C-sections and SPD

[pie]

Sorry for no up dates on last weeks drama, wasn't in labour, dunno what it was.

But what ever it was my SPD has worsened by about 100%. I can't even take one step now

I'm 31+1 and if this is how bad it is now, I can't imagine how much worse its going to get.

I know that in severe cases of SPD a c/s can be recommended. To be honest I really don't think I could go through a normal labour. The pain is constant, tear inducing, I can't part my legs at all. I didn't think it could get worse and low and behold it has...so I wan't people's opninions and having a c/s.

Does this qualify as a severe enough case? How much convincing would I have to do with the hospital (assuming I do decided this is the best course of action for me)? Would they understand? Would it be around 38 weeks if a c/s happens?

What should I do?

Hi pie

I'm new to mumsnet so I've not read the thread b4 now.

I do sympathise, I had SPD with my first pregnancy and I'm 28 weeks gone with number 2 and the SPD has returned. I'd never heard of the condition and assumed that severe pain was all part of pregnancy.

With my ds, I had physio following a referral from my GP. The physio I saw, who knew alot about the condition, suggested that a C-section would probably be the best course of action if the SPD worsened. I had crutches and a support belt to see me through the latter stages of pregnancy but it was pretty miserable.

In the end, however, I did go through a 17 hour labour, following an induction and had an emergency c-section as ds got stuck. All through the labour I had to keep reminding the staff that I had SPD (your partner comes in very useful here!). In hind sight an elective c-section would have been preferable. I don't intend going through a similar labour with number 2!

There are a couple of useful websites to check out which will give you good information regarding birth plans etc: SPD . I'll find out the other link and add it to the thread later.

Your midwife/consultant should support you regarding a C-section. In terms of when it would happen, I guess that is very much based on size of baby and severity of symptons so I can't really say. Keep on at your GP/midwife/consultant. Although there is no cure as such (apart from delivery), you can be helped with physio etc.

Hope this helps. If you want to chat offline about SPD let me know.

Hi mumbojumbo, this will be my second DD. I didn't have SPD last time round, but I did have a 36 hours labour, about 3 hours of pushing and a ventouse delivery. I guess this is why I'm so worried about a vaginal delivery condsidering my current status. I've had SPD since my 12th week and need a wheelchair for any distance over 5 meters (this 5 I need crutches for) the wheelchair has been necessary since the 22nd week...so its pretty bad.

Physio has told me I'm currently looking at a 5 month recovery time due to the severity.

I just don't want to make things worse, although I do realise that having a c/s doesn't guarantee and easier or quicker recovery in terms of the SPD.

Both SPD UK and the Pelvic Partnership say its a personal decision and often relates to the severity of the SPD...so I'm no closer to knowing what to do.

Hi Pie and Mumbo

I have spd with all 3 of mine. With the my first dd I had a hospital birth and the position I birthed in made the situation much worse. It still hadn't completed disappeared when I got pregnant with my son 18 mths later. I was then on crutches from about 10 weeks. I ended up having a home birth and was supported by a great midwife who did lots of research into spd. As it happened I had a very quick labour (ds arrived 50 mins after the midwife and I only pushed for 6 mins).

With my third baby I ended up having an elective cs because she was in the footling breech position and I was too nervous to go ahead with a normal delivery.

I would say that my recovery from the spd has been better this time, after the cs. Obviously, you have the cs itself to recover from but I definitely think going through the labour would have aggravated the condition even more.

My youngest is now 22 months and I do still get some pain when I have to walk any distance but I do think it could have been worse.

From what I have read before, I don't think there are many (if any) statistics or whether having a cs if helpful for spd, but in my case it was.

SPD definitely seems to be becoming more recognised now and hopefully more help will become available.

I read a terrible story on UKP recently about a girl that had committed suicide because she couldn't cope with the pain of spd. She left behind 2 children and I found it really upsetting.

I'd think seriously about C-section if I were you, love. I'd be fairly sure you qualify, wouldn't you? It's just been all so vile for you, hasn't it?

Just to update you on recovery - I'm getting better, deffo, but realised I shouldn't attempt swimming when I tried ahem getting my knees apart the other day IYKWIM

Pie - can I say that I have only seen a few women with symptoms as bad as yours. I think it would be totally justifiable in your circumstances to have a C/S. It would be planned at about 38 weeks if that was the case. Perhaps you could try labour if you went into labour yourself around that date. You might prefer to be induced at that date. It might be that you would labour quite quickly, without the need for an epidural. The danger with an epidural is your legs could be opened too far because of the pain being masked which could cause more damage. Staff should measure how far you can open your legs without pain prior to an epidural going in. The down side of having a C/S is trying to mobilise with crutches and an abdominal wound. The ideal situation would be you going into spontaneous labour, not having an epidural, baby slipping out with legs closed. It does happen, believe me I think that with the pain you have endured so far, labour pain would be a breeze. The choice really will be up to you pie. No one can make the decision for you.

Thanks mears...I'm completly torn about what to do. DH and my mum think that a c/s would be the best thing. But I really don't want to go through surgery for it to make no difference to the SPD and then have to get over the SPD and the c/s.

I'm sick of being pregnant though, I mean really depressed over the whole thing. Maybe knowing, having a date, would b encouraging in that respect.

