Is That Normal Pregnancy Pressure or Pelvic Organ Prolapse?
Written and reviewed by Anna McMaster, PT, DPT, PRPC
As your pregnancy progresses and your baby grows, your body goes through all kinds of changes. With those changes often comes an unfamiliar sensation: pressure in your pelvic area. While this is usually completely normal, it's natural to wonder: "Is this just part of pregnancy, or could it be something else, like pelvic organ prolapse?" Let's talk about how to tell the difference, so you can have peace of mind throughout your pregnancy.
Normal Pregnancy Pressure: What to Expect
If you're feeling a heaviness or pressure in your vaginal or pelvic area during pregnancy, you're definitely not alone. This is a common experience across all trimesters.
Why it happens: as your pregnancy progresses, your baby is growing steadily and your uterus is expanding to accommodate them. This expanding uterus puts increasing pressure on your lower body, including the muscles in your pelvic floor, which support your uterus, vagina, and bladder.
What normal pressure feels like:
A general feeling of heaviness in the pelvis or vagina
Mild discomfort that changes with position, often better when lying down
Pressure that develops gradually as your pregnancy progresses
Mild discomfort that doesn't interfere with daily activities
No visible bulging or tissue protruding from the vagina
Contributing factors to normal pregnancy pressure include your growing baby becoming heavier and putting pressure on your pelvic floor muscles, the hormone relaxin loosening your ligaments in preparation for childbirth, increased weight from the baby, placenta, blood volume, and enlarged uterus, and constipation, which is common during pregnancy.
Signs of Pelvic Organ Prolapse
While pelvic organ prolapse (POP) during pregnancy is uncommon, it's important to know the warning signs that distinguish it from normal pregnancy pressure.
Pelvic organ prolapse happens when one or more of the organs in the pelvis slip down from their normal position and bulge into the vagina. It can involve the uterus, bowel, bladder, or top of the vagina.
Signs that might indicate prolapse include feeling like there's something coming down into your vagina (it may feel like sitting on a small ball), feeling or seeing a bulge or lump in or coming out of your vagina, problems with bladder function such as leaking urine or not being able to empty the bladder completely, back pressure or pain that is more intense than typical pregnancy discomfort, a bulging or heavy feeling at the vaginal entrance that doesn't improve with rest, and difficulty controlling your bowel or bladder.
When to Call Your Doctor
It's always better to check with your healthcare provider if you're unsure about symptoms you're experiencing. Contact your doctor if you notice intense pressure that makes it difficult to walk or sit comfortably, a visible bulge at the vaginal opening, difficulty emptying your bladder or bowels, pressure that occurs alongside difficulty going to the bathroom, pain when urinating, or fever, or pelvic pain that is sharp enough that you have a hard time walking or talking.
Protecting Your Pelvic Floor During Pregnancy
Whether you're experiencing normal pressure or are concerned about prolapse, there are steps you can take to keep your pelvic floor healthy during pregnancy.
Pelvic floor exercises, including Kegels, can help strengthen the muscles that support your uterus, bowels, bladder, and rectum. Research supports regular pelvic floor muscle training during pregnancy for reducing symptoms of incontinence and supporting pelvic organ support. If you're not sure whether you're doing them correctly, a pelvic floor PT can assess your technique and make sure you're getting the most out of them.
Good posture and body mechanics also matter. Stand with your weight evenly distributed on both feet, keep your feet flat on the floor when sitting, tighten your pelvic floor muscles before and during any lifting, and turn your whole body rather than twisting.
Managing constipation is important too, since straining worsens pelvic pressure and puts unnecessary load on your pelvic floor. Stay well hydrated, eat plenty of fiber-rich foods, stay physically active with your provider's approval, and don't ignore the urge to have a bowel movement.
Pelvic Support Garments Worth Knowing About
For some women, pelvic support garments can provide meaningful relief from pressure and heaviness during pregnancy. These are products I recommend clinically and am not compensated to promote.
The Babybellyband with Groin Support Bands is a pregnancy-specific option that attaches to a maternity abdominal belt and provides upward and inward compression to the groin and pelvic area. It's particularly helpful for vulvar varicosities, pubic symphysis pain, and that heavy, bulging feeling associated with prolapse or hernia during pregnancy. In user studies, 94% reported pain relief and 75% were able to return to normal activity.
The LoveSteady Bottoms Up Support Shorts are athletic compression shorts with a built-in support hammock designed to lift and support the pelvic region from below. Created by a women's health physical therapist, they work well for active women who need support during exercise, prolonged standing, babywearing, or daily life. They can be used during pregnancy and postpartum, making them a versatile investment.
As always, check with your provider or pelvic floor PT before starting any new support garment, especially if you have been diagnosed with prolapse.
The Good News
For most women experiencing normal pregnancy pressure, symptoms will resolve after childbirth as your body recovers. If you are diagnosed with pelvic organ prolapse during pregnancy, conservative management options like a pessary are effective at improving symptoms and minimizing risk to your pregnancy.
The Bottom Line
Distinguishing between normal pregnancy pressure and pelvic organ prolapse isn't always easy, even for healthcare providers. That's why it's important to discuss any concerns with your doctor or midwife, who can perform an examination if needed. Some level of pelvic pressure is expected during pregnancy, especially as you move through the later trimesters. But unusual symptoms or significant discomfort should never be ignored. By staying informed, practicing pelvic floor exercises, and maintaining open communication with your healthcare team, you can protect your pelvic health during pregnancy and beyond.
For personalized support with pelvic floor health throughout your pregnancy, Amie offers programs designed by pelvic floor PTs for every stage of your journey.
References
American College of Obstetricians and Gynecologists. (2021). Physical Activity and Exercise During Pregnancy and the Postpartum Period. Committee Opinion No. 804. Obstetrics & Gynecology, 135(4), e178-e188.
Woodley S.J., et al. (2020). Pelvic floor muscle training for prevention and treatment of urinary and faecal incontinence in antenatal and postnatal women. Cochrane Database of Systematic Reviews, 5, CD007471.
Gyhagen M., et al. (2021). Prevalence and risk factors for pelvic organ prolapse 20 years after childbirth: a national cohort study in singleton primiparae after vaginal or caesarean delivery. BJOG: An International Journal of Obstetrics and Gynaecology, 120(2), 152-160.
Bø K., et al. (2015). Evidence-based physical therapy for the pelvic floor: Bridging science and clinical practice. Elsevier.