I have SPD - any tips for labour/delivery

[TheHun]

I had spd in my first pg and it wasn't managed well by m/w even though I spelt it out, I ended up on crutches after the birth for the first few weeks. I have it again with this pg. Any one got any tips on good positions, what not to do etc. Labour last time was just under 4 hours,, been warned it may be quicker this time. Was so careful up until the birth then the damage was done!

I had SPD during my last pregnancy so I sympathise with what your going through.

The physio I saw took a measurement of the comfortable distance I could open my legs when lying on my back (measured distance between knees) and told me to put this on the birth plan and make midwives etc aware of it. Another good tip is to make sure your partner is aware so he can keep an eye on you and make sure you are not going beyond your safe limits and he can remind the midwives too (as you may be so engrossed in labour that you "forget").

Giving birth in water is supposed to help -I intended to and even had a room with a pool but DS arrived too quickly so they didn't get chance to fill it!

I was given a really helpful leaflet by my hosp physio - I had backache as well.

The positions that are recommended are kneeling on the bed with arms resting on the bedhead IYSWIM or kneeling on all fours. I ended up having an emergency c-section so never got to try them out.

I gave birth hanging over the back of the bed, gravity did a lot of the work as I was upright and I didnt have to open my legs very wide, it definitely worked for me and I walked out of the hospital and left my crutches behind.

Hope things go well for you and good luck.

Hi, I don't have a diagnosed SPD, but three weeks ago my pelvic was really bad - for example I can't knee on soft bed and when walking I can only manage small pace... Anyway, I want to swim a lot for a week, starting with only puddle my legs up and down and walk in water because I can't do proper breast stork. I think after a week going to the pool, I am getting better and now I can walk almost normally. Not sure if this helps but the water really helped me. Good luck.

kneeling/all fours seems the way to go, good advice about measuring safe distance between knees, I'm gonna highlight that on birthplan Zhouqi, sounds like you may have start of spd, good if water helps you, I havent been able to go swimming or to gym since 12 weeks pregnant - too painful.

TheHun, sorry I did not realise you suffer that badly. Hope all goes well with you. I also noticed our local hospital has this "swing belt" thing mount on the celling so you can attach it to your hip and swing, that might help in early labour? Anyway, best of luck.

I was hospitalised for a month before I had DD, bed rest as SPD so bad couldn't move. I was measured, and stuck to opening my legs the 'safe' distance. Had to give birth lying on my back, as could not kneel. But... everythging got much better immediately afterwards, could even walk up and down a flight of stairs 2 days later in a couple of minutes - had taken up to an hour 1 way before! Hoping it goes well for you.

pain of labour took all thoughts of spd away! Tell you what though its not totally gone yet and he is 3 months

NotanOtter - I found I could ditch my crutches as soon as DS was born. However I could still feel that my pelvis wasn't quite back to normal for ages afterwards.

I started doing pilates when DS was about 10 months old and its really helped as it concentrates on your core muscles and stability. Make sure you get a good instructor though who is experienced with teaching people with various complaints (a lot of them have physio-type backgrounds due to the amount of people who take it up to help with back problems).

Hiya
try to keep your legs at the safe distance, and make sure your midwifes are aware of SPD.
However, 7months after my dd, im still using the belt, on crutches at time, and having acupunture to try and help the pain relief for me.

I had SPD last time (probably mildly and undiagnosed the first time as well) and was advised not to give birth on my back if at all possible. That is because if you're on your back the sacrum can't move and so the symphisis pubis is obliged to 'give' a little - which will make the SPD worse afterwards. I certainly couldn't manage to even try to deliver kneeling, although I coped with the contractions kneeling and leanign forward onto a ball or bed. I actually delivered lying on my left, with my knees tucked up as high as instinct led me to do, dh supported the upper (R) knee, while my right foot rested on the midwife's shoulder. It was a very comfortable position (if you can call 2nd stage 'comfortable'! ) and I felt that I could push efficiently. My knees were barely spread at all - not more than 30cm IIRC. I got the idea to deliver that way from \link{http://www.radmid.demon.co.uk/dsp.htm\this site}.

I gave birth to my dd on my side after having SPD in pg... didnt seem to notice any pubic pain though... contractions were hellish!

pretty candles, fab site, thank you.

Hello! I'm 'in the biz' and my advice would be to not give birth either sitting or laying on your pelvis as it needs to expand and separate! Standing / water birth is good and gravity will be on your side. Consider seeing an osteopath who can gently unravel your pelvis (it's not dangerous to you or the baby) in the meantime and again after the birth. You will be suprised at how far a little treatment can go!

Morning newspaper, Is it true that you should avoid stirrups if you need to be stitched afterwards?

That shouldn't be a problem necessarily - you are better off being still and in a position that's good for them to work on you. You need them to do a good job and it will only be temporary anyway!

The second time the midwife offered to stitch me wihtout stirrups, but I couldn't keep still, even with help from dh and another midwfie to support my legs. In the end it was easier (for me and for them) to use the stirrups and relax. Although it's uncomfortable to spread your knees with SPD, at least when you're beeing stitched you're not pushing, so the joint is not under that much stress. I certainly wasn't in any extra pain from being in the stirrups (anyway, the stitching's painful enough to distract! )

would definately recommend water birth, didn't even notice my spd in the pool. giving birth on all fours or on left side seems to be the thing to do. just watch yourself afterwards, it does'nt subside immediately so you still need to be careful when moving around. i'd say i started to feel much better within a couple of months after the birth, good luck.

Water is indeed idea....
Thehun - have you seen an osteopath about your SPD ? I find they help many women! Before and after the birth.

Only thing with a water birth, is how did you get into it?!!
My spd was that severe, i couldnt even get into it!!

Jo... I was Pie's doula (an ex-mumsnetter who had such sever SPD that she was in a wheelchair from 20 odd weeks)... we got her in the pool (midwife and I). Used a step to get in....

At UCH they had a hoist next to the pool to help women with mobility issues in and out of it.

only 1 birthing pool at my hospital and it's out of order. Was cracked when big lady was joined by midwife. Don't think it will be repaired/replaced in time.