SKIP AHEAD. . .
WHAT THE HECK IS LIGHTNING CROTCH?
Check it: you’re 37 weeks pregnant — waddling along, minding your own business and then BAM! A sudden, sharp pain flashes through your pelvis, taking your breath away and possibly stopping you in your tracks for a moment or two. The pain disappears as quickly as it came. And you’re left wondering, “What the F was that??!!”
Just when you thought your pregnancy couldn’t get any more interesting, you enter the world of Lightning crotch — a silly name used to describe an intense experience. Pregnant people have reported the incidence of general pelvic pain during pregnancy at least 48% of the time, so if you’ve felt anything like Lightning crotch, you’re in good company (1).
Lightning crotch refers to those sudden, sharp pains erupting inside or around the pelvis, vulva, vagina or rectum. Lightning crotch doesn’t refer to one specific pain but a class of pain that feels sharp, stabbing, electric, sudden, piercing, or fiery. Sometimes these pains can radiate into the hips and legs too.
And it can happen during the menstrual cycle, in addition to during pregnancy!
As opposed to muscular or structural pain that’s dull, throbbing, or pulsating, lightning crotch refers to any pain that arises from stimulation or compression of the nerves. It’s just, with a fetus sitting on the cervix, there are a lot of nerves to compress.
Most people report experiencing pelvic pain in their second or third trimester. And while doctors don’t have a clear understanding for why this occurs, there are several reasons you might experience lightning-like pelvic pain:
Round Ligament Pain → During your second trimester, as your baby is going through growth spurts, you might feel gnawing hip and pelvic pains (2). The uterus is suspended between 2 ligaments on either side, which attach to the inside of the pelvic bowl. The weight imposed on the uterus as baby grows tugs on these ligaments. And while these ligaments are made to stretch, any quick movements like a cough or sneeze can send them into spasm, creating sharp pains in the groin.
Baby growing, moving and dropping → As the baby gets bigger and takes up more space inside the uterus, they’re liable to throw a foot into the rib cage — or the cervix — causing the bundles of nerves nearby to be pressed on or otherwise stimulated. This can cause those sudden sharp pains. All these movements are normal for the baby’s growth but may not feel so normal for the structures in the pelvis that can be strained easily from sudden movements. During the third trimester, when baby is ready to position their head downward, their weight puts a lot of pressure on these nerves around the cervix. A lot of people report that the weeks leading to birth are when a lot of this fun can occur.
Digestive issues → Common to the pregnant person’s experience, gas and bloating can create a lot of discomfort and take up more space in an already crowded belly. Compressed gas doesn’t stay that way long, and will fight its way through the digestive tract, creating the havoc it needs to escape.
Pubic Symphysis Dysfunction (PSD)→ The two halves of the pelvis are connected in the front by a disc made of collagen called the pubic symphysis (3). This is the sight of 2 joints — one on either side of the disc — that potentially can be pulled out of alignment during pregnancy. Many people report shooting pains along the front of the pelvis when walking, going up and down stairs, sitting or standing, and general daily tasks that require asymmetrical movement in the hips.
Sacrioiliac misalignment → the sacrum is the bottom vertebrae in your spine. And it connects the two halves of your pelvis in the back, similar to how the public symphysis connects them in the front. Where the sacrum and the pelvis meet, there is a joint called the sacroiliac joint. Due to the additional flexibility of the ligaments during pregnancy, this joint becomes less stable, easily slipping out of place. This can cause some stabbing pains on either side of the pelvis and could radiate into the butt and down the eg if it becomes serious enough.
Causes unrelated to pregnancy
The following are causes of pelvic pain that don’t occur during pregnancy.
- Menstrual cramping
- Endometriosis, a condition that occurs when the lining of your uterus (the endometrium) grows outside your uterus and adheres to other structures or organs (4).
- Ruptured cysts — cysts don’t normally have symptoms, but if you find you’re bleeding outside of your cycle and in intense pain, see your doctor right away.
- Mittelschmerz refers to pain during ovulation (5)
- Interstitial cystitis is a syndrome of chronic bladder pain that can lead to severe pelvic pain (6)
Exercise → one of the best things you can do to stay feeling strong and healthy during your pregnancy is to exercise consistently and appropriately. That means fluid, gentle movements, stretches, and deep breathing. This encourages internal spaciousness and deep relaxation. Moving slowly allows your overly-stretched tissues to change positions smoothly and easefully. Sudden, aggressive movement can actually constrict your body’s range of motion and cause those sudden, sharp pains. Check out the local practitioners in your area that teach prenatal exercises like pilates, yoga, meditation, and tai chi.
TRY THIS (a tip from perinatal movement coach Amy Baumgarten): To keep your pelvis and hips as supple and strong as they can be, practice HIP CIRCLES daily. Stand with your feet wide apart. Your hands can rest on your hips. You can do 5-10 circles in both directions. Let your knees bend if you wish, and move slowly and fully through the movement. Keep breathing as you go.
Breathing → As you probably know if you’ve taken a childbirth ed class, breathing is a great form of pain management (7). Long, slow deep breaths in the moment of extreme pain can have a positive effect on your nervous system. If you don’t breathe, your body will go into the ‘flight or flight’ response of your sympathetic nervous system, further contracting your body and creating more pain-pressure. Slow deep breathing taps into a parasympathetic response that softens your body around the pain, thereby helping the pain recede faster (8).
