Heaviness and pressure ‘down there’ in pregnancy: what’s normal

Lots of pregnant women notice a feeling of heaviness or pressure low in their tummy or vagina, but feel awkward mentioning it. Usually it’s your growing womb and baby pressing down. But it can sometimes be a sign of something that needs checking, including early labour.

Why you might feel pressure

In early pregnancy

Early pregnancy hormones can cause bloating and constipation, which can make your lower tummy feel heavy. Our article on constipation and diarrhoea in pregnancy has tips. If heaviness comes with bleeding or tummy pain in early pregnancy, use the urgent advice at the end of this page.

In the second trimester

As your womb grows, some people get round ligament pain, a sharp or pulling pain at the side of the bump. See round ligament pain.

In the third trimester

Your baby is bigger and heavier, pressing on your pelvis, bladder and bowel. Later on, their head may move down, or ‘engage’, into your pelvis, and your bump may look lower. This doesn’t mean labour is about to start. See our article on tightening and pelvic pressure at night.

Is it pelvic girdle pain?

Pelvic girdle pain (PGP), sometimes called symphysis pubis dysfunction (SPD), is different from a feeling of pressure. It’s pain from stiffness in your pelvic joints, and it affects up to 1 in 5 pregnant women.

You may feel it over the pubic bone at the front, across your lower back, between your vagina and anus, or spreading into your thighs.

PGP isn’t harmful to your baby, but it can make getting around hard. Speak to your midwife or GP if it hurts to walk, climb stairs or turn over in bed. You may be referred to a physiotherapist, and a support belt can help.

Could it be a prolapse?

Pelvic organ prolapse is when the womb, bladder or bowel slips down and bulges into the vagina. Pregnancy and childbirth are among the causes. Signs include a heavy, uncomfortable or pressing feeling in your lower tummy or vagina, a bulge or lump you can feel or see, and problems weeing, such as feeling your bladder isn’t emptying fully.

See your GP or midwife if you notice a lump or any of these signs. It isn’t an emergency, and it can be treated, including with pelvic floor exercises.

Pelvic floor exercises: the one thing worth doing

Your pelvic floor muscles support your bladder, bowel and womb, and pregnancy puts extra load on them. Strengthening them can help prevent leaks after the birth.

Find the muscles. Squeeze and lift around your back passage as if holding in wind, then forward as if stopping a wee mid-flow.
Slow holds. Hold for up to 10 seconds, rest for 5 to 10 seconds, and repeat up to 10 times.
Quick squeezes. Squeeze hard, then let go completely, up to 10 in a row.
Do them at least 3 times a day. Try not to hold your breath.

It takes 3 to 5 months to strengthen these muscles, so keep going after the birth. If you’re not sure you’re doing them right, ask about a pelvic health physiotherapist.

When pressure could be labour

Pressure in your vaginal area can be a sign of labour. If you’re less than 37 weeks pregnant and have new pressure in your vagina or pelvis, especially with period-type pains or regular tightenings, call your maternity unit or midwife straight away, as it can be a sign of premature labour. Call them straight away too if you have any of these:

regular tightenings or contractions
period-type pains
a ‘show’, when the plug of mucus from your cervix comes away
a gush or trickle of fluid from your vagina
backache that comes and goes, or isn’t usual for you

Questions people ask

Is it normal to feel pressure in the vagina at 20 weeks?

Some pulling and stretching is normal as your womb grows. But contact your maternity unit if you have new pressure in your vagina, or any tightenings, period-type pains, unusual discharge, fluid or bleeding. At this stage it can be a sign that your cervix is opening early.

Can I do pelvic floor exercises when pregnant?

Yes. They’re recommended during pregnancy and after the birth.

Is it a bad sign if I leak wee when I cough?

Leaking a bit of wee when you laugh, cough or sneeze is common in pregnancy, because of the extra weight on your bladder and pelvic floor. Pelvic floor exercises help. If you’re not sure whether it’s wee or your waters, or the leaking doesn’t stop, call your maternity unit.

When to get help

If you’re 20 weeks pregnant or more

Call your maternity unit straight away, even in the middle of the night, if you have:

any vaginal bleeding or spotting
a gush or trickle of fluid from your vagina, or you think your waters have broken
regular tightenings, period-type pains or new pressure in your vagina before 37 weeks
tummy pain that’s severe or doesn’t go away after resting for 30 to 60 minutes
tummy pain or pressure with lower back pain, discharge that’s unusual for you, pain when you wee, or needing to wee suddenly or more often
your baby moving less than usual

If you can’t get through, call NHS 111. Call 999 if the bleeding is heavy (soaking a pad soon after putting it on), the pain is severe, you feel faint or dizzy, or you have a strong urge to push and think your baby is coming now.

If you’re less than 20 weeks pregnant

Mild cramps that ease with rest are usually nothing to worry about. But if you’re less than 20 weeks pregnant, get urgent advice from your maternity unit, an early pregnancy unit or NHS 111 if you have:

any bleeding or spotting, even if it’s light
tummy pain that’s severe, on one side, or hasn’t eased after resting for 30 to 60 minutes
pain in the tip of your shoulder

Call 999 if you have bleeding along with severe tummy pain, pain in your shoulder, or feeling sick, faint or dizzy, or if the bleeding is heavy (soaking a pad soon after putting it on). Also call 999 if you have sudden, sharp and intense tummy pain and you feel very dizzy or faint, feel sick or look very pale. These can be signs of an ectopic pregnancy or a miscarriage that need treating straight away.