Round ligament pain in pregnancy

My belly aches sometimes. Is this normal?

Yes. While you're pregnant, it's quite normal for your lower tummy to ache. This aching, as opposed to cramping, is caused by your belly stretching as your uterus expands.

Hormones trigger the muscles and ligaments (the tough, flexible tissues that connect your bones) that support your uterus (womb) (Aquilera 2005, Davis 1996) to be more flexible. This causes an ache that is often called round ligament pain.

You'll probably feel the ache when you're getting up from a bed or chair, when you cough or when you get out of the bath. You may also ache when your baby's head engages in the later stages of pregnancy. It is thought to be more common in second or later pregnancies.

When should I call my doctor or midwife?

Call your doctor any time the aching in your belly is accompanied by:

• sharp pain or cramping
• bleeding
• fever and chills
• a loss of fluid from your vagina
• pain when you wee
• a feeling of faintness

What can I do to relieve my aching belly?

Sit down and relax. Resting comfortably should help. If sitting doesn't help things, try resting on your hands and knees or leaning forwards over the back of a sofa.

Moving slowly and smoothly from a sitting or lying position can also help. Getting up slowly gives your muscles time to adapt and support you before you change position. Try tilting your pelvis backwards by slumping your back before you stand up (Andrews and O’Neill 1994).

Sometimes a support belt or large elasticated tubular bandage (tubigrip), specially designed for pregnancy, can help. A belt will take some of the weight of your baby off your tummy muscles. Your midwife or a physiotherapist will be able to advise you.

Are there any other causes of pain?

Aching in the lower belly can sometimes be a sign of a urine infection (Chandraharan and Arulkuma 2008, Vernami et al 2010). This may be accompanied by a fever and a feeling of being unwell, or pain when you wee. See your doctor or midwife if you're not sure. They will be able to test your urine for signs of infection.

If you feel pain on or around your pubic bone at the front, you may be suffering from symphysis pubis dysfunction (SPD). SPD is a condition to do with particular ligaments in your pelvis. If you think that this may be a problem, talk to your doctor or midwife, or ask to be referred to a physiotherapist.