Groin pain and round ligament pain: what is usual and what needs checking

If you have felt a sharp pull in your lower belly or groin when standing up, coughing or turning in bed, you have probably met round ligament pain. It often feels alarming but is usually harmless.

What is the round ligament?

The womb is held in place by round ligaments that run on both sides towards the groin. As the womb grows in pregnancy, these ligaments stretch and lengthen. With sudden movements the ligament can tighten quickly, causing a short, sharp or pulling pain.

What does it feel like?

• Usually in the lower belly towards the groin, on one or both sides
• Brief: a few seconds, sometimes a few minutes
• Triggered by sudden movement (standing up, turning, coughing, sneezing, laughing)
• Most often seen after week 12 in the second trimester, and may continue in the third
• Eases with rest and does not come with bleeding or fever

Things that may help

• Move slowly: Take your time getting up from bed or a seat and changing position.
• Before coughing or sneezing: Bend your knees slightly and bring your hips forward; this may lessen the pull on the ligament.
• Change position: When pain starts, rest, lean slightly towards the painful side or draw your knees towards your belly.
• Warmth: A warm shower or gently warm compress may soothe.
• Gentle stretching: With your doctor's approval, pregnancy stretching, yoga or exercise in water can help.
• Maternity support belt: A belt that supports the belly from below gives comfort to some people.
• Side sleeping: A pillow under your belly and between your knees helps at night.
• Ask your doctor before taking any medicine for the pain.

Other pains around the groin and pelvis

Some people feel pain at the front of the groin or around the tailbone when walking, climbing stairs, lifting a leg or turning in bed. This may be due to loosening of the pelvic joints (pelvic girdle pain). It helps to tell your doctor or physiotherapist; support and exercises help most people.

Which pains should be assessed differently?

Not every lower belly pain is round ligament pain. If any of the following applies, your doctor should check whether the pain has another cause.

When to contact your doctor

• If the pain is severe, does not go away or does not ease with rest
• If you have vaginal bleeding, fluid leaking or unusual discharge
• If fever, chills, burning on passing urine or blood in the urine come with it
• If you have regular, increasingly frequent cramp-like pains (especially before 37 weeks)
• If you have severe abdominal pain with nausea, vomiting or weakness
• If you notice reduced baby movements
• If you faint or have very severe sudden abdominal pain, heavy bleeding or shortness of breath, call 112 (or your local emergency number) or go to the nearest emergency room

What you can do

Making a short note of when the pain comes and what triggers it reassures you and makes talking to your doctor easier. For regular pains, you can use the contraction timer to record frequency and length. Following your baby's movements with the kick counter is another option.

This article is for information only; your doctor's or midwife's advice for your own situation always comes first.