The round ligaments are found throughout the body in three different places. In all humans, round ligaments are found dividing the liver into medial and lateral sections, at the head of the femur in the leg, and in the elbow. In females, there are round ligaments surrounding the uterus in the pelvic area, which can cause pain during pregnancy. The medical term “round ligament pain” refers to this stretching of the uterine round ligaments.
Pain caused by round ligament stretching is very common during pregnancy and begins around the second trimester, lasting to the end of a pregnancy. As the uterus expands to accommodate the growing fetus, the round ligaments are pulled tight. Though usually thick, a round ligament stretched during pregnancy becomes long and thin, like a stretched-out rubber band. During the stretching, nearby nerve fibers can be pulled and tugged, which is what causes the discomfort. The nerves will actually spasm and cause a muscle contraction or cramp, though the pain will end as soon as the spasm ends.
Pregnant women who experience round ligament pain tend to feel the most strain on the right side of their abdomen, though pain can be felt on both sides and along the width of the pelvis. This is because the growing uterus tends to turn slightly to the right. Otherwise, the pattern of internal round ligament pain follows the area that might outline a high-cut bikini, from the groin along the sides of the hips. Women commonly feel round ligament pain when they are exercising, suddenly stand up, adjust position, sneeze sharply, cough, or laugh. It is a sharp, jabbing pain or a dull ache, but it should only last a few seconds.
The pain that accompanies the stretching of the round ligaments is normal and not a cause for concern during pregnancy. Resting and slowly changing positions should help improve this pain, as well as stretching exercises like rounding the back while on hands and knees. It is also possible to prevent the pain by bending and flexing the hips during a sneeze, cough, or laugh. If the pain does not subside after a few moments, or becomes severe, it could be another problem and should be evaluated by a doctor as soon as possible. If fever, chills, painful urination, bleeding, or four or more contractions per hour occur, this is likely not related to the round ligaments and medical attention should be sought immediately.