Is Pelvic Pressure at 28 Weeks Pregnant Normal?

You're just starting your third trimester of pregnancy when it hits you: There's so much pressure in your pelvis that it feels like your baby is pushing to come out already. But is pelvic pressure at 28 weeks pregnant normal?

You should definitely talk to your pregnancy care provider about any pelvic pressure you are having during your pregnancy, especially if you are at risk for premature labor. But in general, pelvic pressure is fairly common during pregnancy, especially during the third trimester.

"The enlarging uterus continues to put pressure on the cervix and vagina, especially in the 3rd trimester (between 28 and 40 weeks)," explains Michele Hakakha, M.D., F.A.A.P., an OB-GYN in Los Angeles. "This pressure can be extremely uncomfortable," she adds.

Here are a few reasons you might be experiencing pelvic pressure at 28 weeks pregnant.

Your Pelvic Floor Muscles Are Stretched or Weakened

Pregnancy puts enormous strain on your pelvic floor, which consists of all the muscles and connective tissues that support and maintain your reproductive organs, bladder, and bowels.

The Mayo Clinic explains that pregnancy can impact your pelvic floor in many ways, including:

• Placing extra weight and pressure on those muscles and tissues
• Causing constipation, which causes straining and extra weakening
• Hormonal changes that can weaken and change the pelvic floor
• Changing your body mechanics, so you may be prone to injury with lifting or other physical activity
  

Anyone who has been pregnant can experience pelvic floor changes, even with the first pregnancy, but Dr. Hakakha adds that the more pregnancies you have, the more at risk for pelvic floor problems you might be.

"Pressure in the lower abdomen is a common symptom during pregnancy, particularly if this is not your first pregnancy," says Dr. Hakakha. If you have been pregnant before, the muscles that hold up your uterus may not be as strong as with your first pregnancy.

The ligaments and pelvic floor that support your uterus also help keep it elevated, so people who have had more than one pregnancy may feel increased pelvic pressure with subsequent pregnancies. That said, issues with pelvic floor muscle strength and pelvic discomfort aren't limited to people who have been pregnant before.

Talk to a health care provider about your pelvic discomfort. Whether this is your first pregnancy or your fifth, if they suspect muscle strength may be the culprit, get a recommendation for a physical therapist who specializes in pregnancy and pelvic floor therapy to help strengthen your muscles and ease your discomfort.

Your Baby Is Head-Down and Engaged

The closer you get to your estimated due date, the lower your baby will descend into the pelvis in preparation for birth, which often means more pelvic pressure for you. This process is known as engagement, and it is classified into different stages.

In the last few weeks of pregnancy, you might experience what some people describe as "lightening" or when your baby "drops," which is when your baby's head has entered the pelvis and has become fully engaged. Some pregnant people will notice a distinct shift in the baby's position and may feel increased pressure in their pelvis, but also have more breathing room in their rib area.

Of course, not all babies behave the same and some babies may drop lower earlier, which could explain the increased pelvic pressure you're suddenly feeling in the third trimester.

You Have a Bladder Infection

In some cases, pelvic pressure can be associated with a bladder or urinary tract infection (UTI), says Dr. Hakakha. A urinary tract infection can be dangerous for both you and your baby if left untreated, so be sure to let a health care provider know right away if you are experiencing new pelvic pressure and any other symptoms such as:

• Pain with urinating
• A fever
• Blood in your urine
• Very cloudy or foul-smelling urine
• Feeling like you have to urinate very frequently or like you can't empty your bladder fully

You Are Having Premature Labor

Lastly, in rare cases, pelvic pressure can be a sign of preterm labor or premature cervical dilation.

Again, it's rare, but for some people, pelvic pressure can be a sign that their cervix is dilating or labor is beginning. If you are under 37 weeks pregnant experiencing any signs or symptoms of premature labor, be sure to call your doctor right away, especially if you are at risk of early labor or have any other medical conditions.

Your doctor will advise you on the next steps to take and they will not be upset if you call, because it's always best to be on the safe side if you have any doubts about whether or not you are in premature labor.