Round Ligament: Anatomy, Function, Pregnancy Pain and Care
Updated: 3 days ago
Medically reviewed by Dr. Baraa Alnahhal, MD · Last reviewed: October 2026
Quick Answer: What is the round ligament?
The round ligament is a rope-like band of connective tissue that supports the uterus. There are two uterine round ligaments, one on each side, and each is about 4 inches (10 centimeters) long. Each runs from near an upper corner of the uterus, through the abdominal wall and the groin (inguinal canal), to the labia. [1]
Question | Short answer |
Where does it run? | From near an upper corner of the uterus, through the abdominal wall and the groin (inguinal canal), to the labia. |
Why can it hurt in pregnancy? | The uterus grows and becomes heavier, so the round ligaments widen and lengthen to support it. The tension can cause pain that radiates through the groin area. |
When can pain start? | In the second trimester, after 13 weeks. |
When should pain be checked? | Severe pain lasting more than a couple of minutes, especially with cramping, fever or chills, nausea or vomiting, vaginal bleeding, blood in urine, contractions or pain when urinating. |
What the research says
Round ligament varicosity is rare, usually appears in pregnancy and can be mistaken for a hernia. A systematic review of 48 studies describing 159 cases (158 of them in pregnancy) found that nearly 50% of women presented with a painful groin lump. More than 90% were diagnosed by Doppler ultrasound, and conservative management was successful in more than 90%. No maternal deaths or fetal complications were reported, but the condition can be misdiagnosed as a groin hernia, which may lead to unnecessary surgery (Buksh et al., Br J Hosp Med, 2023). [2]
Exercise has moderate-quality support for preventing low back pain in pregnancy. A meta-analysis of 6 randomized trials (2,231 participants) found that stand-alone exercise prevented episodes of low back pain in the long term (RR 0.92, 95% CI 0.85–0.99). This concerns low back pain, not round ligament pain specifically, and the authors noted that high-quality evidence for prevention strategies for lumbopelvic pain is still lacking (Santos et al., Physiotherapy, 2022). [3]
What is the round ligament?
The round ligament is a rope-like band of connective tissue that supports the uterus. There are two uterine round ligaments, with one positioned on each side. Each is about 4 inches, or 10 centimeters, long. [1]
Unlike ligaments that stabilize a joint by attaching bones, the uterine round ligament supports an internal organ. It helps support the uterus and connect it to the lower part of the abdomen. For comparison, see our guide to ligaments in the body. [1]
The term “round ligament” usually refers to the uterine round ligaments. The round ligament of the liver is a different structure: it is the remnant of the umbilical vein, a blood vessel that carries blood from the placenta to the fetus during pregnancy. [1]
How does the round ligament develop?
The round ligaments develop from the gubernaculum, a tissue present in all fetuses during fetal development. As the sex organs form, the ligament follows different developmental paths. In a female fetus, it helps connect the uterus to the outer lips of the vagina, called the labia majora. In a male fetus, it moves down to the scrotum.
This developmental history explains why the round ligament is related to the uterus and groin rather than functioning like a typical joint ligament.
Structure | Description |
Uterine round ligaments | Two rope-like connective-tissue bands that support the uterus. |
Gubernaculum | Fetal tissue from which the round ligaments develop. |
Round ligament of the liver | Remnant of the umbilical vein; separate from the uterine round ligaments. |
Where is the round ligament located?
The round ligament is a pair of ligaments, one on either side of the uterus, that run through the groin and insert into the labia. Several structures arise near the upper corners of the uterus and briefly travel together, including the round ligament, the fallopian tube and the ligament that holds the ovaries close to the uterus. [1]
From there, the round ligament enters the abdominal wall and passes through the groin in the inguinal canal (see our guide to the inguinal ligament). It eventually inserts into the labia, which helps explain why symptoms may be felt in the groin or vaginal area. [1]
Part of the route | Description |
Starting area | Near an upper corner of the uterus. |
Nearby structures | Fallopian tube and the ligament holding the ovary close to the uterus. |
Passage | Through the abdominal wall and inguinal canal in the groin. |
Insertion | Into the labia. |
What does the round ligament do?
