Most pregnancy rib pain is mechanical, which means it’s related to the way the ribs, spine and surrounding muscles are moving and managing pressure. Mechanical pain can be uncomfortable, sometimes remarkably so, but it’s usually something we can work with and treat effectively. Pain beneath the ribs can also come from heartburn, the gallbladder, the lungs or pregnancy complications such as preeclampsia, so this isn’t a part of pregnancy where every concern should be dismissed as simply your baby taking up space.
Where the pain sits, what brings it on and whether anything else is happening at the same time matter considerably more than the fact that you are pregnant and your ribs hurt.
Why do your ribs hurt during pregnancy?
Your rib cage isn’t a single structure that simply sits there while the baby grows underneath it. Your ribs move every time you breathe, and the joints at the back of the ribs have to move with them. During pregnancy, the lower ribs gradually widen (you’ve probably noticed that your bra band had to get a little bigger to accommodate this) and the angle beneath the sternum, or breastbone, becomes larger. Your diaphragm also moves upward as the uterus takes up more room.
These are all expected and normal changes in pregnancy. Your body actually needs to do all of this in order to keep breathing while sharing your abdomen with a growing baby, placenta and a surprising amount of extra fluid. These changes do, however, change how the muscles around the ribs, spine and shoulders do their jobs.
By the third trimester, the top of the uterus is sitting just below the rib cage. If your baby prefers one side, which many do, you may also have a back, bottom or pair of feet repeatedly pressing into the same area. The result can feel like a deep bruise under the breast or bra band, a sharp catch when you twist, or an ache that begins beside the shoulder blade and wraps around the side.
The rib itself isn’t always the only irritated part. The small muscles between the ribs can become sore, particularly after coughing, sneezing or laughing. The cartilage where the ribs meet the sternum can become tender. A stiff area in the mid back can make one rib work harder every time you breathe or turn. Heartburn can create burning pressure in almost exactly the same area, which can be super frustrating when you are trying to work out what is going on.
What does ordinary pregnancy rib pain usually feel like?
Mechanical rib pain usually happens when something changes. It may become worse after sitting, ease when you stand, create a catch when you twist toward the back seat or create sharper pain when you take a deep breath. You can often find a specific sore spot with your fingers, and pressing it recreates the pain you have been feeling. Commonly, people with mechanical rib pain can point specifically to the part that hurts (this is different from some other issues, where the pain might be more diffuse).
Mechanical rib pain may also follow a fairly predictable schedule. The morning is manageable, lunch is when you start noticing it and by late afternoon you have one hand permanently tucked beneath the sore side of your rib cage. That pattern gives us useful information because it suggests the area is becoming less tolerant as the day and its various positions add up.
A tight bra band can make the whole thing considerably worse. So can sitting slightly turned toward a second monitor, working from a laptop at the kitchen table or the couch, always carrying an older child on the same hip or spending the evening curled into the one corner of the couch that everyone in the house agrees is yours.
None of these everyday activities is wrong (because let’s face it, we need to do those things to get through the day!). You definitely don’t need to torture yourself into standing upright like a soldier all day long. Rib pain is rarely about one bad position; more often it’s cumulative: small amounts of strain that add up when you stay in any one position for a long time while your body is already doing extra work.
Why might right-sided rib pain need a closer look?
Right-sided rib pain is very often mechanical. The uterus commonly rotates slightly toward the right, babies frequently choose a preferred side and your liver is a large organ, sitting tucked up under your ribs, mostly on the right side. If the pain appears after sitting, changes when you move, improves when the baby shifts or feels sore when you press the area, the ribs and surrounding muscles may well be involved.
Sometimes persistent pain beneath the right ribs or high in the middle of the abdomen after 20 weeks can also be a concern with preeclampsia or HELLP syndrome. That pain is more likely to feel very, very deep or constant and may not change much when you move. A headache that won’t settle, new vision changes, sudden swelling of the face or hands, nausea or vomiting later in pregnancy, shortness of breath or a strong feeling that something isn’t right all make that conversation more urgent.
If your pain is severe and unchanging, contact your midwife, obstetrician or labour and delivery unit.
Is the baby actually kicking your ribs?
Possibly. Anyone who has watched a foot travel across their abdomen and disappear directly beneath the sore rib doesn’t need to be convinced that babies can create a lot of pressure.
