SPD - natural or c section?

[ToddlingAlong1]

Hi.

I have bad SPD and am on crutches. I cannot turn over in bed and painful opening legs etc. I have seen the consultant, who says that I can be induced at 38 weeks or have a c section at 39 weeks.

I am so undecided. This is my first and last baby and am an older mum. I had always wanted a natural birth, until the SPD got so bad. Now I am worried about permanent damage to my pelvis giving birth naturally. I am an outside person and horses are my living so need to be able to have an intact pelvis at the end.

Has anyone had problems with having bad SPD and ability to have a sweep? Also I was told I could have an epidural with no problem but I really don't want to have one and give birth on my back in the stirrups. They say I can give birth on my side unless baby gets stuck and I need episiotomy or ventouse, then on my back is the only way.

Obviously C section is major surgery and will have a longer recovery. Did people who had an elcs with bad SPD, find it much harder to recover due to wound pain and pelvic pain.

If only one could predict how things would go!! I would hate to go through natural labour to find out I need emcs in the end. So damage down below in addition to pelvic and c section pain.

Any experiences welcome.

Can you have what's called a walking epidural ? It's a slightly different type which leaves you able to move around (this no sturrips!)

I had bad SPD in my first pregnancy and did nothing about it. Now 12 months after having my first baby I'm having another one in a months time . My SPD came back with a vengeance. I find it hard to stand up, walking can be difficult, my legs ache all day every day and my sciatic nerve is always twinging . I ended up with forceps and an episiotomy. You could do natural but you would have to tell the midwife where your pelvis feels comfortable at so they don't over stretch your legs if you have an epidural. That's pretty much what's happened to me and I'm now at physio twice a week with a pelvis that keeps popping out of place. This time I have opted for an ELCS to save my pelvis and pelvic floor (I literally have no pelvic floor since having DD) I am very nervous but everyone I've spoken to have said that they enjoyed their c sections as they were so much calmer than going into labour. Unfortunately I can't advise you on what to do but if I were you if have a big look at the pros and cons of each.

I have severe spd that has been helped by a chiropractor. Being induced or having a section hasn't even been discussed with me. its possible to labour with it, you just have to find a suitable position and spd should go once you have had the baby if that's what your worried about.

I don't understand why I am being told it's fine and as long as I can get in good positions it won't affect labour but you have been offered a section or induction?

Thanks Skipton. I will look into that. I was told by my physio that a good position is on all fours, but having had several knee injuries, kneeling just doesn't happen.

Pixie- those are my exact worries. I can feel a lot of instability in my hip joints on top of the SPD. I am have made a list of pros and cons, I suppose natural has less IF all goes smoothly, but no one can guarantee that.

Coney - I have physio and acupuncture just to keep me mobile. My consultant said that he would prefer me to have a natural birth, as I will be up and moving sooner, but due to my age (whispers) nearly 40 and not having any more children, he has offered an elcs. However, he feels that if I still need crutches after section, on top of wound pain I may be more reluctant to move and that comes with its own set of problems. Hence wondering how others have gone on.

I read somewhere recently (can't remember where, sorry) that about 35% of first time mums induced end up having a c section, so even if you are induced, it still may mean c section. I also have severe spd, and really don't know what I'm going to do, and little bit petrified of how I'm going to manage either way. Despite having had children already (but no c sections) this one just feels so much worse due to the unknown factor - which is stupid because the previous births also had potential to turn out differently.

Ah ok sorry if I sounded standoffish that wasn't my intention. Did you get referred to a consultant for the spd? Or was that for another reason?

I had SPD in both my pregnancies and I have had two elcs (for other reasons). Both times the SPD has been discounted as a factor. Unfortunately I still have my SPD (four years on from my last pregnancy) and it is worsened by my adhesions from my second Csection and my weak abdominal muscles (from the pregnancies but also from both the sections).

There is a theory that natural birth should be easier with SPD because your ligaments are stretched out ready for the birth. However you really need to know that the midwives are up to speed on SPD at your hospital and can help you labour well (birthing ball).

I would say that if there is a problem during labour, the priority will be getting your baby out rather than respecting your pelvis.

Sorry to sound so negative, but there is no easy answer on this one.

This website has good info to help you make an informed decision
www.pelvicpartnership.org.uk/pregnancy-and-birth-with-pgp/how-will-i-get-my-baby-out

I had spd (pelvic girdle pain) in pregnancy. I found that actually my pelvic floor was in medium shape (despite long pushing stage in labour) after religiously doing them as instructed by my physio to ease spd during pregnancy and I knew what I was doing to get back pelvic floor after birth.

I had SPD/ SIJ with my first, on crutches, housebound, could not weight bear on one side at all.

Laboured in the pool which allowed me to stay upright and moderately active, uncomplicated birth with a bit of gas and air. I didn't know c section was an option for SPD?

I had severe spd towards the end of my pregnancy and ended up being induced at 38 weeks for high blood pressure. I didn't want to give birth on my back in stirrups either but that's how I ended up after needing an epidural and to be honest the midwives were really good when they put my legs in the stirrups both when they broke my waters and when I gave birth. I had a forceps delivery and the obstetrician who did it was also very good.

I can't give you any advice about whether to go for a csection but my spd didn't go after I had the baby and I can see what your consultant is saying about the effects of recovering from a csection and having spd - it would've killed me especially with limited pain relief options due to breastfeeding.

could you give birth sitting/squatting on a birthing stool or standing/bent over bed?

Watching with interest. Am in a similar position to coney, no mention of induction or elcs! I'm 38 weeks today, so I assume I'm way past arranging an elcs. Having had 2 vaginal births I think I'd lean toward preferring that again- but I didn't have spd with the first 2.. I hope that whatever you do choose means you're comfortable as possibly during birth! I find that some doctors are quite dismissive of spd, it's quite upsetting.

different I just read your post. I hope I can get in the pool come labour!

