S is for Symphysis Pubis Dysfunction
In our last blog post we covered Round Ligament Pain, so I wanted to talk about another similar source of discomfort some women may experience during pregnancy. Symphysis Pubis Dysfunction, or SPD, affects 31% of all pregnant women. Unfortunately, many are told this is just another "ache and pain" to be dealt with, but for some it can be incredibly painful and make pregnancy much more stressful. Let's take a closer look at what causes it and how we can get some relief.
What is Symphysis Pubis Dysfunction?
You naturally have a tiny gap where the two halves of your pelvis join in the front. This is your pubic bone, and is actually a very stiff joint meant to minutely adjust during pregnancy and childbirth to accommodate your baby. In the case of SPD, this gap widens and can cause pain and stress for the pregnant mother.
What causes it?
There is a hormone, Relaxin, that is known to loosen your joints during pregnancy and is a cause of SPD when too much is produced in the body, or too early in your pregnancy. Some other risk factors include past pelvic trauma, obesity, or carrying a larger baby or twins, however there is no easy remedy for these stressors.
It is nice to know that this pain is not a sign of something serious, but it can be annoying, stressful, and downright painful. The two problems mothers typically face are coping with the pain throughout their pregnancy, and planning to navigate the birth process with this potential discomfort. I'm going to share tips with you for both situations!
Coping During Pregnancy
Be Gentle- You're probably already moving carefully, but there are some extra things you can do. Invest in a maternity pillow (lie on your side!), keep your legs together when making usual movements like swinging your legs out of bed or out of the car door, and take smaller steps up the stairs or walking. It's also a good idea to avoid heels, crossing your legs, or jarring activities like riding a bike. It also needs to be mentioned that when engaging in intimacy with your partner, be mindful to keep your legs together as much as possible to avoid pain.
*This seems like a lot of things to keep in mind, and it can be frustrating. After you get some relief from immediate pain, you may be able to test your limits and see what you're capable of. These are simply general guidelines to help you to make the best choices for your body.
Support Your Hips
The pain from SPD is usually localized, but can sometimes be felt as sciatica or back pain. We covered belly taping in our last post, and that can be a helpful addition to your SPD care plan. Some women swear by portable pillows, or a foam roller to work out the kinks in their lower back and legs. Taking warm epsom salt baths or using a hot water bottle can feel wonderful when you are sore, as well.
Your chiropractor will ensure that every bone in your body is where is should be, to the best of their ability. When things get helped into the right place, relief can happen very quickly. This can also help to correct poor posture, which causes more pain in itself. I personally found great relief from this method! Prenatal massage is a great addition to your chiropractic care, and most offices offer both services.
Pelvic Floor Exercises
Kegels, Squats, Pelvic Tilts/Hip Thrusters (Bridge Pose, for my yogis) all help strengthen your pelvic floor. If you feel you would like expert help, seek out a local Pelvic Floor Therapist.
Giving Birth with SPD
Supportive Care Providers
If your care provider doesn't understand your pain level and physical history, your birth plan (including special allowances for your SPD condition) may not be taken as seriously as they should. You'll likely have some positions you want to avoid, and may not be able to open your legs very easily or much at all. Talk during your prenatal meetings about your plans for this birth and managing your SPD, and listen to your gut feelings as they respond to your concerns.
It's very important for your birth experience to have a completely supportive and understanding team cheering you on. Along with your choice of medical care provider, having a Doula is a great asset for any birth plan.
Use the methods of relief you have found so far. If taking warm baths was helpful, use a birth tub or plan for a water birth. If you enjoyed your prenatal massages, have your support team ready to go with massage oils and tools. You need to find what works best for you!
If you're considering an epidural for pain relief, keep the physical guidelines for birth in mind. When the sensation of pain is gone, it can be easier for your team to forget the potential damage certain positions can cause for you postpartum. Make sure your birth team respects your choices and birth plan regardless of your pain relief method.
Whatever positions were uncomfortable during pregnancy may be painful during labor and delivery, so make those preferences known ahead of time. Typical birth positions may cause you pain, so instead try positions like kneeling, on all fours, or standing/leaning. Some women report success lying on their sides and pulling their knees up to their chin. Don't be afraid to be creative! These unique or unusual positions are best for your pelvis and should be less stressful. Be vocal during the birth process, let your team know what is and isn't working for you.
*Here are some birth stories shared from midwives and women who have had SPD.
After the birth, keep practicing self care. Relaxin is still present during postpartum recovery, and in fact, it can take up to 5 months for your body to stabilize and feel normal again. This isn't meant to discourage you, but gently persuade you to be easy on yourself! After 6 weeks, gentle exercise is usually okay, but continue following the guidelines in this post until your body is ready for more intense activity.
If you are struggling with your recovery progress, consider a postpartum consult with a Pelvic Floor Therapist. It can also be helpful to have extra care at home from friends or family or Antepartum/Postpartum Doula support.
If you're struggling with Symphysis Pubis Dysfunction, listen to your body and take care of yourself. Let me know in the comments what relief methods work best for you!