Induction and spd (pelvic girdle pain)

[ains73]

Has anyone experienced being induced whilst suffering from spd/pgp?

It's been suggested by my consultant that this would be recommended at 40wks (ivf apparently increases placental deterioration after term)for me but I'm really nervous.

The thought of not being able to use the pool/bath for relief really puts me off and as I would probably go for the epidural to cope with the strength of the contractions, I'm concerned the amount of time I will be sitting/lying down (which is when my condition is at its worst).

Also being able to walk around whilst waiting for it all to kick off is not really an option as I'm on crutches. Terrified I will be stuck on a ball or a bed for days on end in agony.

If they are offering to induce you do it. I had sciatica and spd with my 3rd daughter . I had 2 other kids to look after and i was often in tears. I had a horrible clicking in the pelvic area and shooting pains down legs and pelvic area. My whole labour was done standing up as i couldnt lie down. She was also back to back which made it worse. I am terrified of having an epidural as i have a needle phobia but i would definately recommend it if you are unable to stand up. If i could do it again i would have the epidural. On the plus side once i had her i was elated as i could walk about and the pain/clicking noise totally disappeared. You dont realise how much paind your in till it goes away.

I meant to say i wasnt induced as they refused to do it.

I was induced in Feb last year because of severe SPD at 39 weeks. I won't lie. the labour was pretty awful (after each contraction I had a wave of severe SPD pain - much worse than the contraction - then the next contraction would start). I was unfortunate to have an unusual reaction to pethidine that speeded up the labour without any pain relief, so couldn't have an epidural. DD2 was delivered by ventouse with my knees together as I couldn't get them apart. But it was quite quick.

The major thing was that as soon as DD2 was delivered, the SPD pain literally disappeared. I could barely walk beforehand.

Hi, I am 38+3 and been suffering with spd / pgp since week 20 and am also on crutches. I have been advised against induction but having sweep at 40 weeks if I haven't gone by then. I want to avoid inductio if possible for the usual reasons although pain and discomfort is now getting a bit too much!

I am also surprised to hear that you say epidural is a good idea. I really really want an epidural but have been warned it is a bad idea because I won't be able to tell them where my pain barriers are. My physio has measured how far I can move my legs etc and recorded in my notes but says that if I was to have epidural I wouldnt be able to feel pain barriers in pelvis and lower back area and could end up doing more damage! Maybe I will have to reconsider this at the time as I am wimp with pain!

I never asked for an epidual so i dont know if they would have given me one or if they recommend it. What i would say is if they say it is safe to do so have one to help you through the labour especially if your unable to lie down.

I had induction and SPD. It was a great moment when my waters broke as the pressure eased instantly off my pelvis. I didn't have any pain relief in labour. I had done hyonobirthing and to be honest the pain of SPD was the worst thing anyway. I leant over a height adjustable bed but was continuously monitored, There was no way I could have lied on my back due to SPD pain. Hope it all goes well foe you. The secret is to relax and not worry...honest!!!

I would agree that an epidural will mean that you have to lie down and how will you know what damage you are doing to your joints/back? If to can't stand up then leaning over a ball would be a good way as would take pressure off pelvis.

During my last labour, wilst I wasn't induced I had the synto to speed things up as it was slow progress and a back-to-back labour. I had been suffering from PGP but decided to have an epidural because of the synto. It was a big mistake for me as the epi didn't get rid of the pain in my back despite being adjusted several times and with each contraction it felt like my back was being torn open. It was so painful that they had to give me 2 spinals on top of the epidurals which were heaven whilst they lasted but they wear off after an hour or so. In the end I had an EMCS as baby was getting distressed after so long in labour and I wouldn't have had the energy to push him out. I wish now that I hadn't had the epi as I would have been able to change postion to try and alleviate the back pain. It was horrible being paralysed and in agony. I would never trust an epi again because of that experince and I am planning a VBAC for this next one. Luckily I have hardly had any SPD pain this time around apart from some twinges and clicking but that is expected I think.

You don't have to be induced but can opt for extra scans and monitoring instead and if you go into labour naturally then a birthing pool might be a good option for you?

I would take the advice off someone whos had the epidural with spd. I just assumed it would ease some of the pain. Ive never had one with my 3 so dont know how effective they are. When i had spd with my 3rd she was also back to back so this prolonged the labour. My 1st was back to back and i couldnt lie on the bed with her either so i dont know if it was down to the spd or being back to back. I can see the point if the epi wears off and your stuck on the bed in a position your uncomfortable in. Its worth a few hours of pain just to get rid of the spd pain. looking back i would say the labour was all worth it just to get rid of the spd and clicking noise. I done it with gas and air as i was too late for pethadine so if i can do it anyone can.

Yes, my last DD was back to back too (turned during labour).

Do a birth plan, stating exactly what you can and can't do. Mine looked like this:

BIRTH PLAN
I have had SPD (symphysis pubis dysfunction, also known as pelvic girdle pain) since mid-pregnancy, which has the following impact:
? I have restricted mobility, and can only walk short distances without support.
? My legs must be moved together whenever possible.
? I cannot move up and down ? for example from a bed ? or from lying to sitting, or sitting to standing, very quickly, and may require help.
? If I require an epidural, I will not be able to feel pain, so care will need to be taken to support my back and move my legs together during labour.
? I understand that delivering in a lithotomic position (particularly with legs in stirrups) may cause me long-term damage in view of my SPD, so please avoid this. A better position may be lying on my left or right side with someone holding my upper leg.
? If an assisted delivery is needed, please could I opt for a ventouse delivery as I understand this can be done laterally?

