Overview: What’s Round Ligament Pain?
Did you feel a sharp pain in your lower abdomen or groin area when you sneezed, coughed, laughed, or moved suddenly? That might be due to round ligament pain in pregnancy. (1)
It’s a normal part of pregnancy, usually occurring in the second trimester. It’s caused by your growing belly stretching your ligaments (connective tissues on each side of the uterus). (1)(2)
As many as 10-30% of pregnant women experience this condition. (3)
Does Round Ligament Pain Affect Your Baby?
No. It’s unlikely that this condition will affect you or your baby. However, check with your OB/GYN if you experience severe pain, vaginal discharge, or other worrying symptoms. (2)
Do Non-Pregnant Women Experience Round Ligament Pain?
Although it can still happen, it’s unlikely. Non-pregnant women have firm, flexible round ligaments in their regular size. These ligaments aren’t stretched, so they’re unlikely to cause pain. (1)
Causes: How Pregnancy Affects Your Round Ligaments
The round ligaments are two rope-like connective tissues on each side of your uterus. (1)(4)
When you’re pregnant, hormones make them more elastic and looser. This allows them to stretch to accommodate your growing belly. (1)
These ligaments also help keep the proper position of your uterus even as it grows with your baby. (1)
However, you might experience pain when your round ligaments stretch. (1)(2)
Symptoms: What Does Round Ligament Pain Feel Like?
It’s often described as a stabbing or sharp pain, with sudden or involuntary movements such as coughing and sneezing. (2)
According to the APA (American Pregnancy Association), some pregnant women also experience pain in their groin area. (5)
In What Part Of Your Tummy Do You Feel Round Ligament Pain?
- One or both sides of your tummy or abdomen (2)
Diagnosis
- Physical exam
- Differential diagnosis to rule out other pregnancy abdominal pains
- Diagnostic tests, such as an ultrasound, to check for other pain sources, including varicocele (enlarged veins), endometriosis, or ovarian cyst
Duration
How Early Does Round Ligament Pain Start?
Most women experience this condition in the middle of their pregnancy. However, some might already feel the pain during the first trimester. (2)
When Does Round Ligament Pain Feel Worse?
It varies among pregnant women. However, your belly stretches the most during the third trimester. The pain may also become worse during this period.
When Does Round Ligament Pain Go Away?
It can go away with rest or with remedies, such as pregnancy-safe medications like acetaminophen (read about Tylenol in pregnancy here). Be sure to check with your OB/GYN before taking any medications during pregnancy. (1)
Does Round Ligament Pain Go Away After Delivery?
Yes. Your reproductive system gradually returns to its pre-pregnancy state after delivery. You can also expect the pain to resolve independently as the round ligaments shrink to their original size. (1)
Things That Can Worsen Round Ligament Pain
These can worsen the pain: (2)
- Lack of rest
- Continued movement
- Increase in abdominal pressure (e.g., laughing, sneezing, and coughing)
Can Round Ligament Pain Go Away Without Treatment?
Round ligament pain is often temporary and can even go away without treatment. You might only need to rest to relieve the pain. (1)
Treatment: How To Ease Round Ligament Pain In Pregnancy?
If pain persists, seek medical advice to rule out other conditions. Some ways to alleviate round ligament pain include: (1)
Pain Relief Options For Round Ligament Pain
Some ways to ease the pain: (1)
- Pregnancy-safe pain medications such as acetaminophen
- Warm bath or compress (with a heating pad)
- Use a pregnancy support girdle, maternity belt, or belly band
- Change positions slowly & avoid making sudden movements
- Pregnancy-safe exercises (e.g., stretching and flexing your hips, prenatal yoga, and swimming)
- Reduce intensity of exercise and activities (because these can stretch your ligaments)
- Get plenty of rest
- Elevate your feet
Try to monitor and determine your triggers so you can avoid them. For example, sleeping on your side, laughing hard, or sudden movements. (1)
What Is The Best Sleeping Position For Round Ligament Pain?
