In response to those seeking tips on how to minimise pain of spd
When I first developed spd, I thought I was imagining things, then I decided that agony that felt like a kick in the pubic bone by a very angry bull could not possibly be imagined, and it could not be ?just another ache of pregnancy?.
I got pretty severe spd at 24 weeks.
I have managed to alleviate some of my symptoms quite dramatically by a two-fold plan:
- find out as much as I can about the condition; and
- find out as much as I can about how my body reacts to it.
I have done some extensive research about this, and there are plenty of excellent resources available on the internet. I recommend that you take a look at what is out there, but look at several sources, because this condition is sometimes not well understood by the medical community. I attach a link which provides a lot of good information:
www.plus-size-pregnancy.org/pubicpain.htm#Anatomy%20and%20Structure
WHAT CAN YOU DO TO HELP YOURSELF
Frustratingly, different women react differently to different tips and treatments (while some things help some women they aggravate the condition in others!). I list below the most common ones, but emphasise that every woman seems to react differently and you need to get to know your body and what works for you (and what aggravates your condition)
Medically the most effective appears to be visiting an osteopath specialising in pregnancy ailments. They realign the pelvis, which helps the cause of the pain. Second most effective appears to be going to a chiropractor (again one specialising in pregnancy ailments).
Options which some women find excellent (and others find useless) are:
? physiotherapy
? belly belt/belly brace
? acupuncture
? reflexology
Options which are helpful to some and aggravate the conditions in others are (you need to do a bit of trial and error testing here. I found that my agony was so bad that I was prepared to try anything, and am glad I did because I can be totally pain free some days by using some of these tips):
? swimming ? 15 to 30 minutes of slow swimming (this works best for me, leaves me pain free for 2 or 3 days afterwards, other than the agony of turning in bed). Do NOT overdo it. Some find that the breast stroke kick is harmful to the condition. I find that as long as I go at a slow measured pace, any movement through the water helps including breast stroke (even walking through the pool). The first 5 to 8 laps are generally very uncomfortable, but if I keep going it really works for me (I am not a good swimmer at all, and often just and kick up and down). NOTE: swimming on your stomach is good for getting baby to position well for birth, while swimming on the back can make your baby more prone to go into a breach position.
? Walking ? again a slow walk of 15 ? 30 minutes helps some people. Generally walking on a flat surface. Some women report pain for the first 5 to 10 minutes, but say that if they keep going through that then it really helps. (Walking is the worst thing for me and severely aggravates the pain, but it was worth giving it a go to know what to avoid. I keep all walking to a minimum, and particularly try and avoid slopes or stairs).
? Any other gentle exercise that helps realign the pelvis. Due to my limited walking, I do a lot of circling of my hips when I sit or lie down. These are small, gentle circles (or small gentle rocking backwards and forwards). Some women find that doing similar movements down on all fours helps. Try it out. The movement should be painfree, and should serve to keep your muscles from stiffening up (a complaint of women ordered to move around as little as possible).
? Keep doing pelvic floor exercises. Nothing really to do with spd, but will help with the actual birth and helps to avoid pregnancy induced incontinence (which we could all do without).
? Some women are recommended not to move at all (stay sitting or lying down). This can work in some cases, but most often tends to cause frustration and other complications (worsen veracious veins, constipation, haemorrhoids, general feelings of isolation and feeling useless and not in control). If you can find some exercise (as above or some gentle yoga exercises or any others) that you can do in moderation, this may have a better effect both on your spd and your general health (and keep you in better shape for the actual birth). Some find that the more active they can be the better (for the spd and for their feeling of sanity), but they have to adjust and do things that do not aggravate the spd.
? Massage ? but be careful and let the therapist know when you are in pain and how much pressure to apply.
? Hot packs/cold packs ? generally where the pubic bones meet, but also may be helpful on the hips.
? Hot bath. Take care, some women find this makes them dizzy (or aggravates dizziness if they have low blood pressure). Also, some experts advise avoiding hot baths (as it is thought that this can disrupt blood flow away from your baby). This may only provide very short term relief, but can help in severe cases. Perhaps it is relaxing in the bath/spa that helps. Find a temperature that suits you. Also, take care getting in and out of the bath, support yourself on the edge of the bath with your hands, to take the weight off your legs, and to ensure better balance.
? Sleep with a pillow or folded duvet between your knees (WARNING: this only aggravated my spd).
? I do have some exercises which can help, I will try and get a link up to these shortly.
Most common tips that seem to help most women with spd
? ROLLING OVER IN BED! Most people have a problem with this. The ONLY thing I have found that helps is to keep your shoulders, hips and knees aligned. Lying on your left side, push your shoulders around with your left elbow, and simultaneously rotate your hips and knees (keeping them all aligned) keep rolling until you get onto your back. Swing your left arm across your body to the right, drop your knees to the right, and swivel your hips to the right ? all at the same time, until you lie on your right hand side. Others find that wearing silky pajamas or using silky sheets help with turning over.
? Getting into bed ? sit on your backside on the bed. ?fall over? onto your side (with your head onto your pillow), at the same time that you ?fall over? raise your legs up onto the bed (legs together, still bent) ? so the weight of the shoulders dropping down help you swing your legs up.
? Avoid activities which require weight on one foot only (eg. Sit when putting on pants, get into the car with both legs together and slide your butt in first then both legs, avoid stairs, get out of bed by putting weight on both legs not just one).
? Avoid lifting heavy items (especially if you can feel it pull in your pelvis when you lift). This might mean rearranging your lifestyle. I get my husband (or a visitor) to carry my laundry basket up and down the stairs. They are usually very happy to help.