AFTER DELIVERY

? 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 are supported to prevent further damage to my pelvis.
? I have and would like to use a pelvic support belt to wear postnatally to help stabilise my pelvis. I may also require additional support with moving around and lifting my baby on the postnatal ward, and would be grateful if my notes made this clear.
? I would like to see a physiotherapist whilst in hospital to discuss treatment and modification to standard postnatal exercises, and would be grateful if I could be referred for postnatal physiotherapy as I am likely to need this to fully stabilise my pelvis following birth.

Thank you for taking the time to read my plan and I hope it has not offended your professionalism in any way.

Hope this helps and good luck!

Thank you all for your replies. It's so reassuring to hear how the pain should hopefully subside once the baby is born.

Chestnut soup. That is a great birth plan. Might steal a few of those points for my own! Can I ask how long the induction process took in total? Did they start with a membrane sweep? Why were you given pethadine? Was this the first option before they considered an epidural?

Purple rainer. I've spoken with several consultants now about epidurals and pgp. They all agreed it is perfectly possible to have one as long as midwives are aware of your condition. They all seem confident the chances of doing anymore damage to the pelvis due to the fact you are numb, is very small. In my experience it was the physio's who were trying to persuade me not to have one. I posted a message last wk about epi's and pgp and heard from women who had one with pgp and didn't regret it.

I didn't have a sweep as I was 39 weeks so it was the pessaries. Nothing happened after the first but waters went very soon after the second. Within a couple of hours it was very painful, the gas and air wasn't helping so I was given pethidine as I was only 3cm and wasn't allowed to transfer from antenatal to labour ward, which is the only place they do epis at my hospital.

Unfortunately I then went to 10cm in 20mins! I had to wait nearly an hour for a room to become free on labour ward, then over two hours for a doctor to do the delivery, during which time I was left with a very inexperienced midwife. Still, it all worked out in the end.

One final thing: although the spd pain will appear to have gone afterwards, please take it easy and see a physio for a while. The hormones will still be coursing round your body and it's so easy to have a setback. So don't overdo it.

Sorry to hijack but just had a quick query for ains73 if you get a chance - is there anywhere I can look to find out about the idea that IVF affects placental deterioration after term? I'm 11 days overdue (with IVF baby) and no one has mentioned this - but haven't been overly impressed with my midwife, to be honest, and haven't seen anyone else. I'm due to go in for assessment tomorrow with possibility of induction, but have been wondering about delaying it (as feel fine and would rather not be induced if poss - because most people seem to agree it's more painful - any thoughts on that from anyone welcome too!). But if there is a link IVF and placental deterioration obviously that's a reason not to (and hope I'm not already in that boat...). Don't worry if you don't but if you have a chance, any info would be great. Thanks.

Hi LeviStubbsTears

The first time I heard about it was when I told my consultant a few weeks ago that I would prefer not to be induced. Prior to that I thought the only reason for wanting to induce me was my pelvic condition.

I tried to get some more info on this when I got home but struggled. However, google did throw up a few posts from other woman with an ivf pregnancy who had been told the same thing so I suspect there is some truth in it.

You could always speak to the clinic/hospital where you had the ivf done if you feel you need more info before speaking to your midwife. Failing that, I would definitely ask to speak to a consultant.

Sorry I don't have more info. Good luck for tomorrow.

Good luck!

ains didn't see this post before I posted on the other one.

I had an epi during my labour and it worked for about an hour, then failed on one side. They topped it up but it kept failing. As chestnut said - I too had syntocin drip and I would experience a contraction but this was actually more bearable than the pain of my pubis symphysis joint, and hip and back pain. It was unbearable, I was off my face on gas and air. I could not lie on my side, I remained upright sitting on the bed. Not what I wanted. I'd had to sleep sitting upright since about 26 weeks pregnant due to the SPD/PGP.

I also had a birth plan, but in all honesty it went out the window and when you are in the moment you sometimes just have to go with how you feel. But, it does help to set boundaries.

I am not wishing to scare you but I am 11 mo on and I still have twinges and issues with my pelvis. I did get a good physio to see me afterwards and have been in her care since.

I didn't want an epi as I thought if I got to push, I don't want to damage my pelvis. My baby wasn't even descending properly and I thought my body was tearing in two. Some people don't have problems afterwards, or if they do - it's much less. I have taken months to be able to be pain free. BUT not everyone does, I think it's all the hormones. Good luck xx

Firstly, get thee to a chiropractor. Mine got me from unable to walk to normal in 2 weeks in late pregnancy.
Induction would be hard on your pelvis. Sitting on your bum will close down your sacrum making your pelvis narrow and your contractions more painful. You'll want to be on all 4s or on a ball, but for induction they will want efm and although you can sometimes be mobile on a monitor, it may not be possible. You are also likely to need an epidural which means sitting on your bum even more.
Water would be much better, but I understand the pressure to not wait. You might want to consider acupuncture to encourage things along, or expectant monitoring to delay induction, but if you need to be induced for the health of your baby, the best thing to do is get a chiropractor to sort your pelvis (its also lovely to "get back" those last days before baby arrives and enjoy them pain free)

(Won't hijack again but thank you v. much ains - good idea to speak to the IVF clinic - I'll do that but think I'm going to go for it today anyway! V v. best of luck to you and all with SPD (and without) going through induction and/or labour.)