Your baby moving around repeatedly in the same area can leave your internal tissues tender, and some babies are remarkably committed to one spot. But the baby is rarely the whole story. If the joints at the back of the ribs are already stiff, the muscles are tired, a foot under the ribs may just be landing in an area that wasn’t especially comfortable to begin with.
The advice to simply wait for the baby to move isn’t usually particularly useful. Yes, the baby may move. But they may also return five minutes later, because babies aren’t particularly well known for respecting personal space. Helping the rib cage and mid back move more comfortably can reduce how much the area hurts when your baby ends up in the same spot again.
What may actually help pregnancy rib pain?
Change position before the pain becomes awful
If your rib pain starts at roughly the same time every day, use that information to your advantage. If you’re able to, get up and out of your chair before the situation is dire. Stand for a phone call, walk to refill your water or lean back with your arms supported above your rib cage for a few minutes. Small changes made earlier often work better than trying to undo six hours of irritation at the end of the day.
A small cushion behind the lower or mid back may help you sit without collapsing toward the sore side. Supporting your feet can also make a difference, especially if your chair is high enough that your legs are dangling or you are tucking one foot underneath you all afternoon. (Pro ergonomic tip here: your feet should always be touching the floor or a footrest when you’re sitting, never dangling.)
Give the ribs room to move
Lift the arm on the sore side and lean gently away until you feel space opening through the side of the rib cage. Take a few easy breaths into the side and back of the ribs, then come out of the position. The movement should feel relieving or mildly stretchy, but hopefully not sharp.
You can also place your hands around the lower ribs and notice whether the ribs move into your hands when you breathe. Your ribs should have a “bucket-handle” motion: picture a sand bucket that you would take to the beach, with a handle that flops down the side when you’re not carrying it. Your ribs should move like that; they should move out before they move up. In pregnancy, they tend to move a bit more as a single unit. It can be remarkably helpful to spend a bit of time breathing into those ribs to encourage them to move out and up instead of just straight up. This is called “box breathing”. If you aren’t sure what that should feel like, our short How to Do the Core Breath video is a useful place to start.
Reconsider the bra
If your band is squeezing the sore spot, that will definitely impact your pain. Using a band extender, finding a bra with a softer band or a wireless/sports-bra kind of option can make an almost ridiculous amount of difference.
Use a fortress of pillows at night
Side sleeping can compress the lower side of the rib cage, particularly when the mattress is soft and your baby bump pulls you forward. Support your bump with a small pillow if it’s comfortable, place a pillow between the knees, making sure it goes all the way down to your ankles, and use enough height under your head that your upper back isn’t bending sideways toward the mattress. Some people are more comfortable with the sore side on top. Others prefer a slight backward lean with a pillow behind them.
Try hands and knees, without expecting a miracle
Spending a few minutes on your hands and knees (like a cat-cow yoga move) may temporarily take pressure away from the ribs and encourage your baby to shift. It’s worth trying because it’s simple and often comfortable.
What should happen during an assessment for your rib pain?
During your assessment, we’ll ask a lot of questions. We’ll want to know whether the pain begins at your ribs beside your spine, through the muscles between the ribs, at the cartilage near the breastbone or beneath the rib cage. We also want to know what happens when you breathe, reach, twist, sit and change position.
The exact timing helps. Pain that appears after twenty minutes in the car may have a different driver from pain that wakes you at night regardless of position. Pain you can reproduce with one movement gives us different information from deep pain that remains unchanged no matter what you do.
Your practitioner will look at movement through the mid back and shoulders, how the ribs widen when you breathe, what the muscles around the sore area are doing and whether you have started avoiding movement on that side. They should also ask enough health questions to recognize when the concern belongs back with your maternity care team.
You should leave with an explanation that makes sense and a plan you can actually use. If the entire plan depends on doing forty minutes of exercises twice a day while very pregnant, it likely hasn’t been designed for your real life.
How prenatal care may help
Prenatal chiropractic care may be useful when the rib joints or mid back feel stiff, movement is catching or the pain repeatedly returns with sitting and turning. Care is adapted as pregnancy progresses, including positioning that doesn’t require you to lie flat on your stomach and techniques that are chosen for what is comfortable and appropriate that day.