TRY THIS (a tip from perinatal movement coach Amy Baumgarten): If you come upon a moment of Lightning crotch, take a long deep breath OUT for 5 counts, then a long breath IN for 5 counts. Repeat this as many times as you need to recover from the jolt.
Warm (not hot) Baths → Soaking is not only a sweet way to take time for yourself — it’s also a great way to relieve pain. Hot water therapy is good for all kinds of soreness. It dilates blood vessels, enhancing blood flow to areas that have become restricted. But keep it to a minimum. The American Pregnancy Association reminds us that your temperature shouldn’t rise above 102 degrees while pregnant. Overheating during pregnancy has been known to increase “risk of birth defects in babies of women who had an increased body temperature during the first trimester of pregnancy (9).”
Manual therapies → Various kinds of practitioners specialize in prenatal care, acupuncture, chiropractic, massage, craniosacral, pelvic floor, and other forms can provide relief for over-taxed muscles, ligaments, and nerve endings.
Supportive Belts → Some swear by the supportive braces that they wrap around their pelvis and lower abdomen. The brace hugs your pelvic bones together, taking excess strain off the tensioned muscles and ligaments inside, thereby allowing them to relax more easily.
When to see a doctor
Pelvic pain is to be expected during pregnancy. But pay attention to your body. If it feels abnormal to you, trust your intuition and go see your doctor. Here are a few clues to help you interpret those pains.
Location: Track where you feel the pain. Does it happen at the same place, in the same way, each time, or does it move to different areas? If you feel it more toward the front, this could by PSD. If you feel it radiating down the back of your hip, this could be SI pain. If it feels more deep and internal, it may correspond to round ligament pain or a byproduct of baby’s position on top of your nerves. While painful, these sensations come with the territory but don’t usually stay too long. If pain persists, go see your doctor.
Duration: Do these pains come and go? Do they linger for a while? Do they get worse or better when you move around? If they stick around and don’t subside relatively soon, check with your doctor or midwife.
If you experience bleeding, increased frequency of pain, contractions or other signs of labor alongside lightning crotch, talk to your midwife or doctor right away to ensure everything is ok.
Biggest takeaway: aches and pains during pregnancy are normal. Your body is going through a massive transition, putting a lot of pressure on your structure. While lightning crotch may be partly out of your control, good pain management practices like exercising regularly, taking time to relax, and working with skilled bodyworkers can keep some of the most extreme pain at bay. Don’t forget to keep breathing!
Written by Amy Baumgarten, allbodies practitioner and holistic movement coach and owner of Home Body Movement.
Medically reviewed by: Aisha Wagner, MD. Family Physician with fellowships focusing on contraception and abortion advocacy
All content found on this Website, including: text, images, audio, or other formats, was created for informational purposes only. The Content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.
- Howell, Emily R. “Pregnancy-Related Symphysis Pubis Dysfunction Management and Postpartum Rehabilitation: Two Case Reports.” The Journal of the Canadian Chiropractic Association. Canadian Chiropractic Association, June 2012. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3364059/
- “Round Ligament Pain: Causes and Treatment.” American Pregnancy Association, September 20, 2017. https://americanpregnancy.org/pregnancy-health/round-ligament-pain-during-pregnancy/.
- Howell, Emily R. “Pregnancy-Related Symphysis Pubis Dysfunction Management and Postpartum Rehabilitation: Two Case Reports.” The Journal of the Canadian Chiropractic Association. Canadian Chiropractic Association, June 2012. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3364059/.
- Mayo Clinic Staff. “Symptoms and Causes.” Mayo Clinic. Mayo Foundation for Medical Education and Research. Accessed August 27, 2019. https://www.mayoclinic.org/diseases-conditions/chronic-pelvic-pain/symptoms-causes/syc-20354368?p=1.
- Pietro, MaryAnn de. “Lightning Crotch: Causes, Remedies, and How It Feels.” Medical News Today. MediLexicon International. Accessed August 27, 2019. https://www.medicalnewstoday.com/articles/322088.php.
- “What Is Interstitial Cystitis (IC)?” Interstitial Cystitis Association. Interstitial Cystitis Association, January 9, 2015. https://www.ichelp.org/about-ic/what-is-interstitial-cystitis/.
- “Breathing for Pain Relief during Labor.” Evidence Based Birth®, November 13, 2018. https://evidencebasedbirth.com/breathing-for-pain-relief-during-labor/.
- Busch, Volker, Walter Magerl, Uwe Kern, Joachim Haas, Göran Hajak, and Peter Eichhammer. “The Effect of Deep and Slow Breathing on Pain Perception, Autonomic Activity, and Mood Processing–an Experimental Study.” Pain medicine (Malden, Mass.). U.S. National Library of Medicine, February 2012. https://www.ncbi.nlm.nih.gov/pubmed/21939499.
- “Hot Tubs During Pregnancy: Safety Concerns and Health Risks.” American Pregnancy Association, July 16, 2019. https://americanpregnancy.org/pregnancy-health/hot-tubs-during-pregnancy/.