5 Common Pelvic Health Symptoms in Pregnancy

Congratulations — you’re pregnant!

You’ve probably heard stories from friends or family about morning (or all-day) sickness, heightened senses, or unusual cravings, and may be wondering which combination of symptoms you’ll experience. But there’s one area that often doesn’t get enough attention: your pelvic health during pregnancy.

It’s an important topic that’s part of many women’s pregnancy journeys—so let’s talk about it.

Summary of this article:

• How pregnancy influences the pelvic floor: Pregnancy places increased demand on these muscles, which may lead to tightness or overactivity.

• Five common pelvic health symptoms in pregnancy: frequent urination, urinary leakage, discomfort in the low back, hips, or pelvis, painful intercourse, and diastasis rectus abdominis (abdominal separation).

• How prenatal pelvic physiotherapy helps: Strengthening the connection between the pelvic floor and surrounding muscles can help manage symptoms and prepare for labour and delivery.

The Pelvic Floor

The pelvic floor is a group of muscles located at the base of the pelvis, connecting to the pubic bone, tailbone, sacrum, and sitting bones. When these muscles contract, they lift and support the pelvic organs (bladder, uterus, and bowels) and tighten the openings of the urethra, vagina, and anus. When they relax, these openings soften and release naturally.

Beyond organ support, the pelvic floor also plays key roles in sexual health, circulation, and core strength.

How Pregnancy Affects the Pelvic Floor

As pregnancy progresses, there’s an increased demand on the pelvic floor due to several changes in the body:

1. Anatomical and physiological changes

• Increased weight from your baby, placenta, uterus, and fluid

• A rise in total blood volume (up to 45% more)

• Growth of breast tissue and supportive fat stores

• Increased extracellular fluid and muscle development

These natural adjustments mean your pelvic floor must work harder to support the extra weight—typically 15–40 lbs of additional load depending on the individual and pregnancy.

2. Decreased activity of adjacent core muscles

The core includes the transverse abdominis, diaphragm, pelvic floor, and multifidus muscles. As the uterus expands, it can limit the ability of some of these muscles—especially the diaphragm and transverse abdominis—to contract effectively. As a result, the pelvic floor takes on more of the load throughout the day.

Take home: During pregnancy, the pelvic floor works overtime. Like carrying a weight constantly, the muscles can become tight or overactive (a “hypertonic pelvic floor”) if they don’t get a chance to rest and relax.

Five Common Pelvic Health Symptoms During Pregnancy

1. More frequent trips to the washroom

Rising hormones (such as progesterone and hCG) and increased body fluid levels make the kidneys work harder, often leading to more frequent urination during the first trimester. Things usually ease up in the second trimester, then return in the third as your baby places more pressure on your bladder. Some women may also notice slower flow or incomplete emptying.

2. Urinary leakage when laughing, coughing, sneezing, or exercising

This type of leakage, called stress urinary incontinence, is very common during pregnancy. Studies show that about 46% of women experience it during their first pregnancy and up to 66% in subsequent ones. The pelvic floor muscles work harder to manage increased pressure from the uterus and bladder, but can fatigue over time, leading to small leaks when pressure spikes. While common, urinary incontinence is not normal and can be treated.

3. Low back, hip, or pelvic pain

Roughly 3 out of 4 Canadian women experience pelvic girdle pain during pregnancy. This results from the additional weight and altered body mechanics that shift how forces are distributed across the pelvis and spine. The abdominal muscles also stretch and become less efficient, making deep core activation more challenging.

4. Pain or discomfort during intercourse

With the pelvic floor working harder to support pregnancy, these muscles can become tight and overactive, making sexual activity uncomfortable. Around 22–30% of women experience pain during intercourse in the second trimester. This can present as burning, pressure, or cramping, and may vary throughout the experience.

5. Diastasis Recti Abdominis (DRA)

DRA refers to the natural separation of the two sides of the “six-pack” (rectus abdominis) muscles as the linea alba stretches to accommodate the growing baby. Nearly 100% of women develop some degree of DRA by 35 weeks of pregnancy. While normal, learning strategies to support your core and linea alba can help promote healing and minimize dysfunction after birth.

How Prenatal Pelvic Physiotherapy Helps

Pelvic Health Physiotherapists are specially trained to help women maintain and optimize pelvic function during pregnancy, labour, and postpartum recovery. Through education, manual therapy, and exercise, these professionals help manage or prevent symptoms, improve coordination and flexibility, and support the body’s preparation for birth.

If you’re unsure whether Pelvic Health Physiotherapy could help with your symptoms, we’d be happy to guide you. Book a complimentary 15‑minute phone consultation with one of our specialized Pelvic Health Physiotherapists to discuss your concerns and find the best next steps for your care.