome. These experiences include:
- Pain in the pelvis
- Pain whilst having sexual intercourse
- Urinary incontinence
- Faecal incontinence
- A feeling of ‘dragging’ or heaviness within the vagina (particularly when sneezing, coughing, of lifting something heavy)
Of note, pelvic pain after birth is more commonplace if:
- A baby is born above average size
- A woman’s vaginal tissue is not very stretchy,
- Instruments (vacuum cup or forceps) are required for delivery [1]
Vaginal Tissues
Vaginal birth is far easier when these tissues are flexible. Yet, there is no guarantee that post-birth, the vaginal tissues will completely return to normal. And in this scenario, vaginal prolapse could be more likely [1].
Pubic Symphysis
In a normal vaginal delivery when giving birth stretched the pelvic joint (in the middle of the front of the pelvis), peliv instability and pelvic pain can result [1].
Episiotomy & Vaginal Tears
Larger tears may be linked to ongoing pain, whilst generally speaking, Grade 1 and 2 tears normally heal on their own. However, many of our patients visit out Specialist Physiotherapist for guidance and advice [1].
With regard to episiotomy: “recovery can be painful and some women may develop pudendal neuralgia, which is nerve damage that causes intense post-episiotomy pain and long-term pelvic discomfort. Episiotomy pain can intensify when you sit, walk, or go to the bathroom” [2].
Breastfeeding Hormones
When a woman breastfeeds, her oestrogen levels are low. This renders the vaginal skin drier or thinner. Moreover, breastfeeding hormones can add to the new mother’s pain by keeping the ligaments loose and soft [1].
References
[1]. Pelvic Pain Foundation of Australia (2025). “Pelvic Pain After Pregnancy.”
[2]. Advanced Reconstruction (225). “Understanding Episiotomy Pain and Perineal Tears.”