A sudden, sharp, stabbing pain low in your belly or in your groin when you move, cough or roll over is most often round ligament pain. It is one of the most common complaints of the second and third trimester, it is uncomfortable, and it is not dangerous. Usually it settles on its own.
What the round ligaments do
You have two round ligaments, one on each side of the uterus, running from the uterus out to your pubic area and groin. Outside pregnancy they have very little to do.
In pregnancy they earn their keep. As your uterus grows heavier with your baby and your placenta, it gains momentum, so any sudden movement swings a much heavier weight around. The round ligaments are what hold the uterus centred in your pelvis while that happens, keeping it supported as you move.
Why it hurts
The ligaments are being pulled into a lengthened position and held there all day. When you then move suddenly, they pull and cramp as they fight to keep the uterus centred. That is the pain.
Movements that commonly set it off:
- Coughing, sneezing or laughing
- Standing up quickly
- Walking faster than usual
- Rolling over in bed
- Changing direction abruptly
What round ligament pain feels like
Most people describe a sudden, sharp, stabbing or cramp-like pain in the groin or the lower abdomen. It lasts seconds rather than minutes, and it stops when you stop moving.
Some feel a dull ache underneath, which is the ligaments sitting tight in their new lengthened position all the time.
It usually shows up in the right round ligament, though it can be the left, or both.
What helps
Round ligament pain is a normal part of pregnancy and most of the time it goes away by itself. These things take the edge off it:
Move slower. Most episodes are triggered by speed. Slowing down how you stand, walk and roll over prevents most of them.
Sleep on your side with support. A pillow between your bent knees and another under your belly stops the ligaments being dragged as you turn.
Brace your belly before you move. Before you cough, sneeze or stand, gently draw your navel in. That gives the ligaments a hand instead of letting them take the whole load.
Support the weight. Abdominal support garments take some pressure off the ligaments carrying the uterus.
Tilt your pelvis back during a spasm. Imagine tucking your tailbone under, flattening the curve through your lower back. That effectively shortens the round ligaments at the front and can ease the pulling sensation.
Belly taping. A physio can tape your abdomen to offload the ligaments. This is something we do in the clinic regularly during pregnancy.
When to get it checked
Round ligament pain is sharp but brief, it comes with movement, and it eases when you rest. Get seen the same day if any of the following apply:
- Pain that is constant rather than coming in short jolts
- Pain with bleeding, fluid loss, or any change in vaginal discharge
- Pain with fever, chills, or pain when passing urine
- Contractions that come regularly and do not settle
- Your baby moving less than usual, or you cannot feel movement
- Pain that wakes you or stops you walking
None of that means something is wrong. It means it is worth having someone look, and quickly.
While round ligament pain settles, staying gently active makes everything else feel easier — our Pilates Fundamentals for Pregnancy classes are physio-led and built for every trimester.
For the fuller picture, read round ligament pain in pregnancy. If the pain is not settling, book in with our pregnancy physiotherapy team in the Sydney CBD studio.