I've been reading horror stories on the SPD UK site about women whose symphisis pubis has torn up to 7cm during labour...mears do you know how likely a tear really is?

Pie, I have never heard of it tear at 7cm. I don't really know what they mean by that. The best person I think for you to speak to is your physio. Are you being seen at all?

I get seen by my physio as often as I want. At the moment this is only working out about every 4 weeks as there is really nothing she can do, so its a sort of touch base kinda thing. She has said its going to be a very long recovery for me. Queen Charlottes (where I'm booked) delivers about 5000 babies a year, she has told me she only has one other patient as bad as me. She started talking about c/s, though to be honest at the time I didn't ask her why. I see her in a couple of weeks and she said she was going to start measuring my 'safe' gap. She also said that when I got to 38 weeks she would personally go over to labour/post natal ward tell them my name and the treatment she recommends so that they would be forewarned. So all in all she has been great.

From what I read the gap between the bones was 7cm for these poor ladies as the actual ligament tore...

Meant to ask as well mears, would a hospital be ok with inducing? I know that the bigger the baby the more risk of damage. DD was born on her due date, but presumably if I were induced at say 38 weeks the baby would be smaller than at 40 or if I go over and perhaps less risk of damage? Is that right? Would that be a good reason for inducing?

Arrrgghhhh, I think my head is falling out through my pelvic floor!!

The reason for inducing would be if you couls stand the pain no longer basically, pie. It is a good reason for induction. I am off to work now.

Oh Pie ... poor you ... no advice ... just loads of sympathy .... and hugs {{{{{}}}}}

Lots of sympathy here too Pie. I obviously only have a mild from of spd but its causing me alot of problems and I'm starting to get worried about labour. I can't even imagine how this must be for you. I would definatley go for an elective c-section at 38 weeks, I would demand it.

I don't think the surgery would make the SPD any better but it might stop it getting worse.

I asked the doc at my checkup on Thurs about my SPD and he suggested an internal (!) (not conducted by him - he obviously felt it was quite embarrassing enough to ask me about contraception)to check for prolapse...I have to say that had never occurred to me, but since he hadn't heard of waterbirths at all either I think I won't bother, what do you think?

How are you feeling at the moment?

I'm sore!!!

I had a check for prolapse a few weeks ago, it hurt so much I cried throughout the entire examination...so be prepared if you do have it. The OB was checking for the prolapse of ligaments but she said it was very very very rare, so I wouldn't worry too much about having that checked.

Pie, sorry to hear you are much worse. If I were you I would def go for a csection, haven't you suffered enough already? Mind you, recovery from a csection isn't great but nothing compared to the pain you have been in I should think.

Bekki, incidentally, I had a vaginal (home, waterbirth) delivery although I don't think my overall care took nearly enough notice of my 'safe' gap.

But pie, I'd doubt if you have much of a gap at all, do you? God, this is all so vile for you. And I'm SO angry at the profession/s for not recognising it (not all midwives are like you, mears!). I keep saying I want to write something on this when I'm back at work.

I think my safe gap is about 6 inches, so not very much, and in fact I think since the dramatic worsening it may be less...

I hope you do write something on it motherinferior. I read that at least 1:800 women with have SPD during or after pregnancy and that of these about 3 will end up permanently disabled. So not everywhere, but certainly alot more widespread then you would ever know by the total lack of general knowledge around.

Totally wrong intial figure sorry, I read that 1:35 women will get some form of SPD and 3 will be permanently disabled by it....so there is alot of it about.

The good and bad news is that this is one of those things whereby if you throw money at it, the problem will kind of disappear. i had spd terribly with my first child, and the nhs were rubbish. i got a loan out this time around and went private - weekly osteopathy and watching my posture meant that i went from "the second worst case I've ever seen" to feeling almost normal by 34 weeks. i delivered vaginally last week with no drugs and feel fine now. fyi: breast-feeding, sadly, delays yr recovery. huge luck - who doesn't weep when their mimsy is under attack?

The breastfeeding thing is contraversial. Not all papers I have read agree on that.

didn't know the breastfeeding theory but as b/feeding going OK will keep on with it, methinks...

...pie, honey (or even honeypie), any further thoughts?

Just caught up with this thread and wanted to send you hugs, Pie (and Motherinferior too). SPD sounds agonising and I hope you get good advice and the birth you want at the end of it Pie.

sorry your SPD is so bad pie. I did manage viginal birth with moderate SPD on all fours. m/w took no notice of safe gap but i tried to stay aware of it. Was still bad for a couple of days after but it did ease. now three weeks and is not 100% but am more mobile than a friend recovering from c/section with no SPD.

Have you considered vaginal birth on your left side? You can give birth this way with barely parting your legs. You keep your legs paralel and have your partner/midwife support your right leg, rather than having your right foot down and knee up (ie knees parted). The Association of Radical Midwives (Midwifery?) has some very good stuff on giving birth with SPD.

ps I speak with the voice of experience - tho not as bad as yours!

Can I ask someone - Pie? - what the exact symptoms are of SPD. During my last pg and now again this time (although earlier) I have a painful dragging sensation on my lower left side - only when I am active - walking, going up stairs, turning over in bed. Could this be SPD or just a ligament strain due to extra weight? Last time I could hardly walk after about 34 weeks...Thanks!