What Is Round Ligament Pain?

Occurring in 10% to 20% of pregnancies, round ligament pain (RLP) is a common cause of discomfort in pregnancy.

Usually beginning at the end of the first trimester or the start of the second trimester, RLP can feel like a brief sharp pain in the lower abdomen or groin on one or both sides, or it can be a longer-lasting dull ache.

RLP is not usually dangerous for mother or baby, but can have similar symptoms to other conditions that are more serious, so pain during pregnancy should not automatically be dismissed as RLP.

Symptoms

The symptoms of RLP include:

• A sudden, brief, sharp pain on one or both sides on the lower abdomen or hip area
• Pain on one or both sides of the lower abdomen that comes on suddenly with movement or changing positions
• Discomfort in the lower abdomen on one or both sides
• Pain or discomfort that goes down into the groin
• A dull ache on one or both sides of the lower abdomen

RLP can be triggered by:

• Walking
• Standing up quickly or other sudden movement
• Rolling over in bed
• Coughing
• Sneezing
• Laughing
• Getting out of bed, out of the bath, or up from a chair
• An active day

When to Call Your Healthcare Provider

While round ligament pain is not usually harmful, its symptoms can be similar to other conditions that are.

Call your healthcare provider if you experience:

• Fever or chills
• Intense pain or cramping
• Bleeding
• Unusual vaginal discharge
• Premature contractions
• Painful urination
• Cloudy or foul-smelling urine
• Nausea or vomiting with abdominal pain
• Lightheadedness or dizziness
• Difficulty walking
• Low back pain (especially if not previously experienced) and/or pressure in the pelvic area
• Pain that doesn’t subside with rest
• Long-lasting pain
• More than four contractions in an hour (even if they are not painful)
• Concern about any other symptoms

Diagnosis

Diagnosis for RLP is based mainly on symptoms, and sometimes a physical exam.

If other symptoms are present, such as bleeding, the healthcare provider may order or perform more testing, such as an ultrasound, to check for another cause for the pain and symptoms.

Causes

During pregnancy, the uterus grows from 70 g to 1,110 g. It changes from a pelvic organ into an intra-abdominal organ by about 12 weeks gestation. By 20 weeks gestation, the uterus can be felt at belly-button level. This is a lot of growth in a relatively short amount of time.

Attached at the top and sides of the uterus, extending to the bones of the pelvis, are two ligaments (one on each side). These ligaments support the uterus and stretch as the uterus grows.

When not during pregnancy, these ligaments are short, firm, and flexible. During pregnancy, they get softer, stretch, and become under tension as the uterus becomes bigger.

These ligaments tighten when the pregnant person moves, which causes temporary pain. This pain can be sharp and sudden with a movement such as getting out of bed, or it can be dull and achy, such as after a busy, active day.

Treatment

RLP will generally resolve on its own in the third trimester or after the baby is born. It does not usually require any specific treatment, but there are things that can be done to ease the pain and discomfort or prevent it from occurring. These include:

• Rest, both when there is pain and as a general habit
• Avoid strenuous activity or prolonged periods of activity
• Avoid rapid or repetitive movements
• Change positions slowly
• Take a warm (not hot) bath
• Use a maternity support belt
• Flex hips before coughing or sneezing
• Gently stretch
• Rest on one side with knees bent and pillows between the legs and under the belly for support
• Try to avoid specific movements that trigger RLP
• Keep active with moderate exercise (if deemed safe by a healthcare professional)
• Swim or do water exercises
• Avoid laying flat on the back
• For a sudden pain in the abdomen, bend forward to the point of pain to relieve tension and relax the tissue

If these do not provide relief, acetaminophen can be taken, if okayed by a healthcare provider.

A Word From Verywell

Round ligament pain is an uncomfortable but normal pregnancy experience in response to your growing uterus. It will usually go away on its own by the third trimester of pregnancy.

In the meantime, the discomfort can be managed with controlled movements, lots of rest, and acetaminophen if recommended by your healthcare provider.

If you are experiencing symptoms in addition to RLP, or are concerned, check in with your healthcare provider.