Postpartum

Pubic Bone Pain After Birth: The SPD Story

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Pubic bone pain that hurts to walk after birth is usually symphysis pubis dysfunction, a strain of the joint at the front of the pelvis loosened by pregnancy hormones. Most cases ease over the first several weeks, and pelvic floor physical therapy, supportive belts, and paced activity help it settle.

Last updated: July 2026

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What is symphysis pubis dysfunction?

Symphysis pubis dysfunction is pain and instability at the pubic symphysis, the cartilage joint that links the two halves of the pelvis at the front. During pregnancy, the hormone relaxin softens this joint so the pelvis can open for birth, loosening a normally rigid structure. After delivery the joint is often left tender, and weight-bearing on one leg — walking, climbing stairs, getting out of a car — pulls the two sides apart and triggers a sharp or grinding pain. Clinicians group it with pregnancy-related back pain under the umbrella of pelvic girdle pain. The discomfort is real, mechanical, and treatable, not a sign of permanent damage.

Why does it hurt to walk after delivery?

Walking hurts because each step loads the pelvis through one leg at a time, shearing the still-loosened symphysis. The relaxin and progesterone of pregnancy take weeks to clear after birth, so the joint stays lax while the surrounding muscles are also weak and stretched. Movements that split the legs — stairs, getting in and out of bed, lifting your baby from a low crib — tend to be the worst. Pain often centers at the pubic bone but can radiate into the groin, inner thighs, or lower back, which is why some new mothers describe it as hip pain. The intensity usually tracks with activity and eases with rest and support.

How long does pubic bone pain last?

Most postpartum pubic bone pain improves substantially within the first 12 weeks after birth, the window that ACOG's postpartum care guideline calls the fourth trimester 1. Early relief usually arrives as hormone levels normalize and the joint stiffens back up. A supportive pelvic belt, shorter strides, keeping the knees together when turning in bed, and avoiding single-leg loading can lower daily pain while healing proceeds. Active treatment centers on pelvic floor physical therapy: a therapist retrains the deep core and pelvic floor muscles that stabilize the pelvic ring, and Cochrane evidence on pelvic floor muscle training in pregnant and postpartum women shows meaningful benefit for pelvic function 3. A smaller share of women have pain that lingers past 12 weeks and deserves a closer look.

What helps SPD recover faster?

Paced, progressive movement helps SPD settle faster than either total rest or pushing through pain. Gentle activity within a comfortable range keeps the joint mobile, and ACOG recommends most people work back toward about 150 minutes of moderate activity a week once recovery allows 2. Rebuilding deep-core and pelvic-floor support is central, whether birth was vaginal or by cesarean; a graded plan for rebuilding your core protects the pelvis as load increases. Joint laxity from shifting hormones is not unique to birth — some people first notice loose, achy joints in adolescence, and again as estrogen falls across the perimenopausal years — so a history of hypermobility can make pelvic girdle pain more likely. Warmth, supportive footwear, and short rests round out day-to-day management.

When pelvic girdle pain needs a clinician

Pelvic girdle pain that keeps worsening, does not budge past the fourth trimester, or leaves the pelvis feeling like it might give way warrants an in-person assessment. A clinician can rule out a rare true separation of the joint, check your gait, and refer you to pelvic floor physical therapy, which is the best-studied treatment 3. Persistent pain paired with fever, difficulty passing urine, or numbness in the legs points to something other than ordinary SPD and deserves prompt review. Postpartum visits, ideally including contact within the first 3 weeks, are a natural place to raise it 1. Gale can help you organize your symptoms before that appointment.

Common questions

Yes, pain and instability at the pubic joint are common after birth because pregnancy hormones loosen the pelvic joints and labor strains them. For most women it eases over the first weeks to a few months. Pain that is severe, keeps worsening, or stops you from bearing weight is worth having checked.

Many women notice steady improvement over the first several weeks, with most cases settling within the fourth trimester as hormones normalize and the joint tightens. A pelvic support belt and paced activity often make walking easier in the meantime, and pelvic floor physical therapy can speed things along.

It can. Women who had pelvic girdle pain in one pregnancy have a higher chance of it returning in a later one. Staying active, building core and pelvic-floor strength before and during pregnancy, and working with a physical therapist early can lower how much it limits you.

For many people, yes. A snug support belt worn around the hips compresses the pelvis and can make walking and standing more comfortable by limiting the shearing motion at the joint. It is a symptom aid rather than a cure, and it works best alongside activity changes and physical therapy.

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When postpartum pelvic pain needs a closer look

  • —Pubic or pelvic pain with fever, chills, or a hot, swollen area is a reason to seek same-day clinician review.
  • —A sudden feeling that the pelvis has given way, or being unable to bear weight or walk, is a reason to seek urgent evaluation.
  • —Pain paired with difficulty passing urine or stool, or new numbness in the legs, is a reason to seek prompt medical review.
  • —Pelvic pain that keeps worsening past the fourth trimester is a reason to book a clinician visit.

This article is general health education, not medical advice. Whether your pubic bone pain is ordinary symphysis pubis dysfunction or something that needs imaging or referral is best decided with a clinician such as your obstetric provider, primary care clinician, or a pelvic floor physical therapist.

References

  1. 1.American College of Obstetricians and Gynecologists (2018). ACOG Committee Opinion No. 736: Optimizing Postpartum Care. Obstetrics & Gynecology. doi:10.1097/AOG.0000000000002633 ✓ACOG's postpartum care committee opinion frames the fourth trimester as the first 12 weeks after birth and recommends initial contact within 3 weeks, defining the recovery window and care timing referenced here.
  2. 2.American College of Obstetricians and Gynecologists (2020). Physical Activity and Exercise During Pregnancy and the Postpartum Period: ACOG Committee Opinion, Number 804. Obstetrics & Gynecology. doi:10.1097/AOG.0000000000003772 ✓ACOG's committee opinion on exercise in pregnancy and the postpartum period supports a gradual return to activity toward about 150 minutes of moderate-intensity activity per week as recovery allows.
  3. 3.Woodley SJ, Lawrenson P, Boyle R, et al. (2020). Pelvic floor muscle training for preventing and treating urinary and faecal incontinence in antenatal and postnatal women. Cochrane Database of Systematic Reviews. doi:10.1002/14651858.CD007471.pub4 ✓Cochrane systematic review of pelvic floor muscle training in antenatal and postnatal women, supporting pelvic floor physical therapy as evidence-based for postpartum pelvic function.

3 sources, numbered by first appearance. General health information, not medical advice. AI-assisted editorial content — every citation independently verified. Editorial policy

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