Pregnancy brings a lot of changes to your body, and some of them can feel surprising or uncomfortable. One common example is round ligament pain, which can cause sharp, sudden pain in the lower belly, hips, or groin as the uterus grows.^1,2,3,4

Round ligament pain often appears in the second trimester as the uterus expands and the ligaments supporting it stretch. The pain can feel intense, especially with sudden movement, coughing, sneezing, laughing, or rolling over in bed.^1,3

While round ligament pain is common, sharp abdominal pain during pregnancy should always be taken seriously. Here’s what round ligament pain can feel like, what causes it, how to find relief, and when to call your provider.

What Are Round Ligaments?

Ligaments link things together, and several ligaments hold the uterus in place inside the abdomen, like the way a spider web is held in the corner of a doorway. The spider web is intricate and strong, with many elaborate parts, but it might be attached to the actual corner in only three to five places.

The uterus is similar. It has eight different attachments, or ligaments, to other parts inside the body (four on each side), but it’s still somewhat free-floating. As the baby and uterus grow, the connecting ligaments begin to stretch and lengthen. This can lead to round ligament pain.^3,5,6

Related: Ways to Cope With Pregnancy Discomforts

What Is Round Ligament Pain?

Round ligament pain comes from the uterine ligaments having spasms as they stretch to accommodate the enlarging uterus during pregnancy. (See the above picture.) These pains or spasms can be quite sharp and intense. It’s more likely to happen during physical activity, as the uterus moves up, down, or side to side with body movements. But it can happen any time out of the blue.^2,6,7

What else is a painful spasm you might be more familiar with? A Charley horse in the leg. This comes from a muscle spasm, while the round ligament pain is from a ligament. Unfortunately, they both produce the same result: extreme, sharp, piercing pain that catches you off guard and makes you wish for immediate relief.¹⁰

Related: Second Trimester Checklist: What to Do in Weeks 13 to 27

What Causes Round Ligament Pain in Pregnancy?

As the uterine ligaments stretch and thicken along with the increased size of the baby and uterus, they become less flexible and tighter, like a stretched-out rubber band. When they’re tight, certain movements or positions of the mother can cause those ligaments to spasm. This pulls on local nerve fibers, causing sharp, knife-like, severe pain.^2,7,11

Common movements that can trigger round ligament pain during pregnancy include standing up too fast or turning to the side quickly, sneezing or coughing, or making any sudden movements in general.

Even laughing hard can cause a spasm! Also, turning over in bed too rapidly can shift the weight of the uterus.^2,7,11

What Does Round Ligament Pain Feel Like?

The first time you feel round ligament pain in your pregnancy, it may scare you into thinking there’s a problem because the pain can be so intense. Once your provider confirms it is round ligament pain, you can focus on ways to manage the discomfort.

Although there’s nothing wrong with your pregnancy, the pain is still a mighty force to deal with.

Round ligament pain usually leaves as fast as it appears, out of nowhere. It’s a sharp, stabbing pain that can take your breath away. The most common location of round ligament pain is on the right side of the hips and lower belly, but it can be felt on both sides. This pain can also shoot down into the groin area in pregnancy. Many women don’t realize that the pain in their groin during pregnancy might be round ligament pain.^2,6,11

Related: 6 Hip Opening Stretches During Pregnancy

When Does Round Ligament Pain Start?

It can happen at any time during pregnancy. Still, round ligament pain more commonly starts in the second trimester, months four through six (or 13 to 28 weeks). At this point in the pregnancy, you’ll begin to show more and realize your balance and center of gravity are changing. All these things are part of a normal pregnancy, including, unfortunately, round ligament pain.^7,8,11

How Long Does Round Ligament Pain Last?

Typically, round ligament pain begins in the second trimester and persists throughout the rest of the pregnancy. It’s usually not a constant pain, just one that comes and goes. It’s often a fleeting pain that strikes like lightning and then immediately recedes. Other times, it can be intermittent, or off and on. Some women experience round ligament pain throughout their pregnancy, while others hardly experience it at all.^2,7,8,11

Round Ligament Pain Relief

If you’re consistently having round ligament pain, a few simple changes may help reduce the pulling, stretching, or sharp discomfort. Always check with your provider before trying new exercises, medication, or heat therapy during pregnancy.^2,6,7,8,9,11

1. Avoid Sudden Movement

First, try to avoid making any sudden movements. Stand still and bend slightly at your hips if you feel a sneeze, cough, or big laugh coming. This will protect the round ligament from being pulled. When working or doing chores at home, make slower, more deliberate movements and change positions slowly.

2. Do Yoga and Stretches

Stretching exercises and yoga are great ways to help prevent and relieve round ligament pain. Make sure you’re doing the specific stretches for round ligament pain, as well as prenatal yoga. We still need to make sure we’re protecting you and the baby. Your Obstetrics provider (OB) can provide information about stretches and yoga.

3. Use Heat

Applying heat to the area of the round ligament where you feel pain is another way to help soothe it. You can use a heating pad or a warm bath. Your provider may also instruct you to use over-the-counter pain medication, such as Acetaminophen (Tylenol). However, you must work closely with your provider so they’re aware of any medication you’re using.

Related: Pregnancy-Safe Medications: A Comprehensive List

4. Wear a Maternity Belt

Maternity belts are lower back and abdominal support devices for pregnant women. They can also help keep your round ligaments from stretching too far. Follow your provider’s instructions for properly using a maternity belt.

5. Rest

One of the best treatments for round ligament pain during pregnancy is just plain old rest. Your body is doing an incredible amount of work to support your growing baby. Rest is always needed!

Related: Safe Exercise During Pregnancy: Dos and Don’ts

When To Call Your Doctor About Round Ligament Pain

Round ligament pain is common, but not every type of abdominal pain during pregnancy should be assumed to be round ligament pain.

If you feel sharp pains during pregnancy and are unsure where they’re coming from, contact your provider. Even when you’re not pregnant, abdominal pain can be a symptom of many different serious medical conditions and shouldn’t be ignored. Throughout your pregnancy, you’ll become familiar with your body’s changes and how it communicates with you. Once you’ve described your pain symptoms to your provider and have been diagnosed with round ligament pain, you can follow their recommendations for how to manage the pain.¹¹

There are some signs and symptoms that could indicate more of a complication with the pregnancy. If you see any of these in conjunction with abdominal pain, contact your provider immediately:^2,11

• Any new or different vaginal discharge, including blood
• Lower back pain or pressure after 30 weeks of gestation
• Consistent contractions that aren’t Braxton Hicks contractions
• Signs of an infection (fever, chills, nausea, or vomiting that isn’t related to morning sickness)
• Feeling dizzy or lightheaded
• Difficulty walking due to severe pain
• Extreme pain that persists
• Pain when urinating
• Abdominal cramping and vaginal bleeding together

Round ligament pain is common during pregnancy, but that does not mean you have to ignore it. Once your provider confirms the pain is related to your round ligaments, small changes like moving more slowly, resting, stretching, using heat safely, or wearing a maternity support belt may help.

If your pain is severe, persistent, new, or comes with bleeding, fever, dizziness, contractions, pain with urination, or unusual discharge, call your provider right away. Trust your body, and never hesitate to ask for guidance when something feels off.