Round Ligament Pain

Round ligament pain is a sharp, stabbing or aching pain in the lower abdomen, hip, or groin during pregnancy, caused by the round ligaments — the bands of tissue that support the uterus — stretching as the uterus grows.

When it occurs

Round ligament pain is most common in the second trimester, typically from weeks 14-27, as the uterus expands rapidly. It is often triggered by sudden movements: rolling over in bed, standing up quickly, coughing, or sneezing. Some women describe a dull ache that lasts longer; others experience sudden, sharp pains that pass in seconds.

How it differs from SPD

Round ligament pain is the stretching of supportive tissue. SPD is a joint stability issue. They can coexist and can feel similar, which is why medical assessment matters if your pain is persistent or severe. Briefly:

• Round ligament pain tends to be sharp, brief, and triggered by movement.
• SPD pain tends to be aching, persistent, and worsened by asymmetrical leg movements.

What helps during sleep

Round ligament pain at night is typically worsened by rapid position changes. Strategies that help:

1. Move slowly when rolling over — pulling the knees together before turning reduces the ligament stretch at the point of movement change.
2. A bump support wedge or full-body pillow may reduce the ligament stretch when lying still by supporting the weight of the uterus from underneath.
3. Pillow between the knees keeps the pelvis level, reducing the rotation stress on the round ligaments when lying on your side.

What does not help

Round ligament pain does not respond to heat in the same way as muscle pain. Firm compression (a support belt) can help during the day but is not appropriate during sleep.

When to see your provider

Round ligament pain is normal and expected. If the pain is severe, persistent for more than a few minutes, accompanied by fever, heavy bleeding, or urinary symptoms, contact your midwife or OB. Persistent abdominal pain should always be assessed to rule out complications.

Always consult your midwife or OB about sleep positioning recommendations during pregnancy, especially if you have complications.