Pregnancy & Postpartum
Pregnancy, Pelvic Girdle Pain, and Postpartum Joint Instability
We're not doctors. This page pulls together what the published research says about hypermobility during and after pregnancy, so you have something concrete to bring to your own OB or midwife.
Pregnancy already loosens joints for most people, as relaxin and progesterone rise to let the pelvis widen for delivery. For someone with hEDS/HSD, whose connective tissue is already more elastic, that added laxity can show up as pelvic girdle pain (PGP) during pregnancy and joint instability afterward. Here's what the data actually shows about how much, and where it stops answering questions.
How much does hypermobility raise the risk of pelvic girdle pain?
A 2020 retrospective cohort of 2,217 pregnant women found that self-reported generalized joint hypermobility (GJH) was associated with a higher risk of pelvic girdle pain, with an adjusted odds ratio of 1.27. That's a real but moderate increase, not an inevitability. Most people in the cohort with GJH did not develop severe PGP, and the study measured association, not cause.
Body weight changes the picture
A follow-up prospective cohort of 356 people, published in 2023, looked at what happens when GJH is combined with a BMI of 25 or higher. That combination carried the highest odds of PGP in the study: an adjusted odds ratio of 6.88. The confidence interval on that number is wide (1.34 to 35.27), which means the true effect could be much smaller or much larger than 6.88. This points to a real interaction worth discussing with a provider, though the precision isn't there yet to treat 6.88 as a fixed number.
Delivery mode has no consensus
A 2011 literature review looked at delivery-mode recommendations for EDS and found no consensus recommendation specific to hEDS. Cesarean delivery is clearly indicated for vascular EDS, a separate and more dangerous subtype where arterial and organ walls are also fragile. That recommendation doesn't automatically transfer to hEDS or HSD.
Claims that circulate about hEDS causing unusually rapid labor or higher rates of postpartum hemorrhage come from individual case reports, not controlled studies. That doesn't mean they're false. It means they haven't been tested at the level of evidence that would let a page like this state them as fact. If you've read those claims elsewhere, it's fair to bring them up with your OB as questions rather than settled risks.
What to do with this
The clearest, best-supported step here is getting pelvic-floor and PGP-informed physical therapy started during pregnancy, ideally before pain is severe. This is the treatment approach with the most direct support in the research above.
Delivery mode is worth an individualized conversation with your obstetrician, one that accounts for your specific joint history rather than a blanket EDS recommendation. After delivery, ask about ongoing monitoring for joint instability, since the same laxity that caused PGP during pregnancy doesn't necessarily resolve the moment the baby is born.
Sources referenced on this page
- 01Retrospective cohort study, n=2,217 pregnant women (2020): GJH and pelvic girdle pain risk (link not yet sourced)
- 02Prospective cohort study, n=356 (2023): GJH, BMI, and PGP odds (link not yet sourced)
- 03Literature review (2011): delivery mode recommendations in EDS subtypes (link not yet sourced)