What the coccyx is
The coccyx is a small, triangular bone made of fused segments at the bottom of the spine. It supports your weight when sitting and anchors muscles, tendons and ligaments of the pelvic floor and buttocks.
Why the tailbone hurts in pregnancy
- Hormones: relaxin loosens ligaments around the pelvis.
- Posture: the growing bump shifts your centre of gravity.
- Baby’s position: pressure on the coccyx late in pregnancy.
- Weight gain: more load when sitting.
- Constipation: straining irritates the area.
See also SI joint stretches.
Tailbone pain after giving birth
During vaginal birth, the coccyx moves backwards to make room for the baby. It can be bruised or strained, and less commonly dislocated or fractured, especially with a large baby, a fast or assisted delivery. Pain usually improves over weeks to months.
Symptoms
- Pain and tenderness at the base of the spine.
- Pain when sitting, especially leaning back.
- Pain when standing up from sitting.
- Pain during bowel movements.
- Pain during sex.
Sitting tips
- Use a wedge or U-shaped cushion that takes pressure off the coccyx.
- Lean slightly forward when sitting.
- Sit with weight on your thighs and sitting bones.
- Stand up and move every 30 minutes.
- Avoid soft, low sofas that tilt you backwards.
Sleeping and resting
Sleep on your side with a pillow between your knees and a pillow under the bump. Avoid lying flat on your back for long periods in later pregnancy.
Gentle exercises and stretches
- Pelvic tilts on hands and knees.
- Cat-camel for gentle spinal movement.
- Child’s pose with knees wide.
- Piriformis stretch seated or lying on the side.
- Pelvic floor relaxation with slow breathing.
Other ways to ease pain
- A warm (not hot) compress or ice pack wrapped in a cloth.
- Paracetamol at the recommended dose; avoid ibuprofen in pregnancy unless advised.
- A warm bath.
- Gentle massage of the buttock muscles.
Check with your midwife or pharmacist before taking any medicine in pregnancy.
Avoiding constipation
Constipation is common in pregnancy and makes tailbone pain worse. Eat plenty of fibre, drink enough water, stay active and use a footstool on the toilet. Ask your midwife about safe laxatives if needed.
How a pelvic health physiotherapist helps
A specialist physiotherapist can assess the coccyx, pelvis and pelvic floor, provide manual therapy, release tight muscles, advise on posture and support belts, and design a safe exercise programme. After birth, they can help with recovery of the pelvic floor.
Planning for birth
If you have significant coccyx pain, discuss birth positions with your midwife. Upright, forward-leaning or side-lying positions may take pressure off the coccyx during labour.
When pain persists after birth
If coccyx pain lasts more than a few months after birth, further assessment may include X-rays taken sitting and standing. Treatment options include physiotherapy, injections and, rarely, surgery.
Everyday movements
- Get in and out of the car with knees together, swivelling on the seat.
- Roll onto your side before getting out of bed.
- Avoid standing on one leg to dress; sit down instead.
- Take stairs one at a time if pelvic pain is also present.
- Use a footstool to keep your knees slightly higher when sitting on the toilet.
When to contact your midwife or doctor
- Severe or worsening pain.
- Fever, redness or swelling at the base of the spine.
- Vaginal bleeding or fluid leakage.
- Numbness in the legs or around the genitals.
- Changes in bladder or bowel control.
Key points to remember
- Tailbone pain is common in pregnancy and after birth.
- Hormones, posture and the baby’s position contribute.
- Cushions, posture changes and gentle exercise help.
- A pelvic health physiotherapist can provide specific treatment.
Questions about tailbone pain in pregnancy
These answers are general information and do not replace an examination or individual medical advice.
Is tailbone pain normal in pregnancy?
Yes, it is common and usually not serious.
When does tailbone pain start in pregnancy?
Often in the second or third trimester.
Does tailbone pain mean labour is coming?
Not usually, though back and pelvic pressure can increase near labour.
What is the best cushion for tailbone pain?
A wedge or U-shaped cushion that takes pressure off the coccyx.
Can childbirth injure the tailbone?
Yes, it can be bruised or, rarely, fractured.
How long does tailbone pain last after birth?
Usually weeks to a few months.
Can I take ibuprofen for tailbone pain in pregnancy?
Avoid it unless advised; paracetamol is usually preferred.
Can a physiotherapist help?
Yes, a pelvic health physiotherapist can treat coccyx pain.
Is sitting on a ball good for tailbone pain?
It can help some people by encouraging movement and posture changes.
Can tailbone pain affect breastfeeding positions?
Yes; side-lying or reclined positions with a cushion can take pressure off the coccyx.
Sources
This guide is for general information and does not replace medical advice. How a problem is diagnosed and treated depends on your examination and medical history. If you think you have an emergency, contact your local emergency services.