? Limit lifting up your toddler (if you have one). Just this one thing has made a huge difference to my pain levels. This is difficult, but I have taught my two year old that mommy has a sore back and he needs to help me. He has learned how to climb into his own car seat, how to climb into his high chair/the shopping trolley (with me holding his arm for support and guidance). I minimise as far as possible picking him up off the floor. Our snuggle time now happens with me sitting on a chair and him clambering up (with me helping pull him up if it necessary). Toilet time is still a challenge, but I have a stool for him to climb on so that I don?t have to lift his weight off the floor, but rather off the stool and onto the loo. I?ve put a chair by the hand basin, which I help him climb onto, so that he can stand there and wash hands rather than being held.
? Make use of slippery surfaces for difficult movements. Eg. Put a plastic carrier bag on the seat of your car to help you slide in and out, wear silky pyjamas/use silky/satin-type sheets (or the inside of a sleeping bag/upside-down eiderdown) on your bed to help with that agonising roll-over in bed.
? Avoid bending too far down. If you need to get something off the floor, sometimes a better option than bending is to get onto all fours (not very gracious, but then nothing about this condition is!)
? Do not be put off by health care professionals who have never heard of spd or think it is just another ?ache of pregnancy?. Find out who your local practitioners are who are aware of this condition and find out what they recommend for you.
? Avoid standing if this aggravates you. Even a five minute stand really increases my pain levels for the rest of the day. I now peel and chop veges either at the dining room table, or on the sofa in the lounge. I also have a chair in the kitchen for a bit of a rest in between cleaning up. I have not vacuumed for months.
? Avoid sitting down and standing up too many times. This puts strain on your pelvis and can cause more pain. Make sure you have everything you need before sitting down, or ask your children/partner/visitors to fetch you whatever you need from across the room. Sounds silly, but it really reduces the stress on the pelvis.
? Let your family know that you need their support (including children). With a bit of management most women can significantly ease their pain, but it requires help from others. Remind them (if they need it) that having you in agony is not going to be any fun for them, and the few things that they can do that will be no big deal for them (carrying out the rubbish/carrying the laundry basket to the washing machine/doing a bit of vacuuming) will make a real difference to you. You can compensate by helping out with some activities that you don?t usually do, but which do not aggravate your condition. Some women get spd so severely that they end up on crutches for months! Remind your family that if that happens, they?ll have to do EVERYTHING.
? Know your limits. Overdoing it will cause more pain for a longer period.
? Balance this with trying to be useful/active in non-harmful ways, as this helps your spd, your relationships, your mental state and your fitness levels.
? Most women find they need to sit more (or lie down more) than usual. Find out what works best for you. Some women find a soft chair is a killer, and something hard like a kitchen chair is needed. Reclining on your side (propped up with pillows or a beanbag if necessary) can also provide some relief. Sometimes just changing positions (sitting on different chairs at different times) seems to help (different levels of support seems to kick in).
? Avoid rapid/sudden movements.
? Hold on to banisters and rails (eg coming down stairs, in a bus). Some women use this to take weight off their legs (holding on and putting some weight on their arms). Even if you don?t need to transfer weight off your legs, holding on lightly is a good idea, because your balance can be off when you are pregnant, and the last thing you need (even without spd) is a fall.
? Some women swear that not wearing any panties helps!
? Avoid bending down (sometimes it is easier to get onto all fours and crawl around to do whatever you need to do, than to bend at the hips/knees) eg for cleaning or picking things off the floor.
FOR THE BIRTH
I know, who can think of birth when it is agony just to roll over in bed or walk. But this seems to be very important to the recovery time after birth. Again, everyone is different, but generally it seems that there are a couple of very important things you can do to help yourself recover from spd after the birth.
- Let you care giver and your birth partner know about your condition and give very strict instructions about positions you do not want when birthing.
- Find out all you can about birthing positions. Practice now. If it aggravates spd now then it is likely to have longer lasting negative effects after the birth.
There is something out there called the Pink Kit (see www.commonknowledgetrust.com). It is a book, video, audio tape which puts together all the tips and knowledge on birthing that women used to get from being involved in the birthing process in their communities. It provides suggestions on pre-birthing exercise (some of which can help with spd) and also on different positions. It encourages you to get to know you body prior to birth and try out some of the positions to see which ?opens you up? for optimum birthing positions. When suffering from spd, you would use these exercises also to help you see which positions make your spd worse, so you can tell in advance which positions you want to avoid. I have no connection to the makers of this product, but have heard good reviews about it, and am currently working through the kit myself. Some of the advice on dealing with birth in child birth is already coming in handy in dealing with spd pain.
Some women recover quickly from spd after birth, some take longer. Birthing positions can help, but sometimes there is no explanation that we know of as to why the body reacts like it does.
CONCLUSION
Sorry this is so long! But to everyone out there TAKE HEART. You are NOT alone, and there are things that you can try to help yourself. These may or may not work for you, but at least you can regain some power by giving them a try. Some of the things (small hip circles) will give you something to do that will at least not make your condition worse.
Personally, despite the ongoing agony, I feel that the days and hours that I get pain free by following some of the tips above make it worth it. Also, I feel as though I am doing something (and am determined to complain as little about the pain as I can). So even when it does not work, I try to give myself credit for trying.
My aim is to have the best pregnancy and birth possible, and nothing (not even spd) is going to get in the way of that.
Most encouraging is that most women do find that spd disappears fairly quickly after birth. For some it lingers a bit longer, and for some they have occasional recurrences (eg when lifting something heavy). Even for those who are slow to recover the good news is that it does get better.
Good luck with your pregnancy and birth ? I pray for an easing of your pain, a good birthing experience, and happy & healthy babies for you. I think you?ll make great mums ? based on the courage and determination you show right now while suffering through something really difficult.