Prenatal massage may help when muscular tension has built through the mid back, side, shoulders or chest around the painful area. Sometimes the rib is only one member of a much larger group complaint involving the neck, shoulder blade and muscles that have been trying to hold you in a tolerable position for weeks.
Orthopaedic physiotherapy can look at breathing, movement and strength around the rib cage and spine. Pelvic floor physiotherapy may be particularly relevant when rib pain is happening alongside pelvic pressure, leaking, pelvic pain or difficulty managing pressure through the abdomen. Osteopathic care is another hands-on option for looking at movement through the ribs, spine and surrounding areas.
You don’t need all of these appointments. You need the one that best fits what is happening, and it’s perfectly reasonable not to know which one that is. Oona’s free Care Navigator call exists for exactly that reason.
Learn more: prenatal care at Oona | pregnancy chiropractic care | prenatal massage in Toronto and Newmarket | pelvic floor physiotherapy | osteopathic care
When should pregnancy rib pain be checked urgently?
Most rib pain can be discussed at a routine appointment. Some concerns should go directly to your maternity care team or emergency services.
- Contact your midwife, obstetrician or labour and delivery unit the same day for persistent pain beneath the right ribs or high in the abdomen after 20 weeks, particularly with a severe headache, vision changes, sudden swelling, nausea, vomiting or feeling very unwell.
- Call 911 for sudden chest pain, new or worsening shortness of breath, coughing up blood, fainting, or chest concerns with a swollen and painful calf.
- Arrange prompt medical care for rib or upper abdominal pain with fever, repeated vomiting, yellowing of the skin or eyes, pain after an injury, or severe pain that doesn’t change with movement.
If you’re unsure, call.
Will pregnancy rib pain go away after birth?
Mercifully, the pressure beneath your ribs usually improves after birth because the uterus is no longer pushing upward in the same way. The rib cage, diaphragm and abdominal wall don’t immediately return to their pre-pregnancy positions, though. It takes a bit of time. Unfortunately, feeding, carrying and sleeping beside a newborn introduce an entirely new set of positions.
If the pain continues, moves into the mid or low back, or becomes part of a larger ache through the shoulders and spine, it’s worth assessing. Having had your baby doesn’t make persistent pain irrelevant, and you absolutely haven’t missed the window to do something about it.
Continue reading: why your back hurts after having a baby and what actually helps
Pregnancy rib pain FAQ
Is rib pain common during pregnancy?
Yes, particularly later in pregnancy as the uterus rises and the rib cage changes. Remember though – common doesn’t mean you just have to live with it. There are effective and gentle treatments available to help you feel your best.
When does pregnancy rib pain usually start?
It’s most common in the late second and third trimesters, although it can begin earlier. The timing alone doesn’t tell us what is causing it. Where the pain sits, what changes it and what else is happening are more useful.
Can a baby kick hard enough to hurt your ribs?
A baby can absolutely create pressure and leave one area feeling tender or bruised, especially when they repeatedly push into the same spot. However, a rib fracture caused by fetal movement would be extremely unusual. Sudden sharply localised pain, pain after an injury or a feeling that something has popped should be medically assessed.
Can pregnancy rib pain make breathing uncomfortable?
A sore rib joint or strained muscle can feel sharper with a deep breath because the ribs move every time you inhale. New shortness of breath, chest pain, faintness or difficulty breathing is different and needs urgent medical assessment.
Is chiropractic care safe during pregnancy?
For most uncomplicated pregnancies, chiropractic care is generally considered a very low-risk option when it’s provided by a chiropractor with prenatal experience and treatment adapted to pregnancy. Tell the chiropractor about any pregnancy complications or new concerns, and involve your midwife or obstetrician when medical assessment is needed.
Do I need a referral to book prenatal care at Oona?
No. You can book directly with an Oona chiropractor, registered massage therapist, physiotherapist or osteopathic practitioner. Insurance requirements vary, so check whether your own plan requires a prescription or other documentation for reimbursement.
Where to start
If you know which service you want, you can book directly and no referral is needed. If you’re still trying to work out whether the pain belongs with a chiropractor, physiotherapist, registered massage therapist, osteopathic practitioner or your maternity care team, book a free 20-minute Care Navigator call and talk it through before choosing.
Book prenatal chiropractic: Toronto | Newmarket
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