Symphysis pubis dysfunction
It’s thought that around one mom-to-be in 30 suffers from symphysis pubis dysfunction (SPD) and it causes intense pain that can make walking, climbing stairs, dressing, getting out of a car, and any other movement that involves the pelvic bones, intensely painful.
Your pelvis is formed of three separate bones held together by ligaments and not designed to move apart. However, during pregnancy, the hormone relaxin causes the ligaments to become stretchy. This is necessary so that the pelvic bones will be more flexible when it comes to accommodating the passage of your baby’s head during the birth. However, if the pelvic ligaments are too flexible the joint can become unstable and separate, resulting in SPD. This is more likely in late pregnancy, as the growing baby’s head presses down on the pelvis, although some women get it as early as the first trimester (weeks 0-12) and some develop it after the birth.
What are the symptoms?
Symptoms of SPD include pain in the lower abdomen and around the hips and inner thighs. The pain increases with any activity that involves opening or lifting the legs, and may be accompanied by a clicking sound from the pelvis. If you experience pain or hear a clicking noise, tell your OB-GYN or midwife straightaway, as your condition could have implications for your baby’s birth. She will likely arrange an
ultrasound scan to examine your pelvic joint. If you have SPD your caregiver may prescribe painkillers and refer you to a physiotherapist who can fit you with a support belt. If the problem is especially severe you may have to use crutches to help you walk.
Self-help measures
It’s vital that you limit excessive pelvic movement if you have SPD. Take smaller steps while walking, try to avoid using stairs as much as you can, and if you’ve been swimming for exercise during pregnancy avoid doing the breast stroke.
When it comes time to have your baby, be sure that all of your caregivers are aware that you have SPD, as it’s important that your legs are not spread during the delivery. If you have an
epidural, keep in mind that you may not necessarily feel the pain of your condition so you’ll need to be especially vigilant not to extend your range of movement or be maneuvered into positions that aggravate it. Ask your caregivers to lay you on your side for pushing. If you’re giving birth without an epidural, an all-fours or side-lying position is best for pushing. Avoid squatting.
Rarely, SPD can worsen after the delivery but for most women the condition eases as pregnancy hormones tail off after their baby is born. It can recur during future pregnancies, although this isn’t always the case.
The information in this feature is intended for educational purposes only. If you have any concerns about your health, the health of your child or the health of someone you know, please consult with a doctor or other healthcare professional.
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Last Modified: 12/10/2008
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