I've had SPD with all four pregnancies getting worse with each, I've had vaginal births with all four, 3 spontaneous and one induced labour. I tended to labour on my side only turning to my back to actually deliver the baby. The induction was really easy, probably as it was number four he just fell out.

As for the SPD it went as soon as the baby was out well I was stiff and have twinges but nowhere near the pain before.

I had PGP with previous two births and had vaginal births both times (gas and air, diamorphine).

Sorry, that was meant to read had PGP with previous two pregnancies! I'm pregnant with baby no3 and have PGP again, but will go for epidural and vaginal birth again. Haven't got the support network to deal with recovery time after a CS.

I had spd with all three and had vaginal deliveries. 1st pregnancy was the worst and I ended on crutches. Went into labour spontaneously but needed forceps. Got a spinal and legs up in stirrups job. Was fine the next day(spd wise, the episiotomy was something else!). The spd was loads better very quickly and my ligaments were back to normal after a year.

For the other babies i knew what to do so the sod was less bad.
Baby 2 I had a sweep soon after my due date, laboured quickly, but he got shoulder dystocia (9lbs11). They had to put me on my back for the mcroberts(essentially feet by your ears job)and my ligaments tore. Took much longer to heal, was still occasionally wearing a belt the following year.

Baby 3 I was induced. Most painful birth of all. Possibly cause I was not allowed the birthing pool which I had with the other two. I healed well though, have not needed to wear a belt all year.

So my advice is to avoid induction (it massively reduces your options) and make the birthing pool a priority. I hate baths and swimming. But the birth pool allowed me to move and change positions freely.also I found my spd less restrictive than I thought/feared during childbirth.

Good luck.

Thanks everyone.

I unfortunately have no birthing pool facility at my hospital, (not in UK) as that would have been my first choice. I am starting to wonder if I just suffer on and not have the induction. Arrgh, starting to get anxious about it all now. Just want an intact pelvis at the end!

Think that I can try standing up for as long as I can tolerate it and then on my side? Did you feel the SPD during labour or did the relaxation of the ligaments ease the pain?

Think its a bit of a no win, win situation, but at the end of the day, just want a happy healthy baby.

Did you feel the SPD during labour or did the relaxation of the ligaments ease the pain? To be honest I can't say I noticed it much during labour though I had codeine during early labour and then gas and air later before the epidural so that may have helped and the contractions may have distracted me.

Heat can also help so perhaps use a hot water bottle?

The recovery time would be quicker with a natural birth even though I didn't really fully recover for a good 6 weeks anyway.
Make sure if you do have an ELCS that you are able to distribute cleaning
Etc and that you're not doing any lifting including picking up your new baby at least for the first week. You will need someone to pass your baby to you.
I should be ok as I'll have my DP and DM around for the first couple of weeks- I'll need them as I won't be able to pick up my 1 year old.
Getting up and moving around is advised but not to go on long walks and take it really easy.
The recovery from a c section is 6 weeks. Some women I know recover quickly and are fine after 2! I've not had mine yet so don't know what to expect. If you like we can keep in touch and I'll let you know how I'm getting on (I'm assuming I'm due before you?) so that you have a better idea of what to expect?

Thanks Pixiechops. I am due for induction on Tues (38 weeks) or cs week after, but the more I think about it, I will probably wait til the week after regardless. When are you booked in for cs?

Thankfully, I would have loads of help as have family staying, as not able to do much on crutches so no problems there. I come from a family where most have had sections for one reason or another and were up and about quickly after, so they are a bit one sided on their advice.

Thanks Auntie. That makes me feel a bit easier knowing that the pain wont be so bad or at least eased with gas and air.

I've got pretty gnarly spd, have been on crutches since 24 weeks (am 38wks at the moment). I've also got a number of problems with my back from pre-preg, and am on pretty hardcore painkillers just to make things like getting out of a chair manageable. I've got 12 days to get labouring on my own or I will be induced (which is fine, as I currently feel like I'm breaking in half) . Pool isn't an option for me, I'm just too unstable. The relaxin has affected some of my other joints as well so I am really wobbly (ankles, knees).

plan A I've agreed with Consultant is patient controlled mobile epidural and I will labour on my knees propped up with cushions over the back of the bed. Plan b is on my side with one leg slightly elevated. I don't have a plan C! I'm reluctant to go down the section path, as having an abdo scar will not help my back recover, although I am even more reluctant to be manhandled with forceps either - it's entirely likely I'll prolapse another disc if I have to deliver on my back, so it's really deciding what the lesser of two evils is. I'm hoping plan A works.

I've been seeing an osteopath for the best part of 10 years and although the sessions have helped in the short term, it's not been a cure all by any stretch. (And not cheap either) That said I am STILL on the waiting list to see the NHS physio after my initial assessment 14 weeks ago. The consultant joked that I will probably get an appointment after I've delivered. I didn't laugh...

Not surprised you didn't laugh at that Tee, don't think I would've found it funny either. Dicks!
I'm due to see my consultant on the 9th June to book a date in for the week after so I think you'll have already had baby by then if you go the c section route, you'll have to give me hints and tips instead

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. Can i have c section due to spd. I know it depends a lot on consultant you get. Has anybody from somerset has any experience with requesting elcs? Im so scared i cant sleep...:(

Hi Pixiechops.

Just wondering how you got on with your c section? I am really pleased I opted for an elcs (although the pain was bad for the first 48 hours, I was not so sure)! My SPD pain disappeared straight away, although my hip joint pain has taken a little longer, now fine. Baby didn't wait until my scheduled date, as waters broke at 38 +2. Now back home and loving my little bundle.