Tailbone pain is much more common in women than in men, and pregnancy and childbirth are among the main reasons. Many mothers notice it in the weeks after delivery, often while sitting to feed the baby, which is exactly when sitting is hardest to avoid.
Why pregnancy and childbirth affect the coccyx
- Hormones loosen the joints. During pregnancy, hormones relax the ligaments of the pelvis so the baby can pass through. The joint between the sacrum and the coccyx loosens too.
- The baby's head presses on the coccyx during a vaginal delivery, pushing it backwards. Occasionally the coccyx is bruised, strained or even displaced.
- Weight and posture change. Through pregnancy, the way you sit and stand changes, putting new strain on the lower spine and pelvic floor.
- Assisted or long deliveries and larger babies make injury a little more likely.
What it typically feels like
- An ache or sharp pain right at the base of the spine
- Worse when sitting, especially leaning back, and when standing up
- Sometimes painful bowel movements or discomfort during intercourse
What helps
- A cut-out (wedge or U-shaped) cushion for feeding and for the car.
- Feeding positions that take weight off the tailbone: lying on your side, or sitting leaning slightly forward with good back support.
- Gentle pelvic-floor exercises once your midwife or doctor says it is safe.
- Keeping stools soft: fluids and fibre, and avoiding straining.
- Heat or cold packs for short periods.
Before taking pain relief while breastfeeding, check with your doctor or pharmacist which medicines are suitable.
When to get it checked
Postnatal tailbone pain often eases over a few weeks, and in Dr Rajveer Singh's experience most of it settles within 3 to 4 months of delivery. If it is still there after about 4 months, keeps returning, or makes caring for your baby difficult, ask for an examination: the coccyx may have been pushed inward or outward during labour (see tailbone subluxation). When the coccyx has been pushed out of its normal position or the surrounding muscles stay in spasm, hands-on treatment can help a great deal, and you don't need to "just put up with it".
See a doctor urgently if you have fever, a wound or swelling near the tailbone, numbness, or new problems with bladder or bowel control.
