Why Tailbone Pain is Common in Pregnancy and Postpartum

That nagging ache at the base of your spine? You’re not alone. Between 50-80% of women experience back pain during pregnancy, and while tailbone pain specifically is less common than general back pain, it affects a significant number of women. About 7% of all coccydynia cases in women are related to childbirth, yet so many mothers suffer silently, assuming it’s just something they have to endure.

Here’s the truth: while tailbone pain can happen during any trimester, during labor, or months after delivery regardless of whether you had a vaginal birth or C-section, you don’t have to just live with it. Understanding what’s causing your pain and knowing your options can genuinely help you feel better.

Understanding Your Tailbone

Your tailbone, or coccyx, is a small triangular bone located at the very base of your spine. It’s made up of three to five fused vertebrae and normally curves slightly forward. While small, your coccyx plays an important role: it’s surrounded by ligaments and muscles that form part of your pelvic floor, and it serves as an attachment point for various muscles involved in pelvic stability.

During pregnancy and childbirth, this area undergoes significant stress and changes. Understanding the anatomy helps explain why so many women experience tailbone pain during this transformative time.

Tailbone Pain During Pregnancy: What’s Happening?

Pregnancy brings profound changes to your body, and many of these directly affect your tailbone.

What causes tailbone pain during pregnancy:

• Relaxin hormone: Loosens pelvic ligaments (including those supporting your coccyx) to prepare for delivery, creating instability and allowing the tailbone to shift more easily
• Postural changes: Growing uterus shifts your center of gravity forward, increasing your lower back curve and placing backward pressure on the tailbone
• Extra weight: More compression on your coccyx when sitting, especially uncomfortable in the third trimester
• Baby’s position: Your baby’s head can press directly against the coccyx in the third trimester when space is limited
• Pain progression: Less common in the first trimester; worsens in second and third trimesters as baby grows and hormones peak
• Triggers: Prolonged sitting, standing up from seated position, and bowel movements often intensify discomfort

Tailbone Pain After Pregnancy

After Vaginal Delivery

Many women expect some tailbone discomfort during pregnancy, but they’re often surprised by how much it can hurt after a vaginal delivery.

During childbirth, your baby’s passage through the birth canal requires your coccyx to move out of the way. The tailbone is pushed backward during crowning to create more room for your baby to emerge. This rapid stretching and pressure can bruise, dislocate, or in rare cases, even fracture the coccyx.

Factors That Increase Risk

Several factors can make tailbone injury more likely during delivery:

• Prolonged labor: Extended pushing phases increase the duration and force of trauma to the tailbone
• Large baby: A bigger baby creates more pressure and force on the coccyx
• Rapid delivery: Ironically, very fast deliveries can also cause problems, as the tailbone doesn’t have time to gradually adjust
• Ligament damage: The supporting structures around your coccyx can tear or overstretch during delivery

Timeline of Pain

Pain from vaginal delivery trauma is often immediate, starting right after birth. It frequently worsens in the first two to three weeks as inflammation peaks. For some women, if the injury was significant or goes untreated, the pain can persist for months.

After C-Section

If you had a cesarean section, you might assume you’ve avoided tailbone problems since your baby didn’t pass through the birth canal. Unfortunately, that’s not always the case. Many women are surprised to discover they have tailbone pain even after a C-section.

Common causes after C-section:

• Prolonged labor before surgery: Baby may have already descended enough to impact your tailbone before the C-section decision
• Operating table positioning: Extended time flat on your back during surgery puts pressure on the coccyx
• Guarding the incision: Altered sitting and movement patterns to protect your abdomen create unusual stress on the tailbone
• Limited mobility: More sitting time during early recovery increases weight-bearing on the coccyx
• Post-surgery constipation: Pain medications and reduced activity cause constipation; straining affects the tailbone

The key point here is that while C-section avoids the direct trauma of birth, many other pregnancy-related factors that affect the tailbone remain present.

Finding Relief

The good news is that most cases of pregnancy and postpartum tailbone pain improve with conservative treatment. Here’s what can help at different stages.

During Pregnancy

• Use specialized cushions: Invest in a donut-shaped or wedge cushion with a coccyx cutout. These cushions remove direct pressure from your tailbone when sitting.
• Correct your posture: When sitting, focus on placing your weight on your thighs rather than your tailbone. Sit toward the front edge of chairs when possible.
• Stay active: Prenatal yoga focused on hip and pelvic flexibility can help maintain better alignment and reduce pressure on your tailbone.
• Change positions frequently: Don’t stay in one position for too long. Set reminders to stand and move every 30-45 minutes.
• Apply warmth carefully: Warm compresses can help, but keep temperatures pregnancy-safe and avoid prolonged heat application.

After Delivery

• Ice first, then heat: In the first 48-72 hours after delivery, ice packs can reduce inflammation. After this initial period, alternate between ice and heat therapy.
• Consider pelvic floor physical therapy: This is perhaps the most effective treatment for postpartum tailbone pain. A physical therapist specializing in women’s health can assess your pelvic floor, work on internal and external muscles, and teach you exercises to support recovery.
• Use pain medication wisely: Discuss appropriate pain relief options with your doctor, especially if you’re breastfeeding.
• Keep using that cushion: Continue using a coccyx cushion for sitting during your recovery period.
• Prevent constipation: Use stool softeners if needed and stay well-hydrated. Straining can significantly worsen tailbone pain.
• Return to activity gradually: Don’t rush back into high-impact exercise. Listen to your body and build up slowly.

When Conservative Treatment Isn’t Enough

If your pain persists despite these measures, medical interventions may help:

• Specialized physical therapy: Working with a therapist trained in manual coccyx manipulation
• Imaging studies: X-rays or MRI to check for fractures or other structural issues
• Corticosteroid injections: For severe cases, targeted injections can reduce inflammation
• Coccyx manipulation: Performed by trained professionals to realign the tailbone

Get the Relief You Deserve

Tailbone pain during pregnancy and postpartum is common, but you don’t have to accept it as an inevitable part of motherhood. Most cases improve significantly with the right treatment approach, especially when you address the problem early. At Physioveda Dubai, our specialized women’s health physiotherapists understand the unique challenges of pregnancy and postpartum tailbone pain. We offer comprehensive pelvic floor therapy in Dubai tailored to your specific needs, whether you’re currently pregnant or recovering from delivery.