“What’s up with the stabbing pains in my vagina?!”
In a 2021 interview, Hillary Duff shared that she sent off this frantic text message to her midwife late in her pregnancy with her third child. Duff found the pain particularly concerning because she hadn’t experienced it during her previous pregnancies and described it as “awful, like you’re being struck by lightning.” Her description unwittingly nailed the condition on the head. Her midwife wrote back that it was something called “lightning crotch,” and that it was nothing to be concerned about.
In preparing for pregnancy and birth, many of us learn to expect pain during the birth process. But the types of pain experienced during pregnancy, including lightning crotch, aren’t discussed as widely. So pain during pregnancy can take some expectant mothers, like Duff, by surprise.
In this article, we’ll explore the causes of lightning crotch and what you can do when it strikes. Looking for the TL;DR? Here it is:
- Lightning crotch is not a medical term. Rather, the term is used to refer to sharp pelvic pain during pregnancy caused by the weight of a growing baby on the pelvis, which is more flexible during pregnancy.
- Pelvic pain during pregnancy is generally considered normal, especially in the third trimester. One study found that 31.7% of pregnant people experienced pelvic pain during pregnancy.
- While pelvic pain during pregnancy is not usually cause for alarm, it’s a good idea to let your healthcare provider know if you’re experiencing it. They may be able to help you find ways to relieve it. Additionally, knowing if you’re prone to pelvic pain can also inform your birth plan.
- Sometimes pelvic pain occurs weeks before labor begins and doesn’t necessarily signal that labor is near.
- Lightning crotch pain is quick, sharp, and irregular, typically felt at the upper vagina/near the cervix — versus labor contractions, which are also painful, but more regularly spaced.
So… what is lightning crotch during pregnancy?
Lightning crotch typically refers to quick, painful vaginal or pelvic twinges towards the end of pregnancy. Contrary to its name, lightning crotch isn’t limited to the crotch only.
Symptoms can include:
- Sudden, sharp, shooting, or burning pain in your pelvis, most often at the top of your vagina and cervix
- Jolting pain that radiates beyond the pelvis (lower abdomen, back, groin, space between the anus and the vulva, thigh, and leg)
Lightning crotch can occur throughout pregnancy, but it’s most common in the third trimester. It almost always goes away after delivery.
What causes lightning crotch during pregnancy?
Lightning crotch pain is likely triggered by a hormone called relaxin, which is produced by the body in preparation for birth and helps joints, ligaments, and muscles in the pelvic area to loosen. As your baby continues to grow and get heavier, their weight presses down on the nerves in your now-loosened pelvic area, which can irritate those nerves. This can cause pain.
Is lightning crotch a sign of labor?
In short, no. There are many different types of aches and pains in pregnancy, and not all of them are sure signs that labor is around the corner. Sharp, fleeting pains, like those of lightning crotch, are typically related to normal physiologic changes of pregnancy. Muscles and ligaments stretch as the pregnancy progresses, and become more easily injured with changing body mechanics. Regular, crampy, and persisting pelvic pain however, might be more consistent with uterine contractions.
Is there anything you can do to prevent lightning crotch?
Sure, it's reassuring to know that once you give birth, pregnancy-related pelvic pain will typically go away. But that knowledge won’t lessen the pain in the meantime. Here's what might, according to the Cleveland Clinic:
- Non-steroidal anti-inflammatory drugs (NSAIDs)
- Ice packs
- Comfortable shoes
- Pregnancy support belts (also called, sacro-illiac joint belts)
- Sleeping with a pillow between the legs to keep the spine and hips in a neutral position
- Specialists like physical therapists, chiropractors, acupuncturists, or massage therapists
What other pains are common during pregnancy?
So much is happening inside your body during pregnancy that it can cause other kinds of aches, pains, and discomforts. Here are some other common pregnancy discomforts to be mindful of:
- Abdominal cramps
- Leg cramps
- Back pain
- Hip pain
- Pelvic bone pain
- Pressure under the rib cage
- Swollen feet, ankles, and hands
How can you tell the difference between lightning crotch and other forms of pelvic pain during pregnancy?
In the third trimester, the most common forms of sharp, attention-grabbing pelvic pain, outside of lightning crotch, are Braxton-Hicks contractions and real labor contractions. Here’s how to tell the difference between them:
- Happens randomly and causes an instantly sharp pain
- It’s called lightning crotch for a reason — it feels like you’re getting an electric shock in your upper vagina / cervix
Braxton-Hicks contractions (aka false labor pains):
- Typically mild to moderate cramping, but not severe
- These contractions can feel like a tightening in the abdominal area and are sometimes described as similar to mild menstrual cramps
- Don’t occur in regular intervals — they come and go randomly
Real labor contractions:
- Painful abdominal or pelvic tightening, that typically lasts around 60 seconds
- The pain occurs in regular intervals
- The contractions actually change (soften or open) your cervix (your OB provider determines this for you with a cervical check)
- These contractions will start happening closer together and for longer periods of time as labor progresses
When should you reach out to your healthcare provider?
There are other times where you may want to follow up with your doctor or midwife to discuss your pain:
- If pain is so bad that it’s hard for you to move
- If pain is associated with nausea, vomiting, fever, or chills
- If the pain is new or different than your previously evaluated pain
- If you also have vaginal bleeding or leakage of watery fluid from your vagina
Wrapping it all up: Is experiencing lightning crotch during pregnancy cause for concern? No.
We’ve been taught that where there is pain, there is usually a problem. But, at least in the case of lightning crotch, we know that this specific discomfort is just part of the pregnancy experience. Hillary Duff was no exception. (Spoiler alert: 12 days after the interview we quoted at the top, Duff welcomed a healthy baby girl into her family.)
No matter what level of pain you’re experiencing, it's worth letting your care team know about your pelvic pain as soon as possible so they can help you get relief and plan ahead for your birth.
This article was medically reviewed by Dr. Jennifer Conti, MD, MS, MSc.