Pelvic pain & SPD

Advice on coping with pelvic pain and SPD in pregnancy.

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Many women suffer from severe pelvic pain during pregnancy and in the months after their baby is born. This has often been dismissed as a nasty side effect of carrying a child however more of the medical profession are starting to take this relatively common complaint more seriously.

SPD or symphysis pubis dysfunction can occur from the first trimester onwards and is caused by a loosening of the pubic symphysis, a joint at the front of the pelvis, during pregnancy. Symptoms include tenderness, pain and a feeling of pressure in the pubic area, severe discomfort lifting or parting your legs, shooting pains in your lower body, a clicking feeling in your pelvis as you move (possibly feeling like your hip is moving around in the joint) and sometimes backache too.

What causes it?

The symphysis pubis is the strong, ligamented joint that holds the front bones of the pelvis together. It helps to stabilise the pelvis, allowing free movement of the legs and lower body and under 'normal' circumstances is very inflexible. During pregnancy the pelvis needs to be more adaptable than usual to make room for a growing baby and to allow for baby's passage during birth. However, just as you can overstretch other joints in the body during pregnancy, some women experience an overstretching of the symphysis pubis which can be responsible for the aforementioned symptoms.

It is the aptly named pregnancy hormone 'relaxin' that is responsible for this loosening and stretching of the ligaments to make room for a baby. Its believed that SPD and pelvic pain may be down to an excess or oversensitivity to this hormone coupled with misalignment of the pelvis or lower back. Unfortunately for this reason its believed that if you suffer with SPD during one pregnancy and do not receive treatment, you may also experience it during subsequent pregnancies although there is no way of knowing for sure.

What can be done?

If you are suffering from pelvic discomfort you should visit your doctor as soon as possible as they will be able to advise you on the best course of action to take and may prescribe you some pregnancy-safe pain relief or refer you to a specialist physiotherapist or osteopath. However there are many steps you can take in your day to day life that will help to reduce your discomfort, these include...

• Wearing a support band or Tubigrip to provide more support to the pelvic area.



• Placing a pillow between your legs while sleeping.



• Keeping your legs as symmetrically together as possible when sitting or lying down and when getting out of bed or a car.



• Sitting down to get dressed and when putting on shoes.



• Taking the stairs one at a time; placing one foot on a step and bringing the other up to meet it before moving to the next step.



• Swimming, floating or exercising in water to help aleviate pressure on this joint



• Practicing pelvic floor exercises to help bring more stability to this area



• Resting whenever possible

What about the birth?

You should inform the midwifes present at your birth that you have suffered with pelvic pain during your pregnancy so that they will be able to support you accordingly. Generally, more active birth positions such as kneeling or all fours are more comfortable however you should do whatever feels best for you at the time. If you do have trouble parting your legs during the latter stages of pregnancy do ensure that your midwife knows this especially if you have an epidural as they will be able to keep you focused on not over widening your hips.

Fortunately for the vast majority of women pelvic pain lessens and gradually disappears in the months after their baby arrives. Treatments such as osteopathy and physiotherapy area also a great help in speeding up the recovery process.