Q&A: I have sharp pains behind my pubic bone. Is this labor?

by Dr. Gerard M. DiLeo

I am in my thirty-second week of pregnancy and am getting sharp pains directly behind my pubic bone that are constant and accompany a lot of pressure, but no back pain. Is this labor? I can't stand up without this pain.

This particular pain sounds like what's called symphysis pubis diastasis. Translated, this means that the joint between the two central pubic bones is opening a little. Progesterone, a hormone that rises considerably in pregnancy, relaxes this joint (as well as other joints—and the bowels too, causing the famous constipation of pregnancy). This opening up of the pelvic ring results in a larger circumference for the baby to pass through, increasing the chance of successful passage at the time of delivery. And since the pelvis is a ring structure, don't be surprised if the payback causes a crimping pain in the back, at the sacroiliac joints on either side of your lower middle back.

Urinary tract infections can be pretty sneaky in pregnancy, so any midline pain may invite a urinalysis or urine culture. An exam of your cervix to check for premature dilatation, although unlikely, may be prudent as well.

The pain is almost always harmless to you, and certainly harmless to the baby. Physical therapy may be an option. Insurance should pay for a visit to the physical therapist, so ask your health care provider to write you a prescription.

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