If you’ve noticed sharp or aching pain at the base of your spine, especially when sitting, getting up, or during bowel movements, you’re not alone. Tailbone (or coccyx) pain after childbirth is surprisingly common, and it can be confusing to know whether it’s from a new injury or something that’s been brewing for a while.
Let’s unpack why it happens, what’s really going on inside your body, and what you can do to start feeling better.
What Happens to the Tailbone During Pregnancy and Birth
Your tailbone sits at the very bottom of your spine, and during pregnancy, your body produces a hormone called relaxin. Relaxin loosens ligaments in your pelvis to make room for your baby, including the joints around the coccyx.
During a vaginal delivery, your baby’s head passes through the pelvis and can put direct pressure on the coccyx, sometimes pushing it backward or even bruising the joint and surrounding muscles. In some cases, the tailbone can become dislocated or fractured, though that’s less common.
Common Causes of Postpartum Tailbone Pain
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Direct trauma from delivery
Pressure from the baby’s head or use of forceps/vacuum assistance can strain or bruise the tailbone. -
Muscle tension and imbalance
The pelvic floor and glute muscles attach around the coccyx. After childbirth, these muscles can tighten or spasm, pulling on the tailbone and creating persistent soreness. -
Ligament laxity
Even after birth, relaxin stays in your system for several months. This can make the coccyx joint unstable, especially if your posture, sitting habits, or core strength haven’t fully recovered yet. -
Old injuries resurfacing
If you’ve ever had a fall on your tailbone, a car accident, or pelvic trauma, pregnancy and childbirth can reactivate that pain. The added pressure and changes in alignment may “wake up” a previously silent injury.
Is It a New Injury or an Old One?
Here’s how to tell:
Signs its a New Injury:
- Sharp pain starting right after delivery
- Pain with sitting or rising starting suddenly after postpartum
- Localized tenderness, swelling, or bruising
- Improves gradually over weeks
Signs its an Old Injury Reactivated
- Tailbone pain existed before or early in pregnancy
- Pain feels familiar to a past fall or injury
- Deep ache that flares with posture or long sitting
- Persists or flares during certain activities
In reality, it’s often a bit of both, childbirth may cause new irritation to an area that was already vulnerable.
What You Can Do About It
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Change how you sit
Use a U-shaped or wedge cushion (not a donut) to offload pressure from your tailbone. Sit tall and avoid slumping. -
Gentle movement and stretching
Light stretching for the glutes, piriformis, and pelvic floor can relieve tension. Avoid long periods of sitting early postpartum. -
Pelvic floor physical therapy
A pelvic floor PT can assess whether your coccyx pain is due to muscle tightness, joint misalignment, or nerve irritation, and design a plan to address it safely. -
Heat or cold therapy
Warm compresses can ease muscle tension; ice can help if there’s acute bruising or inflammation. -
Patience and posture
Healing takes time. Supporting your posture, strengthening your core, and rebalancing your pelvis all help reduce long-term pain.
The Takeaway
Tailbone pain after giving birth is common, but not normal, meaning it deserves attention and care. Whether it’s a brand-new injury or an old one reactivated, there are effective ways to relieve pain and restore comfort.
You don’t have to just “wait it out.” With the right support and guidance, your body can heal and move comfortably again.
If you’re struggling with any pregnancy or postpartum concerns and want a personalized evaluation and treatment plan, make an appointment with one of the Pelvic Floor Physical Therapists at The Pelvic Health Center in Madison, NJ. We’re trained to help identify and treat the causes of your pain!