Giving birth with SPD/PGP

[ZuleikaJambiere]

This is a WWYD question. I'm 39 weeks with DC2 and have had PGP/SPD for most of the second and third trimesters. Fortunately it's not been too painful, more uncomfortable, but it has affected my mobility. As the midwives didn't seem to have many ideas on what it might be I took myself to a private physio, who diagnosed it and gave me exercises to do and a list of dos and don'ts. I think overall I'm doing quite well, it's not got worse and, with care, I'm managing my daily routine. My midwives continued to pretty much dismiss it so I pinned one down at my last appointment and was told they didn't want to put it in my notes as a formality, as then I'd have to be referred to a consultant, which wouldn't achieve much as I was managing on my own anyway and would mean I wouldn't be able to give birth in the MLU, and would end up with lots of monitoring, intervention etc. She basically has trusted me to know my own body and its limits, which is flattering but also worrying me at the same time.

That was a bit of a ramble, sorry, just wanted to set the scene. Thanks for bearing with me

So my question is: should I put that I have SPD in my birth plan, so when I arrive at hospital it is clear and the midwife is considerate of positions I should use? Or will this flag up an issue and maybe not allow me to use the pool or have drs/consultants invited in, or whatever? Should I go with the alternative and not mention it in my plan and just hope I and DH stay with it enough to say no if something isn't good for me? What would you do, if you were me?

Thanks!

Yes I would but it in your birth plan.

I gave both birth on all fours with the 2 pregnancies that I had severe SPD for.

I am sorry to hear that you have SPD.

Yes you should put it in your birth plan. There are some important considerations.

It is a bad idea to give birth on your back as its puts strain on your pelvis. The
nhs obstetic physio recommended giving birth in a supported kneeling position. (Ie. on your hands and knees) Make it clear in your plan you want to use active positions and you do not want continous monitoring.

It is a good idea to measure how far you get get your legs apart and cut a ribbon so your legs are not stretched further apart than is safe. It best to try and avoid being in stirrups and if they are an absolute necessarity then you need to make sure they use the ribbon that you have cut to avoid your ligaments being over stretched.

Waterbirth is supposed to be good for SPD.

I had a home birth with SPD so I see no reason why it should stop you from going to MLU. My labour was very quick. The excessive relaxin that has caused the SPD makes it easy for the baby to exit.

I have suffered with bad SPD with my last two and this pregnancy, its important to include it in your plan, and even remind the midwife as while I was giving birth to DS2 a midwife was quite merrily trying to widen my legs, and was leaning on my knee when I screamed 'SPD' in agony and through gritted teeth the penny dropped!

I was never told that by including it in my notes I would have to see a consultant, its was in my notes and I was receiving physio all times and had a home water birth last time which I am planning on again.

Good luck, I found upright on my knees in the water was a good position for me, and the water is brilliant for mobility in changing positions!

I woul definitley put it in you birth plan (top line - just in case mw doesn't get to read it all!)

I had spd with ds2 and ended up on crutches. I delivered him kneeling up, leaning forward onto the head end of the bed - he arrived very easily 5 minutes after we arrived at the hospital! My pelvis was very flexible due to having so much relaxin about so it was an easy delivery - hope yours is too op.

Thanks for all the quick replies - its seems like you are all unanimous. I thought I'd read somewhere that I wouldn't be allowed a water birth in case I couldn't get out of the pool, but that seems not to be the case and in fact it would be beneficial. Phew - there's not much else in the way of pain relief in MLU if water is a no! I'll go through my birth plan again and be crystal clear this time about SPD and positions I want and don't.

Thanks everyone

I have had severe SPD since 21 weeks, and been on crutches since then. I'm under the consultants for other reasons anyway, so my choice was only ever limited to labour ward, but I would certainly advocate putting SPD sufferer in large letters in your birth plan and telling every single soul who walks into your delivery suite whilst you're labouring.

www.pelvicpartnership.org.uk/pregnancy-and-birth-with-pgp/birth-plans.html
the above website is very useful for guidelines in how to manage SPD and also how to inform other healthcare professionals that you have it and how to treat you.........
I'm due in 2 weeks now, and am terrified about how to get the baby out, as any position I have been told to try has been agony so far!

Thanks for that link Nursee, I amended my birth plan and used lots of the suggestions in there.

My DD2 was born yesterday and I used the pool to give birth in, I found myself naturally floating on my side with my knee resting on a ledge (I think actually it was supposed to be a seat), in the same position I've been sleeping in (with a pillow under my upper knee, rather than a ledge!). Maybe that would work for you? Good luck for your birth

Sorry, just realised you are under a consultant, so probably won't have a pool. But could you try the side position on a bed?

Congratulations op!

Glad to hear that it all went well.

This is just an aside, but I had v bad SPD during my last trimester (over the summer) and read online there was nothing that could be done about it. Then I was recommended to visit an osteopath. I did, somewhat sceptically, and within a week I could walk without crying and open my legs enough to get in and out of bed without too much trouble. I had one more appointment before the birth as I was starting to feel pain again (6 weeks later).