Round ligament pain

A sudden sharp pain low down in your tummy or groin can be unsettling during pregnancy, particularly if you were not expecting it. One possible cause is round ligament pain, which happens as the ligaments supporting the womb stretch as pregnancy progresses.

Round ligament pain is commonly felt as a sharp or stabbing pain on one or both sides of the lower abdomen or groin. It can be triggered by movement, such as getting up quickly, rolling over in bed, coughing, sneezing or laughing.

Although round ligament pain itself is a recognised pregnancy symptom, abdominal pain can have many causes. New, severe, persistent or worrying pain should not automatically be assumed to be ligament pain. Your midwife, GP or maternity unit can help assess what is happening.

What is round ligament pain?

The round ligaments are bands of connective tissue that help support the uterus and attach it to the pelvis.

As the uterus grows during pregnancy, these ligaments stretch. Tommy’s explains that this stretching can cause the ligaments to spasm, producing pain in the lower abdomen or groin.

The NHS also lists pain at the sides of the abdomen caused by the expanding womb as a common pregnancy symptom and refers to this as round ligament pain.

It usually becomes noticeable during the second trimester, although some people experience it earlier.

What does round ligament pain feel like?

Round ligament pain is often described as sharp, stabbing or jabbing rather than as a constant dull ache.

You may feel it:

low down in your abdomen
around the sides of your bump
in the groin
on one side or both sides

Tommy’s notes that sudden movements can make the pain worse. Standing up from sitting, turning over in bed, coughing, sneezing or laughing can all trigger it because these movements can suddenly stretch the ligaments or increase pressure in the abdomen.

The sensation and intensity can vary from person to person. If your pain does not fit this pattern, lasts for a long time, becomes severe or comes with other symptoms, contact your maternity team rather than trying to identify the cause yourself.

When does round ligament pain usually happen?

Round ligament pain is particularly associated with the second trimester as the uterus continues to expand.

NHS pregnancy guidance lists pains at the sides of the abdomen caused by the expanding womb among symptoms experienced during the second trimester. Tommy’s similarly says round ligament pain usually begins during the second trimester, although some people notice it earlier.

There is no exact point at which everyone develops it. Some people may barely notice ligament discomfort, while others experience repeated episodes.

Having no round ligament pain is not a sign that anything is wrong.

What can trigger round ligament pain?

Movements that quickly change the position of your body can suddenly stretch the ligaments.

Common triggers described by Tommy’s and NHS maternity guidance include:

standing up quickly
rolling over in bed
coughing
sneezing
laughing
other sudden movements

You may begin to recognise particular movements that bring the pain on.

Abdominal and pelvic discomfort in pregnancy can also have other causes, including constipation, trapped wind and pelvic girdle pain. Similar locations do not necessarily mean the underlying cause is the same.

What can help with round ligament pain?

If a healthcare professional has confirmed that your symptoms are consistent with round ligament pain, simple changes may make episodes easier to manage.

NHS guidance suggests that resting with your feet up may help. Royal Berkshire NHS Foundation Trust also advises moving and changing position slowly rather than rushing, resting on your side with a pillow between your knees, and supporting underneath your bump when coughing or sneezing.

A warm bath may sometimes ease discomfort.

If you feel you need pain relief, speak to your midwife, GP or pharmacist about what is appropriate during pregnancy rather than starting or changing medication based on general online advice.

You do not need to push through pain. If particular activities repeatedly make it worse or the discomfort is interfering with normal daily life, mention this to your maternity team.

Round ligament pain or pelvic girdle pain?

Round ligament pain and pregnancy-related pelvic girdle pain can both cause discomfort around the lower abdomen, pelvis or groin, but they are not the same condition.

RCOG describes pelvic girdle pain as pain affecting the joints of the pelvic girdle. It can be felt around the pubic area, lower back, hips, groin, thighs or knees. Walking, climbing stairs, standing on one leg and turning over in bed can make it worse.

Round ligament pain is more typically described as a sharp or stabbing pain caused by stretching of the ligaments supporting the womb.

Because symptoms can overlap, you do not need to work out the diagnosis yourself. Tell your midwife or doctor if pelvic or abdominal pain is persistent, affecting your mobility or worrying you.

Could abdominal pain mean something else?

Yes. Not every pain in pregnancy is round ligament pain.

Tommy’s notes that abdominal pain or cramps can have several causes during pregnancy. Some are common and relatively minor, while others need medical assessment.

This is why the pattern of your pain and any accompanying symptoms matter. Pain that feels different from your usual symptoms, is severe, does not settle or occurs alongside other concerning symptoms should be discussed with a healthcare professional.

If you are uncertain about abdominal pain in pregnancy, it is reasonable to contact your midwife or maternity unit for advice.

When to get professional advice

Contact your midwife, GP or maternity unit if you have abdominal pain and are worried about it, particularly if the pain is severe, persistent, getting worse or feels different from discomfort you have experienced before.

Seek prompt maternity advice if abdominal pain happens with vaginal bleeding or spotting, regular tightenings or contractions, unusual vaginal discharge or fluid loss, pain or burning when you urinate, or other symptoms that concern you. Abdominal pain has several possible causes in pregnancy and should not automatically be attributed to round ligament pain.

If pain is making it difficult to move or carry out normal activities, speak to your midwife or doctor. Pelvic girdle pain and other musculoskeletal causes may need assessment and support.

Contact your maternity unit for urgent pregnancy concerns. NHS 111 can advise if you cannot reach your maternity service or are unsure where to seek help. Call 999 in a life-threatening emergency.