Symphysis Pubis Dysfunction
There are a lot of unpleasant pregnancy symptoms that no one mentions until you’re already pregnant. Bigger shoe sizes, heartburn, and a permanently stuffed nose to name a few. One of the most painful of these is Symphysis Pubis Dysfunction, also known as SPD or pubic bone pain.
What is Symphysis Pubis Dysfunction?
The pelvis is shaped like a ring but has a small opening on one side to allow for a wide range of movement. This opening, called the Symphysis Pubis, is connected by ligaments and cartilage which help keep the pelvic area stable. During pregnancy your body increases its hormone production. The hormones relaxin and progesterone work together to help loosen ligaments, allowing room for the baby to grow and for the flexibility needed to give birth. This is one of the reasons that women develop a "waddle" towards the end of their pregnancy. A side effect of this loosening is that the Symphysis Pubis has a wider range of movement. This can result in the grinding of the bones at the front of the pelvis, or a pinching of nerves in the back.
Symptoms of Symphysis Pubis Dysfunction
As your pregnancy progresses, you might start to feel a dull ache in your lower pelvic region. A lot of women describe it as a mild pain that feels like it's coming from inside the pubic bone. It’s mild enough that many women probably write it off as one of the many small aches and pains that come with being pregnant. If the Symphysis Pubis becomes too loose, you can develop more severe pain in the lower pelvis, back, hips or even up and down your legs. Some women may have difficulty sleeping, climbing stairs or even walking.
Managing the Pain
If you find yourself experiencing pain, speak with your doctor or midwife right away. There are a variety of things they might try, including:
- Warm baths (never take hot baths while pregnant)
- A pregnancy girdle to keep your hips and pelvis stable
- Using crutches
- Pain medication
- Chiropractor services
There are also some simple ways you can help minimize the strain on the ligaments and muscles. Pay special attention to how you move about during the day with regard to your pelvis, hips and legs:
- When getting into bed or the car, sit first and swing both legs together. Conversely, when getting out of bed or the car, swing both legs out and then stand up.
- Sit with both legs together. Never sit cross legged or "Indian-style."
- Avoid strenuous walking or climbing. Ask for help with chores that require going up and down stairs.
Labour and Delivery
Make sure that the doctors, nurses and/or midwives working with you during labour and delivery are aware of your condition. There are a variety of positions you can use while giving birth and you’ll want to choose those that place the least amount of stress on the Symphysis Pubis. Ask them to avoid forcing your legs open and back while pushing as this can cause significant pain and even permanent damage. Lastly, make sure you have an advocate with you, who can speak on your behalf if you are too distracted. A spouse, parent, sibling or friend who is there to help you with your birth is the perfect choice.
Recovery
Symphysis Pubis Dysfunction typically goes away postpartum as the additional hormones leave your body. Most women feel fully recovered shortly after the birth. In some cases, you may feel lingering discomfort. In rare cases, there is lasting damage which needs to be treated over time. This is highly unusual, but if you have concerns you should definitely speak with your doctor.