Delivery with SPD

[littlelamb]

How do you manage it comfortably?? With dd i had an epidural which was allowed to wear off just as my legs were put into stirrups and the pain was horrible. This time around my SPD is even worse, to the point where I am struggling to walk and get in and out of bed, I was hoping for a more active birth but I just can't see myself crouching or doing any of the other positions that are meant to be good. What can I do to help? ANd can I stipulate that my legs must NOT be forced apart???

[spottyshoes]

I'm sorry I cant be of much help - had severe SPD and had an 'elective' CS - by the time the Epidural wore off the SPD had gone!!!!! Therefore I heart Epidurals!!!!!

[littlelamb]

Wow! I was induced with dd as she was overdue but my SPD is getting worse every day and I am considering asking to be induced again to avoid it getting even worse. I don't really know what to do for the best. I'm 38+2 so not long to go, but even since the weekend the pain is much much worse

[galaxymummy]

go to website pelvic partnership
measure comfortable gap with string of leg opening and refuse to part wider
see obstetric physio at hospital
hth

[TooTicky]

I had bad SPD with dd2. I had to lie on my back, but I was walking around until my waters broke.
Talk to your midwife and stipulate things loudly in your notes/birth plan.

[spottyshoes]

I am soooo please to say I never had to open my legs!!!! the thought of the pain bringing tears to my eyes!!!! and judging the pain of my SPD I am sad to say I would now never request a VBAC - I would now have a CS all the way - the instanst pain relif from SPD being one of the main factors!

[BetsyBoop]

I've a great booklet on SPD (having had it in both pregnancies too, not fun )

I can email it to you if you leave your addie, I've cut & pasted the birth plan bit which I found really useful

"5. Birthplan

I, (Name) ?????????.. have been suffering with Symphysis Pubis Dysfunction during my pregnancy, which has been extremely painful. It would reassure me to know that this birth plan was being followed at a time when I may not be able to express my needs clearly.

My pain free gap is ????.cms. Please help me make sure that my knees do not fall open beyond my pain free gap during delivery.

DURING LABOUR & DELIVERY

I would like to be able to move around as freely as possible during labour and may need your help and encouragement to avoid getting ?stuck? in any one position.

My preferences for pain relief are:-
1 ? To carry on as long as possible naturally ? 2 ? Waterbirth/birthing pool
3 ? Gas and oxygen (Entonox) - 4 ? Epidural/spinal block
5 ? Pethidine/Meptid ? T.E.N.S. (Transcutaneous Electrical Nerve Stimulation)

If possible, I SHOULD NOT deliver in a lithotomy position with legs/feet on midwives hips, or in stirrups as this will not help my condition. A better position would be lying left or right lateral with someone holding my upper leg (within my pain free range), or kneeling. If this is uncomfortable, help me to find a more upright position that puts as little strain or restriction on my pelvis and back as possible.
If an assisted delivery is needed, please could I opt for a ventouse delivery, as I understand this can be done laterally.

AFTER DELIVERY

After the birth, if I need stitches, please could this be done without the use of stirrups. If stirrups have to be ?used? please ensure that my knees be supported to prevent further damage to my pelvis.

I have/or would like, a pelvic support belt (Fembrace/Reenie/Promedics/Trochanteric) to wear postnatally to help stabilise my pelvis.
I may also require enforced bedrest and would be grateful if my notes made this clear for the staff on the postnatal ward.

I would like to see a Physiotherapist whilst in hospital to discuss treatment and modification to standard postnatal exercises. I would also like a referral for follow-up physiotherapy action while I am still in hospital, as I WILL NEED this help to fully stabilise my pelvis following birth.

Thank you for taking the time to read/discuss my plan. I hope it does not offend your professionalism in any way. I realise things do not always go to plan but I wanted to make you aware of my condition, and the pain I have been/am in."

[PortAndLemon]

Left lateral (i.e. lying on your left side) is supposed to be good with SPD.

[littlelamb]

My spd didn't go for a while after dd- but there is no way of knowing if this would have happened anyway or because of the damage done by the stirrups. I remember crying after deivery because of the pain in my pelvis Not something I wish to repeat but I know how easy it is to feel intimidated by medical staff, as last time the stirrpus were used even though I was pleading with them not to. Especially if it is a long labour, even if I do explain it to the first midwife I see, there is no guarantee that she will be the one there at delivery

[littlelamb]

Betsy Boop that is fantastic thank you. I will definately print that off and make it in LARGE letters!

[whomovedmychocolate]

Littlelamb: learn the following phrase by rote:

'I would consider it an assault if you tried to put me in stirrups or in a position which compromised my pelvic disorder'.

That will sharpen the minds of assorted mws/docs considerably

[jamila169]

See a chiropractor to get aligned as well as possible before the birth, and as has already been said -Epidurals are not good and section when you have spd ain't all that - I had both with my first and ended up with twisted SI joints and a partially dislocated hip,taking 12 weeks to be able to sit up in bed independently. Thats why the obstetric physios all recommend no epidural unless absolutely necessary( you need sensation to tell you if you are doing too much)and giving birth on all 4's for preference (obviously no one can force your legs too far apart if you're using them!),left lateral if not, but you'd need the scarf round the knees because you are letting someone else control your upper leg.
If you need ventouse/stitches it can be done in left lateral, despite what you may be told. It would be worth putting in your birth plan that only someone who is competent working with you in LL should do those things if they are needed.
You'll be pleased to learn I've had 3 other DC's since my DS1 2 born at home, one a hospital transfer all were born with me on all 4's, and my SPD, which was worse with each one, was pretty much history by the end of the first week

[Lulumama]

have a look at www.pelvicpartnership.org have to say that left lateral position, lying on the bed on your side, with your leg raised, is a good position, and you don;t have to open your legs too wide...all fours holding onto the head of the bed too .

avoid stirrups at all cost. as has been said!

[sweetkitty]

I have had SPD and SI pain in all 3 pregnancies (this time the worst) I have never had an epidural (too fast labours) last time I laboured mostly on my side scrunched up into a ball or on all fours. I believe I actually ended up delivering on my back but it was right at the end when the head was crowning and it seemed the right position. This time I am going to put in my notes that I watn to try standing up on kneeling if I can.

TBH the pain went as soon as the baby was out, hope yours does too.

[Becky77]

That Birth Plan wording is great Betsy Boop. Thanks s much for posting it.

I have a bit of a dilemma. I have quite mild SPD, although it's getting pretty bad now that I have 2 weeks left to go... The thing is it doesn't hurt when I spread my legs... It hurts when walking, standing on one leg and turning etc... Should I tell the midwifes I don't want my legs spread further than a certain amount to be safe? Or should I be honest and risk them putting me in stirrups?