Pain around the tailbone can make sitting, standing up or going to the toilet uncomfortable. It is worth asking for help, particularly if it is affecting work, sleep or movement. Pregnancy does not automatically explain the pain, and you do not need to wait until after birth to be assessed.
When to get urgent help
Seek emergency care for back or tailbone-area pain with new loss of bladder or bowel control, difficulty passing urine, numbness around your genitals or bottom, or new leg weakness. Call 000 if you lose feeling or movement in your limbs, collapse or cannot travel safely.
Get urgent medical advice after a significant fall or injury, for severe or rapidly worsening pain, fever, or if you cannot move normally. Contact your maternity unit immediately for bleeding, leaking fluid, contractions or pelvic pressure before 37 weeks, or reduced or concerningly changed baby movements.
Severe lower abdominal pain, shoulder-tip pain, dizziness or fainting in early pregnancy needs urgent assessment, even if you initially thought the discomfort came from your back.
Where is the tailbone?
The coccyx, or tailbone, is the small bone at the very bottom of your spine. Pain centred here is sometimes called coccydynia. It may feel tender, dull or sharp and can be worse on a hard seat or when moving from sitting to standing.
Pain elsewhere in the buttocks, pelvis or lower back may have a different cause. Pelvic girdle pain, nerve-related pain and tailbone pain can overlap in how they feel. Pointing to the sore area and describing the activities that bring it on can help a clinician work out what to check.
Why might it hurt during pregnancy?
A fall onto your bottom, prolonged pressure from sitting or an old injury may contribute. Changes in posture and loading during pregnancy can also affect the muscles and joints around your back and pelvis.
It is not possible to tell from the symptom alone that your coccyx has shifted, your baby is pressing on it or a particular hormone is causing the pain. Occasionally pain has another cause that needs treatment, such as infection. This is why new, persistent or worsening pain deserves assessment.
Tell your doctor or physiotherapist if you have had an injury, pain with bowel movements, numbness, urinary symptoms or pain travelling down a leg. Our pelvic pain guide explains the early-pregnancy warning signs.
What can help once the cause has been assessed?
A plan often starts with reducing pressure on the painful area and adjusting activities. You might discuss:
- A coccyx cushion with a cut-out or wedge shape, and a seat that supports you comfortably.
- Short, regular breaks from sitting rather than staying in one position for a long time.
- Changing or dividing up tasks that repeatedly trigger pain.
- Gentle movement within comfort, with exercises chosen for your symptoms.
- A warm pack for comfort, protected with a cover so it does not burn your skin.
Heat does not prevent blood clots or correct the position of the tailbone. Stop any measure that makes symptoms worse, and avoid forcing stretches or manipulation of the area.
A pregnancy support belt helps some kinds of pelvic pain, but it is not an automatic treatment for every sore tailbone. Ask a physiotherapist whether a cushion, belt or another approach is likely to help you.
Rest, sleep and movement
Try a supported side-lying position if sitting or lying on your back is uncomfortable. From 28 weeks, settle to sleep on either side; the left side is not compulsory. If you wake on your back, roll onto your side before going back to sleep.
You do not need to be in constant motion, and you do not need to avoid all activity. Balance manageable movement with breaks. If a job or caring task repeatedly hurts, ask what changes can reduce the strain.
A pelvic health physiotherapist can check how your muscles are working and recommend an individual plan. Repeated pelvic floor squeezing or a list of yoga poses may not suit every cause of pain.
If going to the toilet hurts
Constipation and straining can add to discomfort. Regular fluids, fibre-containing foods and activity you can manage may help. Ask your pharmacist or doctor about a pregnancy-suitable stool softener or other treatment if needed.
Do not treat new bladder or bowel-control changes as ordinary constipation or pregnancy leakage when they occur with back pain or numbness. Those symptoms need urgent assessment.
Medicines and further assessment
Check pain relief with your doctor or pharmacist, including any cream, gel or spray. General tailbone advice written for non-pregnant adults may recommend anti-inflammatory medicines that are not suitable to start yourself during pregnancy.
Assessment usually begins with questions and an examination. Imaging is not always needed, but your clinician may recommend it after an injury or if another cause is suspected. Tell them you are pregnant and ask what the test will change about your care.
If pain continues, ask for review rather than assuming it will disappear at birth. Recovery varies, and persistent pain can also need care after your baby is born. The aim is a plan that makes daily life more manageable and responds if symptoms change.
Sources and further reading
- Healthdirect: Tailbone pain and injury
- Healthdirect: Low back pain
- The Royal Women’s Hospital: Pregnancy-related pelvic girdle pain
- Safer Baby: Sleep on your side
This is general information for Australian readers. A health professional can assess the cause of your pain and tailor treatment to your pregnancy.