Round Ligament Pain in Pregnancy: Why It Happens and What to Do About It

That sharp pulling pain on the side of your belly during pregnancy is round ligament pain. Here is what is causing it, why it catches mamas off guard, and what actually helps.

It tends to catch mamas off guard, especially in the second trimester. You roll over in bed, stand up too quickly, sneeze, or cough, and suddenly there is a sharp, stabbing pain on one or both sides of your lower belly, sometimes shooting into your groin. It lasts a few seconds, maybe a minute, and then fades.

That is round ligament pain. It is one of the most common pregnancy complaints, affecting anywhere from 10 to 30% of pregnancies. And most women who experience it have never heard of a round ligament before.

This post explains what the round ligaments actually are, why they become painful during pregnancy, what is happening in the surrounding system when that pain appears, and what helps beyond being told to move more slowly.

What Are the Round Ligaments?

Your round ligaments are two thick, rope-like bands of fibrous tissue, each approximately 10 to 12 centimeters long. They run from the top and sides of the uterus through the inguinal canal, which is the passage in your lower abdominal wall, and into the labia.

Their job is to hold the uterus in position. In a non-pregnant body, they do that quietly. You are not aware of them under normal circumstances because they are not under significant stress.

Pregnancy changes that entirely.

Over nine months, the uterus expands from roughly the size of a pear to the size of a watermelon. The round ligaments stretch continuously to accommodate that growth, and as they stretch, they become thinner, more taut, and more reactive to sudden forces. Under normal circumstances a ligament contracts and relaxes slowly and gradually. When a sudden movement causes a rapid contraction of an already stretched ligament, that is when you feel it.

When Does Round Ligament Pain Most Often Occur?

Round ligament pain is most common in the second trimester, typically between weeks 14 and 27, though it can begin in the late first trimester and continue into the third trimester for some women. This timing is not coincidental.

The second trimester is when the uterus grows out of the pelvis and into the abdominal cavity. That growth period places the round ligaments under their most significant stretch, which is why symptoms peak during this window. The larger the uterus becomes, the more any sudden movement amplifies the tension on these structures.

Women who have had previous pregnancies or abdominal surgery may notice round ligament pain earlier in subsequent pregnancies, as the ligaments have been stretched before and may be more reactive sooner.

What Triggers It

Round ligament pain is almost always triggered by a sudden movement that causes the ligament to contract rapidly against its already-stretched state. Common triggers include:

Rolling over in bed, particularly the quick rotational movement of getting from one side to the other.

Standing up quickly from sitting or lying down.

Sneezing, coughing, or laughing, all of which create a sudden increase in intra-abdominal pressure that pulls on the ligaments.

Walking faster than usual or breaking into a jog unexpectedly.

Reaching across the body or twisting the torso quickly.

The pain is typically brief, lasting seconds to minutes, and resolves on its own when the movement stops and the ligament relaxes. If pain lasts longer than a few minutes, is severe, or is accompanied by other symptoms, it deserves evaluation from your OB or midwife rather than being assumed to be round ligament pain.

Why the Round Ligaments Do Not Work Alone

This is the piece most women are not told, and it matters for understanding why round ligament pain can sometimes feel like more than a simple sharp twinge.

The round ligaments are connected to your pelvis, your hip flexors, and your lower spine. They do not exist in isolation. When they are under significant tension, the surrounding structures respond. The muscles of the pelvis and lower abdomen tighten to stabilize the area. The hip flexors, already under increased demand from the postural changes of pregnancy, take on more tension. The lower spine and sacrum, which anchor much of the lumbopelvic system, shift in response to the altered tension pattern.

This means that for some women, round ligament pain is not just a fleeting sharp sensation. It is a signal that the whole system supporting the uterus is under strain. The pain may come and go quickly, but the underlying tension, the tightened muscles, the compressed hip flexors, the loaded sacrum, persists between episodes and can contribute to a broader pattern of pelvic and lower abdominal discomfort throughout the day.

Women who are also managing SI joint pain or sciatica alongside round ligament pain are often experiencing different expressions of the same underlying picture: a lumbopelvic system that is under significant structural and hormonal demand and needs support.

Round Ligament Pain vs. Other Pregnancy Pain

Because round ligament pain shoots into the groin and sometimes the hip, it is frequently confused with other pregnancy pains. Here is how to tell them apart.

Round ligament pain is felt on the sides of the lower belly, one side or both, and shoots downward toward the groin. It is sharp and brief, triggered by sudden movement, and resolves quickly with rest.

SI joint pain is felt at the base of the spine, typically deep and one-sided, centered around the posterior superior iliac spine on one side. It is a sustained ache rather than a brief sharp sensation and tends to be worse with weight-bearing activities, transitions, and rolling over in bed.

Sciatica follows the path of the sciatic nerve, running from the lower back through the glute and into the leg. It tends to be more persistent, may include tingling or numbness, and travels further down the body than round ligament pain typically does.

Braxton Hicks contractions involve the whole uterus tightening and are felt as a general tightening across the abdomen rather than a sharp, localized side pain.

Preterm labor can sometimes be mistaken for round ligament pain, particularly if contractions are mild. If you are experiencing pain that comes and goes in a regular pattern before 37 weeks, contact your OB or midwife. Timing the sensations and noting whether they have a rhythm is the most practical way to distinguish them.

What Actually Helps

The standard advice for round ligament pain is to move slowly, change positions gradually, and rest when it occurs. All of that is valid. But for women whose round ligament pain is frequent, intense, or happening alongside other pelvic discomforts, there is more that can be done.