The round ligaments support and anchor the uterus. During pregnancy, they are placed under increased tension as the uterus grows to accommodate a fetus. They become wider and longer to help support the growing uterus. [1]
This support role is different from the role of ligaments around a joint. The uterine round ligaments do not stabilize a bone-to-bone joint; they support the uterus and connect it with the lower abdomen.
Why does pregnancy cause round-ligament pain?
During pregnancy, the uterus grows and expands. The round ligaments also expand as they support a uterus that is becoming larger and heavier. Tension in these ligaments can cause pain that radiates through the groin area.
Round ligament pain is a common pregnancy symptom that occurs as the ligaments stretch and contract. It can begin in the second trimester, after 13 weeks, and may feel sharp in the hips, abdomen or vagina.
Pregnancy-related change | Possible experience |
Uterus grows and becomes heavier | Greater tension is placed on the round ligaments. |
Round ligaments widen and lengthen | Stretching and contraction can cause pain. |
Pain radiates through nearby structures | Sharp pain may be felt in the hips, abdomen, groin or vagina. |
Timing | Symptoms can start in the second trimester, after 13 weeks. |
Which conditions can affect the round ligament?
Three conditions or symptom patterns can involve the round ligaments: round ligament pain, round ligament varicosity and endometriosis affecting the round ligaments. [1]
Condition or symptom pattern | Description |
Round ligament pain | A common pregnancy symptom caused as the ligaments stretch and contract; it may start after 13 weeks. |
Round ligament varicosity | Varicose veins in the round-ligament veins during pregnancy, most often in the second trimester; it can cause groin pain and swelling and may be mistaken for a hernia. |
Endometriosis involving the round ligament | Cells similar to those in the uterine lining grow in or on the round ligaments and can lead to pelvic pain. |
What is round ligament varicosity?
Round ligament varicosity is a varicose-vein condition involving veins in the round ligament during pregnancy. It occurs most often in the second trimester and can cause pain and swelling in the groin. Because the swelling may resemble a hernia, professional evaluation is important. See also our guide to varicose veins in pregnancy. [1]
A healthcare provider should monitor round ligament varicosity throughout pregnancy. It generally resolves on its own after delivery. [1]
Can endometriosis affect the round ligament?
Yes. Endometriosis can develop in or on the round ligaments. It can lead to pelvic pain. A symptom does not establish the cause, so ongoing pelvic pain should be discussed with a qualified professional. Learn more about chronic pelvic pain. [1]
Can people assigned male at birth have round ligaments?
Not in the same form. In a male fetus, the same fetal tissue, the gubernaculum, guides the testicles into the scrotum and remains only as a small scrotal ligament, so males do not have uterine round ligaments.
The uterine round ligaments are commonly discussed in relation to pregnancy because pregnancy places them under tension. Their developmental pathway differs according to how the sex organs form during fetal development.
How can round-ligament pain be eased during pregnancy?
Gentle stretches of the pelvis and hips may help during pregnancy, but there is no single way to stretch the round ligament. If a movement causes round-ligament pain, stop the movement and rest until the pain goes away. [1]
An abdominal binder can also help support the abdomen and improve round-ligament pain. Any exercise or support device during pregnancy should be discussed with a qualified pregnancy-care professional when symptoms are persistent, severe or unclear. [1]
Approach | How to apply it |
Gentle pelvic or hip stretching | Try gentle movement only if comfortable; there is no single round-ligament stretch. |
Stop and rest | If pain starts during a movement, stop and rest until it goes away. |
Abdominal binder | It may support the abdomen and improve pain; discuss appropriate use with a professional. |
When should you call a healthcare provider?
Call a healthcare provider if severe round-ligament pain lasts more than a couple of minutes, particularly when it occurs with other symptoms. These include cramping, fever or chills, nausea or vomiting, vaginal bleeding, blood in urine, contractions and pain when urinating. [1]
These symptoms are not a diagnosis. They are reasons to contact a professional who can consider pregnancy timing, symptoms and examination findings together.
