# SPD — Symphysis Pubis Dysfunction in the second trimester

Source: https://www.pregnancypowerhour.com/trimester-conditions/spd-in-second-trimester
Last updated: 2026-07-15

> For many, Symphysis Pubis Dysfunction (SPD) often makes its first appearance in the second trimester as relaxin levels rise, leading to pubic bone discomfort.

The second trimester, spanning weeks 14 to 27, often brings a sense of renewed energy for many. However, for some, it's also when Symphysis Pubis Dysfunction (SPD) might first introduce itself. This can feel unexpected, especially if you're navigating pregnancy for the first time.

## Why it shows up this trimester

During your second trimester, your body is producing more relaxin, a hormone that helps soften and loosen ligaments in your pelvis. This is a natural and essential process, preparing your body for birth. However, for some, this increased laxity can lead to instability in the pubic symphysis joint, which is located at the very front of your pelvis. As your uterus continues to grow, it also places more pressure on your pelvis, which can exacerbate any existing joint instability, making SPD symptoms more noticeable now.

## What it tends to feel like now

In this window, SPD often presents as a dull ache or sharp pain directly over your pubic bone. You might also notice a clicking or grinding sensation in your pelvis. This discomfort can sometimes radiate to your inner thighs or perineum. Many people describe it as particularly noticeable during activities that involve asymmetrical leg movements, such as getting in and out of a car, turning over in bed, standing on one leg, or climbing stairs. The pain often eases with rest but can return quickly with movement, making daily tasks feel challenging.

## What helps in this window

One option might be to focus on gentle, symmetrical movements. Activities like swimming or walking can be supportive, while avoiding wide-legged stretches or lunges that might aggravate the joint. Practicing mindful posture, especially when sitting or standing, can also offer some ease. Some find that a supportive maternity belt or pelvic compression garment can provide external stability. Gentle pelvic floor exercises, guided by a pelvic floor physical therapist, can also be a helpful tool for supporting the deep core muscles that stabilize your pelvis. Remember, you get to decide what feels most comfortable and supportive for your body.

## Working with your care team

If you're experiencing pubic bone pain, a conversation with your OB or midwife is a valuable first step. They can help confirm if what you're feeling is SPD and rule out any other concerns. Your care provider might suggest a referral to a physical therapist who specializes in prenatal care. A physical therapist can offer personalized strategies, exercises, and techniques to help manage the discomfort and support your pelvic stability. This collaborative approach ensures you have a clear and confident path forward in managing your symptoms throughout your second trimester and beyond. Your provider is your best resource for your specific situation.