Slow down your transitions. The most practical immediate change. When getting out of bed, roll to your side first, then push up slowly rather than sitting straight up. When standing, take a beat before moving. Giving the ligaments time to adjust rather than being snapped to attention makes a significant difference in frequency.

Support your bump during movement. Placing a hand under your belly when you sneeze, cough, or stand up reduces the sudden downward pull on the round ligaments that triggers the pain. A maternity support belt can provide similar support during longer periods of walking or activity.

Hip flexor and pelvic floor awareness. Because the surrounding structures are often contributing to the tension pattern, working with a pelvic floor physical therapist to address hip flexor tightness and pelvic floor coordination can reduce the baseline tension on the entire system, making the round ligaments less reactive.

Warm compresses. For the aching discomfort that lingers after an episode, a warm compress applied to the lower abdomen can relax the surrounding musculature and provide relief. Avoid ice on the abdomen during pregnancy.

Chiropractic care. Because the round ligaments connect to the uterosacral and broad ligament complex, and because the pelvis and sacrum are involved in the overall lumbopelvic tension pattern, chiropractic care that addresses sacropelvic alignment can reduce the background tension that makes round ligament episodes more frequent and more intense.

The Webster Technique specifically includes assessment and gentle work on the round ligaments and the surrounding soft tissue structures of the pelvis. By addressing the tension and imbalance in these structures, rather than just waiting for the ligaments to stop hurting, it creates a more stable and comfortable pelvic environment for both the mama and the baby.

When to Contact Your Provider

Round ligament pain on its own is not dangerous and does not affect your baby. But some symptoms alongside lower abdominal pain deserve a call to your OB or midwife.

Contact your provider if:

The pain lasts longer than a few minutes and does not resolve with rest.

The pain is severe or is getting progressively worse.

You have pain alongside vaginal bleeding, fever, chills, or painful urination.

You notice a regular rhythm or pattern to the pain, which could indicate contractions.

You have pain alongside significant lower back pain, leg numbness, or weakness.

Your provider can rule out other causes of abdominal pain in pregnancy and give you confidence about what you are experiencing.

You Do Not Have to Just Breathe Through It

The most common thing women are told about round ligament pain is that it is normal and there is not much to do about it. And while round ligament pain is a normal part of pregnancy, that does not mean it has to be a constant interruption.

Understanding what is happening in your body, addressing the surrounding tension patterns that make it more frequent, and giving your pelvis the structural support it needs through this season of change can meaningfully reduce how often and how intensely you feel it.

Your body is doing something extraordinary. It deserves support to do it as comfortably as possible.

Ready for Support?

At Heal Within Chiropractic in Schaumburg, IL, Dr. Desiree Lombos is Webster Technique Certified and an ICPA member with extensive experience supporting pregnant women through every stage of pregnancy. If round ligament pain is a regular part of your day, we would love to help.

Schedule Your Complimentary Prenatal Consultation Today →

Related Reading

• SI Joint Pain in Pregnancy: What It Is and What Actually Helps

• Prenatal Chiropractic Care: What Every Pregnant Woman Needs to Know

• Postpartum Chiropractic Care: What Your Body Needs After Baby

Frequently Asked Questions

What does round ligament pain feel like? Round ligament pain is typically described as a sharp, stabbing, or pulling sensation on one or both sides of the lower abdomen, sometimes shooting into the groin or hip. It usually lasts only a few seconds to a couple of minutes and is triggered by sudden movements like rolling over, standing up quickly, sneezing, or coughing.

When does round ligament pain start? Round ligament pain most commonly begins in the second trimester, between weeks 14 and 27, as the uterus grows out of the pelvis and the round ligaments come under increased stretch. It can begin in the late first trimester and for some women continues into the third trimester.

How common is round ligament pain in pregnancy? Research indicates that round ligament pain affects between 10 and 30% of pregnancies, making it one of the most common sources of second-trimester discomfort.

Is round ligament pain dangerous? Round ligament pain itself is not dangerous and does not affect the baby. It is a normal response to the stretching demands of a growing uterus. However, severe pain, pain that lasts more than a few minutes, or pain accompanied by bleeding, fever, or regular contractions should be evaluated by your OB or midwife.

How do I tell the difference between round ligament pain and preterm labor? Preterm labor contractions typically have a rhythm and occur at regular intervals, while round ligament pain is triggered by sudden movement and resolves quickly. If you are experiencing pain that comes and goes in a pattern before 37 weeks, time the sensations and contact your OB or midwife.

Can chiropractic care help with round ligament pain? Yes. The Webster Technique includes assessment and gentle work on the round ligaments and surrounding pelvic soft tissue structures. Chiropractic care that addresses sacropelvic alignment and pelvic balance can reduce the background tension that makes round ligament episodes more frequent and more intense.

References

1. American Pregnancy Association. Round ligament pain during pregnancy: causes and treatment. Updated 2026. https://americanpregnancy.org/pregnancy/round-ligament-pain-during-pregnancy/

2. Cleveland Clinic. Round ligament pain. Updated 2026. https://my.clevelandclinic.org/health/symptoms/21642-round-ligament-pain

3. Kesmodel, U.S. & Andersen, C.S. Unexplained abdominal pain in pregnancy and the use of the term round ligament pain: a single centre New Zealand pilot cohort study. Research Square. 2022. https://doi.org/10.21203/rs.3.rs-1862635/v1

4. Movahedi, M., et al. Management of acute abdomen in pregnancy: current perspectives. International Journal of Women's Health. 2009. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2971724/