Symptom accompanying severe pain | Why professional review matters |
Cramping | May indicate a concern other than uncomplicated stretching. |
Fever or chills | May occur with illness that needs evaluation. |
Nausea or vomiting | Adds context that should be reviewed during pregnancy. |
Vaginal bleeding | Requires pregnancy-care assessment. |
Blood in urine | May indicate a urinary or other problem that needs review. |
Contractions | Should be discussed with a pregnancy-care professional. |
Pain when urinating | May point to a urinary symptom that should be assessed. |
Conclusion: a supporting band that works harder in pregnancy
The round ligament is a connective-tissue band that supports the uterus. Two ligaments extend from the upper corners of the uterus, pass through the groin and insert into the labia. During pregnancy, they widen and lengthen as the uterus grows, and this tension can cause sharp pain in the hips, abdomen, groin or vaginal area. [1]
Round-ligament pain is common, but severe or persistent pain should not be self-diagnosed. Call a healthcare provider when severe pain lasts more than a couple of minutes or occurs with cramping, fever or chills, nausea or vomiting, vaginal bleeding, blood in urine, contractions or painful urination. [1]
If you are pregnant and have groin, pelvic, abdominal or vaginal pain, note when it started, what movement triggers it and whether any warning symptoms are present. Share that information with your pregnancy-care professional before trying new exercises or support measures. [1]
Frequently Asked Questions
Is round-ligament pain normal during pregnancy?
Round-ligament pain is a common pregnancy symptom that occurs as the ligaments stretch and contract. It can begin in the second trimester after 13 weeks and may feel sharp in the hips, abdomen or vagina. Severe pain or pain with warning symptoms still needs professional review.
Where do you feel round-ligament pain?
Round-ligament pain may be felt in the hips, abdomen, groin or vagina. Because several conditions can cause similar symptoms, location alone cannot identify the cause.
Does round-ligament pain mean the ligament tore?
Pregnancy-related pain is described as a result of the round ligaments stretching and contracting as the uterus grows. Ordinary round-ligament pain is not described as a tear. A qualified professional should evaluate severe or unusual pain.
Can you stretch the round ligament?
Gentle pelvis and hip stretches may help during pregnancy, but there is no single way to stretch the round ligament. Stop the movement and rest if it causes pain.
Can an abdominal binder help?
An abdominal binder can support the abdomen and improve round-ligament pain. Discuss whether it is appropriate for your situation with a qualified pregnancy-care professional.
What is round-ligament varicosity?
Round-ligament varicosity is a varicose-vein condition in the veins of the round ligament during pregnancy. It most often occurs in the second trimester and can cause groin pain and swelling. It can be mistaken for a hernia, so a healthcare provider should monitor it. It generally resolves after delivery.
Can endometriosis involve the round ligament?
Yes. Endometriosis can develop in or on the round ligaments and can lead to pelvic pain. Ongoing pelvic pain needs professional assessment rather than self-diagnosis.
Do people assigned male at birth have round ligaments?
Not in the same form. In males, the fetal gubernaculum becomes a small scrotal ligament, so males do not have uterine round ligaments.
What symptoms mean I should call my provider?
Call your provider for severe round-ligament pain lasting more than a couple of minutes, especially with cramping, fever or chills, nausea or vomiting, vaginal bleeding, blood in urine, contractions or pain when urinating.
Is the round ligament of the liver the same structure?
No. The round ligament of the liver is separate from the uterine round ligament. It is the remnant of the umbilical vein, which carries blood from the placenta to the fetus during pregnancy.
Related reading
References
Cleveland Clinic. Round Ligament of The Uterus: Anatomy & Function. Cleveland Clinic. Updated March 29, 2024. https://my.clevelandclinic.org/health/body/21646-round-ligament
Buksh MM, Al Naib S, Al Samaraee A. Round ligament varicosity: a rare but important differential diagnosis of groin lumps during pregnancy. Br J Hosp Med (Lond). 2023;84(5):1-15. PMID 37235666. https://doi.org/10.12968/hmed.2022.0469
Santos FF, Lourenço BM, Souza MB, et al. Prevention of low back and pelvic girdle pain during pregnancy: a systematic review and meta-analysis of randomised controlled trials with GRADE recommendations. Physiotherapy. 2022;118:1-11. PMID 36288631. https://doi.org/10.1016/j.physio.2022.09.004
Medical disclaimer
This article is for general educational purposes and is not a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of a qualified healthcare professional with any questions about a medical condition or treatment.
Comments