SPD and C-Section

[scotsgirl23]

First poster but long time lurker, so Hi!

I have had a pretty crap pregnancy - hyperemesis kicked in at 4 weeks, was signed off work for 3 months as a result, and as soon as that went the joy that is SPD arrived.

I am in absolute agony all the time - I can barely walk, I live only 5 minutes away from work but my husband is having to drive me there and back (or I work from home as often as I can), I can't sleep, I can hardly move, etc etc.

My midwife has arranged for me to see a consultant next week (I'll be 36+6)to discuss options for the birth, and I'm just looking for advice from people who have been there.

I know the general recommendation is that you don't need a c-section with SPD as there are some positions you can adopt however I've tried some of these, and I can't do them. Left lateral is the most common one mentioned, but when I lie on my side I can't even part my knees by an inch without being in absolute agony, so I don't think this would work for me. Water birth can't be relied on locally (short supply of pools in the hosital and no way to pre book) and I'm too far from hospital to risk a home birth.

I'm absolutely terrified of the long term damage that could be done to me by giving birth - I'm working myself up in to a real state about it to be honest. Everything I;ve read seems to suggest that while a good birth can be fine for SPD, if anything goes wrong then the damage can be long term/permenant.

I've also had a slightly awkward side effect of SPD, in that, I think because of the pain, everything downstairs has become much, much tighter. Not in a good way! We've tried perineal massage etc, however I physically can't bear it being done (and yes we are doing it right!) and so I think my chances of tearing (and pretty badly) or needing extra assistance eg forceps/ventouse are pretty darned high. Before anyone has a go, this is NOT about remaining ahem, fresh, or anything like that, but stirrups etc seem to be an extremely bad idea from everything I have read about SPD, and I think it's highly likely I would end up needing them. I also have a previously fractured coccyx which has started giving me a lot of pain again, and necause of it I'm supposed to avoid certain positions too, basically anything sitting or lying down.

Basically, I've thought about it a lot, and researched all the risks, and I really think I want to request an elcs. I know there are risks associated with this however I feel it would be better for me physically and mentally. I've had such a crap pregnancy I'm just not sure how much more I can cope with to be honest.

Have any of you had success requesting an ELCS for SPD, and if so can you tell me a bit about it? I should probably mention it's my first baby ( I had a miscarriage immediately before falling pregnant which probably isn't helping) and I'm located in Scotland if it makes a difference.

I had a forceps delivery first baby but didn't suffer with spd however this pregnancy I've got spd!
Based on my previous birth (probsxafter with recovery) I was offered an elcs! At my 36 week consultantsxappoint I saw the registrar rather than consultant she tried to talk me into a VB my hubby had to be quite firm I explained about the SPD and was told they would measure how far my legs could comfly open more so if given an epidural and that it's likely that pain will ease during labour!
However I stood my ground and got mu elcs bear in mind it does depend on how many children you intend to have as well! As they don't like to perform elcs if your intending to have load of children.
I've agreed with mine if spontanious labour starrs I'll do a trial of labour.
My advice would be start chuggling raspberry leaf tea and take someone with you to the appointment who can be firm on your behalf!
Good luck x

Thanks butterscotch - I was aware of the old gap measuring chat however it just seems so likely that, when the going gets tough that will get ignored. And I don't actually think my pain free gap is big enough to get a baby out!

I am prepping my hubby for monday so he can stand up for me too. It doesn't help that everything has been left so late because we barely see a midwife here!
Good luck with your elcs!

you have to do what is right for you.

i had SPD from 16weeks 2nd time and from 24weeks first time. I had vaginal births. i was on crutches and could hardly walk, but didnt consider a c/s as the recovery time wasnt something i wanted to think about!

i didnt have epidurals (fear of needles in spine!) and 2nd time only had g&a. i felt by the time endorphins had kicked in (and i was induced both times!) that the pain of the spd wasnt as noticeable. of course everyone is different, so just listen to your body and go with what feels right. no one can tell you how 'you' feel.

hope appt goes well

xx

Thanks sowhatis. I do actually have a needle phobia too!

scotsgirl23,

I'm sorry you have had such a wretched pregnancy. You must be feeling pretty fed up and depressed. I suggest that you try natal hypnotherphy CDs. They would help you mentally prepare for the birth and develop some coping strageries if you are in pain and epidural is not available.

Women with severe SPD often have very easy births. I had a three minute second stage! The relaxin hormones that have over softened your ligaments make it easy for the baby to get out. Also as the head engages you will get some relief from SPD. I found it much easier to move in labour than a few hours before.

Have you seen a physio and talked about birthing positions. I was recommended to give birth in a supported kneeling positions.
Have you got a birthing ball. They can really help to ease discomfort of SPD in the later stages of pregnancy.

The main thing is to avoid being on your back as that closes up the pelvis.

Hey reallytired

Can I nick your username please?

I saw a physio, who said there was little they could do, gave me a giant tubi grip (so glamorous, lol!) and told me to try and give birth on side or consider a section if necessary. I have tried a gym ball but I just find it agony (possibly because of dodgy coccyx too)

From what I've read it seems to be a bit of a split between women who found labour etc OK and gave birth relatively easily etc and those who feel that giving birth made things much worse and left permenant damage. I would love to be in the first group, but I'm absolutely terrified of the long term damage that is quite likely if I'm not. My mum has had pelvic problems for most of her adult life and I'm scared of ending up like that.

