Back Pain During Pregnancy
The short answer
Back pain affects approximately 50-70% of pregnant people and is most common in the second and third trimesters. It is usually caused by the shifting center of gravity, weight gain, hormonal changes that loosen ligaments, and postural adjustments as the belly grows.
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By Age
What to expect by age
Back pain in the first trimester is less common but can occur due to hormonal changes, particularly the hormone relaxin, which loosens ligaments and joints. Early pregnancy back pain is usually mild. If severe back pain occurs in early pregnancy, especially with bleeding, contact your provider to rule out other causes.
Back pain typically begins or worsens in the second trimester as the uterus grows and your center of gravity shifts. Lumbar (lower) back pain and posterior pelvic pain are the most common types. Staying active with gentle exercise like walking or prenatal yoga, wearing supportive shoes, using a pregnancy support belt, and sleeping with a pillow between your knees can all help.
Back pain often peaks in the third trimester. The additional weight, further postural changes, and preparation for labor all contribute. Warm (not hot) compresses, prenatal massage, gentle stretching, and pelvic tilts can provide relief. Avoid standing for long periods and consider seeing a physical therapist if pain is significant.
Back pain often improves after delivery but may persist for weeks to months as your body recovers. Breastfeeding posture, carrying your baby, and weakened core muscles can contribute. Gentle postpartum exercises focusing on core strength can help. Talk to your provider if back pain persists beyond a few months.
What Should You Do?
When to take action
- Dull, aching lower back pain that worsens with standing or activity and improves with rest
- Pain that developed gradually as your pregnancy progressed
- Mild to moderate pain managed with position changes, warm compresses, or gentle stretching
- Pain on one or both sides of the lower back or posterior pelvis
- Back pain is severe enough to interfere with daily activities or sleep
- Pain does not improve with rest, position changes, or home remedies
- You have numbness or tingling running down your legs
- Sudden severe back pain, especially with vaginal bleeding, which could indicate placental abruption or preterm labor
- Rhythmic back pain that comes and goes at regular intervals, which may be back labor or preterm labor contractions
- Back pain with fever, painful urination, or other signs of kidney infection
Sources
Related Resources
Trust your instincts. If something feels wrong, reach out to your pediatrician.
Worrying about your baby means you care. That is a good thing.
Related Maternal Concerns
Sciatic Nerve Pain in Pregnancy
Sciatica during pregnancy involves pain that radiates along the sciatic nerve, from the lower back through the buttock and down the leg. It affects roughly 1% of pregnant people and is caused by the growing uterus putting pressure on the sciatic nerve, hormonal changes loosening joints, or the baby's position.
Hip Pain During Pregnancy
Hip pain affects many pregnant people, particularly in the second and third trimesters. It is caused by the hormone relaxin loosening hip joints, weight gain changing your gait, the growing belly shifting your center of gravity, and the pressure of side sleeping. It is usually treatable with stretching, support pillows, and gentle exercise.
Back Labor Pain and Management
Back labor refers to intense lower back pain during labor, often caused by the baby being in an occiput posterior (OP or "sunny side up") position where the back of the baby's head presses against the birthing parent's spine. It occurs in about 25% of labors and can be managed with position changes, counter-pressure, water therapy, and other techniques.
Dealing with Abnormal Prenatal Screening Results
An abnormal prenatal screening result can be terrifying, but it is important to understand that screening tests are designed to cast a wide net and have significant false-positive rates. Most people with abnormal screening results go on to have healthy babies after further testing confirms the baby is fine. An abnormal screening is a reason for more information, not a diagnosis.
Pregnancy Over 35 (Advanced Maternal Age)
While pregnancy after 35 carries some increased risks (including chromosomal abnormalities, gestational diabetes, and hypertension), the vast majority of people over 35 have healthy pregnancies and healthy babies. The term "geriatric pregnancy" is outdated and does not reflect reality. With appropriate prenatal care and monitoring, outcomes are excellent.
Amniocentesis Questions and Fears
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