When Hilary Duff experienced sharp pelvic pain during her pregnancy, she had no idea that she was experiencing a condition thousands of women put up with, writes Emma Curzon.
Even if you’ve never had children, you probably know that pregnancy comes with a lot of unpleasantness. Vomiting, constipation, nasal congestion (yes, really)… and then there’s lightning crotch. It’s probably one of the most painful pregnancy side effects – besides, you know, giving birth – but it’s also one of the least well-known. Even Hilary Duff had never heard the name until she experienced it for herself.
So here, with help from two midwives, is everything you need to know about a condition you’ve probably never heard of but which has probably affected someone close to you.
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What is ‘lightning crotch’?
The term ‘lightning crotch’ refers to sharp, shooting pains in the vagina, rectum and/or cervix that can feel like electric shocks, hence the name.
“I used to describe it as being stabbed in the vagina with a machete,” says physiotherapist Claire Gregory, who specialises in women’s health and exercise rehabilitation. “Pain shooting right up inside my body that just came out of nowhere and literally made me have to stop whatever I was doing.”
Lesley Gilchrist, a registered midwife and co-founder of My Expert Midwife, says that it normally starts during the second or third trimester. “Although it’s not talked about that much, many women experience it at some point, especially as their pregnancy progresses,” she explains.
That lack of discussion means that even the professionals can be left ignorant. “We don’t get taught about it in midwifery training but I became fully aware of lightning crotch when I was pregnant myself!” says Hannah Ewin, a registered midwife and founder of Birth Boutique.
For freelancer Michelle Noble, this made pregnancy a frightening time. “It made me incredibly anxious about the wellbeing of my baby, so I always had to stop and rest when it happened,” she says. “I was too scared to move.”
Even after giving birth, it took her a long time to find out what had happened. “I had never heard the term or knew that anyone else experienced such a thing until my daughter was about five years old. Then I realised what had happened to me was fairly common… yet nobody was talking about it.”
What causes lightning crotch?
There are two main causes:
If you’re pregnant, the pressure on the nerves in the vaginal region as your baby moves around or as the head travels downwards in the uterus in preparation for labour can cause discomfort. Alternatively, as your bump grows, the ligaments attaching your womb and groin get thinner and more stretched, causing pain if you move suddenly or too fast.
Endometriosis and other conditions
However, you don’t have to be pregnant to experience the issue. Other causes include endometriosis, a ruptured cyst or a bladder infection.
“Lightning crotch doesn’t have a medical definition,” Gilchrist explains. In fact, the term is often used interchangeably with symphysis pubis dysfunction (SPD), also known as pelvic girdle pain. This causes chronic pain in the hips, lower back and/or abdomen and, according to Gilchrist, it affects around 50% of pregnant women.
“Lightning crotch is different,” she says, “as it is an unpredictable, acute, short lasting, stabbing type of pain which subsides in seconds.” And, crucially, you might experience it even if you’ve never had a baby.
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Lightning crotch isn’t a sign of underlying problems on its own. “But if you become concerned or experience longer lasting pain, with or without other symptoms, make sure to contact your midwife or maternity unit for assessment and advice,” Gilchrist says.
Sadly for Noble, going to the hospital didn’t help. “They were incredibly skeptical and seemed to imply I must be imagining it,” she recalls. “Then, the doctor insisted on doing a full panel for STIs, even though I informed them that my fertility clinic had just recently done thorough testing for any infections.
“They confirmed I wasn’t experiencing early labour, and my STI panel came back clear, no surprise, so I was left to manage the pain – and resulting anxiety – on my own.”
Noble gave birth nine years ago, but her story wouldn’t sound unusual today. Just last month, research into the “gender pain gap” found that 56% of UK women felt that their pain had been ignored or dismissed.
And for Noble, that feeling was emblematic of her entire pregnancy. “I’m grateful I ultimately had a healthy pregnancy and delivery,” she says, “but I believe that women’s concerns are frequently dismissed as something akin to hysteria. The message is so often: ‘You must be imagining it, there’s no medical reason you would experience such a thing.’ It’s medical gaslighting that is rooted in sexism, and patients deserve better.”
How to treat pelvic pain
The good news: once your baby is out and no longer (literally) getting on your nerves, the pains will stop. But if you’re still pregnant or it’s not being caused by a baby, that’s not exactly helpful.
Luckily, Ewin has a few solutions. “If we think about it from a baby position point of view then trying to encourage your baby to move away from the nerve can help,” she explains. “You could try some stretches, lying in a warm bath, sitting on or kneeling and leaning over a birth ball.” There’s also pregnancy pilates, yoga or swimming – all which “will allow ease of movement and take the heaviness of the pregnancy off the pelvis”.
For many people, including Gregory, wearing an abdominal support band has also helped. Not all belly bands are created equal, though, as she discovered: “[It] looked like I was inside a giant condom… so wasn’t totally practical.”
If your pain is endo-related, it might be worth booking an appointment to see a physio who specialises in women’s health. Places like Six Physio specialise in all areas related to obstetrics and gynaecology, while Nuffield Health has a roster of women’s health physiotherapists who specialise in pelvic pain.
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That lack of an official medical definition says a lot about how, when it comes to people with uteruses, there are still blind spots in the medical and scientific fields.
For those of us who aren’t doctors or scientists, it’s easy to feel powerless. But one thing we can do is talk about these issues, raise awareness and make sure that more of us have access to the right information and support. That way, the next time someone gets pregnant, maybe they’ll know about things like lightning crotch already – instead of finding out the hard way.
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