Pelvic girdle pain (SPD)
Do you have, as one Mumsnetter describes it, a "throbbing undercarriage"? Then you may well be suffering from SPD, which stands for symphysis pubis dysfunction, otherwise known as pelvic girdle pain.
We're talking proper pain here, as this Mumsnetter explains: "I'm 25 weeks and already in eye-watering pain; I had no idea that pregnancy had this nice element to it."
What exactly does SPD mean? The symphysis is where your pelvic bones, held together by ligaments, join at the front of your pelvis. There are other 'fixed' joints at each side of the bottom of the spine (sacroiliac), forming the heart-shaped pelvic bones.
A pregnancy hormone called 'relaxin' (fat chance of that) loosens the pelvic ligaments to allow the pelvis to open slightly when you give birth.
One Mumsnetter's SPD checklist
- Wear a support
- - if you can't get hold of a pregnancy support, then wear a maternity swimsuit or tie some old sheeting around your pelvis, you can also use a sarong
- Ironing and hoovering will worsen the pain - try not to do these
- Take stairs one at a time
- Don't overreach or stretch if possible
- Paracetamol generally don't help - try a hot wheat pack instead
- Use a pillow in between your knees when you sleep or get a pregnancy support pillow which you can curl around - try to keep your pelvis in line
- See a physiotherapist or chiropractor
- Keep your legs together
- Try not to lift anything too heavy
- Don't let anyone put your legs in stirrups without first measuring how far you can open your knees painlessly
- Don't let anyone hold your legs back to push
- Try to stay upright or in water - as this alleviates some of the pressure
- Wiggle your hips if your labour pains are in your back, but don't over-sway
- Put 'SPD sufferer' in your birth plan so your midwives are aware
Unfortunately, these ligaments occasionally loosen too much and too early, so your normally stable pelvis moves.
Throw in the increasing weight of your growing baby and the symphysis joint can separate, leaving you with mild to severe pain, aka SPD.
The pain from pelvic girdle pain, which can start at any point but usually in the second trimester, causes difficulty walking, turning in bed, climbing stairs, getting dressed and getting in and out of a car - so pretty much all normal life activities.
You can feel the pain in your pubic area, groin, the inside of your thighs, hips and (literally a pain in the a**e) one or both buttocks. Some women describe a clicking feeling or sound.
It's important you get advice from an obstetric physiotherapist. Unlike some other pregnancy complications, eg cholestasis, it doesn't necessarily get better as soon as you've given birth. And your GP will be able to advise on which painkillers you can safely take while pregnant.
If you need an epidural, make sure that the width you can open your knees painlessly is measured before the epidural is inserted. This will avoid any damage when your knees are apart for examinations or for delivery, or if you need to be in stirrups if a ventouse or forceps is necessary.
Labour can be a daunting prospect if during pregnancy you're so immobilised you're on crutches or in a wheelchair.
One mum makes an important point about pain relief during labour: "I had an epidural. That's when some permanent damage can occur because you're not aware of the pelvic pain and so open your legs 'too' wide, IYSWIM. Make sure all the staff present know you have pelvic pain and let them see how far you can open your legs before you have the epidural."
What Mumsnetters say about pelvic girdle pain
- I went to a physio about other back problems, described the symptoms and was told it's SPD. They gave me a brilliant corset, and I now use crutches also. Also sleep with a pillow between your knees. Katsh
- A physio will be able to advise exercises and positions that will help, as well as the ones to really, really avoid. The only way to ease the pain is to do absolutely nothing and rest - not easy though. Don't push a heavy shopping trolley either - that's a killer! You may be a little limited for labouring positions too when the time comes, but if your pregnancy is problem free other than the SPD, then a pool would help. Mcmudda