Very envious of 3 minute second stage! The way things feel downstairs I have a feeling I'm in the "likely to get worse" group! I don't think the fact I've had to keep working has really helped matters but I can;t turn back the clock on that one.

I've had two labours with severe SPD and am about to have my third. (I'm currently housebound, unable to move or dress without assistance, can't leave the house without a wheelchair, so classed as severe) I'd not consider C Sec for a nano second.
Is this your first baby? Believe me, in the throes of labour you'll barely feel your pelvis and you'd have to spread your legs from here to kingdom come to do permentant damage. The longest you'd have your legs apart is 2 hrs as thats the longest most hospitals let you push for anyway. I kept my brace on and dh and the mw stood next to my legs to make sure I didn't open them too widely.
Policy at our hospital is no induction or sections for SPD and I agree.

sorry you are having such a crap pregnancy

i have had spd with all my pregnancies, not kkicked in with this pregnancy, tho have niggles and i am only 9wksa.

anyway i was offered a c section with my first as my spd was so bad i was hospitalised. BUT i didnt have one, had a three day long labour with an epidural etc but normal vaginal delivery, BUT had problems with my spd after delivery caused by midwives that put my legs in stirrups etc!

when preg with ds2 i researched all my options and was also seen by an orhtapedic surgeon and a physio specialising in spd. they actually said that the BEST thing you can do for spd is to have a normal deilvery as it can help shift your pelvis back into the right postion!

it worked when i had ds2 kneeling up on bed, we was 9lb 3oz, jsut had gas and air and it was fine

same with ds3 and then i had ds4 who was 10lb 13oz in a birth pool seriously having normal deliveries helped my spd and it has got gradually better with each pregnancy.

i agree with trafficcone, tho i will say that i DID feel the pain in my pelvis at times during labour, but gas and air is really rather fab

also agree with really tired, ds4 literally shot out and i didnt have to push at all despite his size and the hynobirthing preg/birth cds are really good xxx

Hi ScotsGirl

I've just had my DS and although I had horrendous SPD I managed a vaginal delivery.

I agree with previous posters - after 10 weeks of being housebound and unable to sleep/dress myself/take a bath I was desperate to have as short a recovery time as possible.

My advice would be to insist on no stirrups and ask for a birthing ball to bounce on in early labour.

You should also clarify as to whether you can use a pool - my health authority refused on health & safety grounds as my SPD was so severe they didn't think I would be able to get out of the pool in an emergency !

Sending you a big hug - it will be worth it my SPD vanished as I pushed and 8 weeks later I'm back in the gym !

Hiya Scotsgirl, I had fairly severe SPD during my pregnancy. I too was unable to dress myself and was signed off work from 24ish weeks. I gave birth at Wishaw and they induced me at 42 weeks. I just wanted to let you know that although my midwives were not overly sympathetic during my pg, when I got to the hospital I told them about the condition and they seemed much more informed. I was wheeeled into the hospital for my induction. I was told that I should have been wearing support stockings throughout the pg as I had been so immobile. Please keep trying to move your ankles etc as a friend of a friend suffered DVT whilst pregnant being so immobile with SPD.
I wanted a completely natural drug free water birth. I started off labour on a bouncing ball and a tens machine. When my contractions started I felt most of the pains throughout my hips although the pain in pregnancy had been my clickity click pubic bone. I thought when it came to pushing I would be able to be on my knees - I didn't get that far and tbh there is no way I would have been able to do it, it was far too painful. BUT as you can see it's not the same for everyone.
To cut a long story short, I ended up with an EMCS as the baby hadn't descended properly. TBH I don't know how I could have even pushed him out, he was 10lbs 1. They did consider giving me a section and in the end it was a relief (in my opinion). This was my first baby and I just want to tell you - something which I learned - for internal exams I couldn't open my legs very wide at all, but you can ask for gas and air to relax you and this does make it easier. If you end up with pain relief you will know your limit of legs opening, and even when I went to theatre I had to tell them I can't roll over onto my side, I can't open my legs etc - I made it clear and staff were supportive. AFAIK they didn't want to offer me a section due to the SPD, but they did try to sweep me at 40 weeks, to get things moving for me. I am now 8 weeks post section and doing well. For me the SPD didn't magically vanish, but it has improved - slowly but surely. I hope you are OK and as others have shared it can be done, everyone is different. It's such a pain in the ass thing to have to deal with as well as all the other pregnancy niggles - but I can say it is soooo worth it.
Love indigo xx

Im 34 weeks pregnant with my second child. I have spd since 22 weeks and have to use crutches to move around. I'm so scared of the complications of vb with spd that i want to request elcs but dont know where i stand with it... i had a lot of complications after my last birth (i had dural tap for 18 months because the doctors ignored me and didnt listen) so i dont trust the doctors when they say everything is going to be ok with vb. Im so scared i cant sleep...:( what do i do?