Consider putting a small, flat pillow under your tummy and lying on the side opposite where you feel the most pain. You might need some trial and error before finding the most comfortable position.
Prevention
- Avoid standing for long periods
- Rest as much as you can
- Avoid strenuous activities and exercise
- Change positions slowly instead of quickly (e.g., don’t stand up or roll over the bed in sudden motions)
- Try to stretch or bend before sneezing, laughing, or coughing
- Regular pregnancy-safe exercises in moderation
- Avoid lifting heavy objects
What Makes Round Ligament Pain Different From Other Pregnancy Pains?
- Can affect one or two sides but usually appears with a sudden movement (1)(2)
- Usually harmless to you and your baby. (2)
- Usually not accompanied by vaginal discharge or other symptoms (2)
- Likely to start around mid-pregnancy or during the second trimester (2)
Other pregnancy pains and how they might differ from round ligament pain: (2)(3)(4)
- Miscarriage – Pain or cramping in your lower abdomen, with fluid vaginal discharge (especially if there are blood clots) and loss of pregnancy symptoms (e.g., morning sickness symptoms such as nausea and vomiting)
- Ectopic pregnancy – Sharp, stabbing pain on one side of your abdomen, with possible pain in your shoulder tip, dizziness, brown (might be watery) discharge, and discomfort during urination or pooping
- Braxton Hicks contractions – Short-lasting, irregular contractions that are more uncomfortable than painful
- Placental abruption – Severe cramps in the second or third trimester, with lower back pain, vaginal bleeding, and contractions
- Preterm labor – Backache, pelvic pain, pressure in your vaginal area, and mucus plug or watery discharge
- UTI (urinary tract infection) – Dull ache on your back or lower stomach, burning sensation while peeing, strong urine smell, and urgent need to pee
- Endometriosis – Pelvic pain due to the growth of uterine lining cells outside your uterus
- Round ligament varicosity – Varicose veins on your round ligaments, causing pelvic pain plus possible pain and swelling in your groin area
- Pre-eclampsia – Sharp, persistent pain on the right side of your abdomen, with vision problems, severe headache, vomiting, and sudden swelling of your limbs and/or face
- Sexually transmitted infections and pelvic inflammatory disease – Pain on one or two sides of your abdomen, with possibly smelly discharge
- Appendicitis – Sharp pain in your lower right abdomen, with the diagnosis confirmed via ultrasound (e.g., an enlarged appendix)
- Kidney stones or gallstones – Sharp or dull and throbbing abdominal pain, with the stones detected or confirmed via ultrasound
Warning Signs & When To See A Healthcare Provider
Immediately seek medical advice for any of the following: (2)(4)
- Cramping or tightening of your abdomen
- Spotting or bleeding, especially during the third trimester
- Fever – temperature of 100.4°F (38°C) or higher
- Chills
- Nausea and vomiting (more severe than your usual morning sickness symptoms)
- Unusual vaginal discharge
- Lower back pain
- Severe pain that doesn’t go away after resting for 30 to 60 minutes
- Worsening abdominal pain
- Burning pain during urination
- Lightheadedness
- Contractions, especially if you have this at least four times per hour
You can see any healthcare professional from the obstetrics department or a women’s health and wellness center in addition to your OB/GYN.
References
(1) Chaudhry SR, Chaudhry K. Anatomy, Abdomen and Pelvis: Uterus Round Ligament. [Updated 2023 Jul 24]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan.
(2) https://www.tommys.org/pregnancy-information/pregnancy-symptom-checker/stomach-abdominal-pain-or-cramps-pregnancy
(3) https://books.google.co.uk/books?id=WBUoBgAAQBAJ&pg=PA104&lpg=PA104&dq=ligament+pain+american+college+of+obstetricians+and+gynecologists#v=onepage&q=ligament%20pain%20american%20college%20of%20obstetricians%20and%20gynecologists&f=false
(4) https://my.clevelandclinic.org/health/body/21646-round-ligament
(5) https://americanpregnancy.org/healthy-pregnancy/pregnancy-complications/round-ligament-pain-during-pregnancy/
