PGP/SPD and induction- more likely with current circumstances?

[Enwi]

Hi everyone,

I don’t know if anyone will be able to advise on this one or not. I did ask my midwife yesterday and she gave a non committal answer and said we’d cross that bridge when we get to it (fair enough!).

I’m 34 weeks pregnant with my second daughter, and struggling terribly with pelvic girdle pain. My partner needs to help me to the bathroom at night, I am in a lot of pain turning over in bed, getting on and off the sofa, walking past midday etc. At the moment, the pain is manageable. I’m taking regular pain medication and just need to be very careful about limiting my activity, accepting as much help off my partner as possible and not doing too much with our 1 year old. However, I’m aware that potentially I could have another 8 weeks to go! I personally feel, having done some quite extensive research online, that my best option is to get induced once I reach full term, or maybe early term depending on how badly I am struggling. I’m very anxious about how I’ll give birth given how difficult I’m finding it to move around all ready, and lying on my back is becoming impossible.

I fully understand all the reasons that normally, they don’t recommend induction due to PGP, but none of these really apply due to the current situation. The physio centres have all shut, and even the online support I was told I’d receive 3 weeks ago hasn’t materialised. I’ve chased up with my midwife and she says she believes the staff have been moved to help with covid19, so at the moment I cannot receive any physio or help with managing the SPD. I also know that they often don’t want to induce because it can lead to more intervention, means I’m less mobile during labour anyway etc but honestly, I think the only thing that’s making my SPD considerably worse is time, and the longer that baby is in there!

I suffered with PGP quite badly last pregnancy too, however not as badly as this. My waters broke at 34 weeks with my daughter and I had to be induced as labour didn’t start automatically. I had a very positive induction experience, she was born within 4 hours of the pitocin drip being started and I had an epidural fitted at the same time which allowed me to labour without feeling my pelvic pains. Last time I was very fortunate that my pain completely stopped the minute my daughter was born.

So yes, after that waffle, I basically want to ask whether you think I might be able to push for an induction, if I feel it’s necessary, at full term if I’m still unable to access any support in managing the SPD?

I’m really hoping that none of this will be necessary anyway. But looking at how much worse the pain is today, from even a week ago doesn’t give me much hope of that.

I’m 39 weeks. In agony with pgp/spd and have been since 20 weeks or so, havent been able to walk since before xmas. Have a 2 year old.
Obviously in same position in that no manual therapy is available to me (they finally listened to me and booked me a physio appt at 35 weeks which was cancelled on the day, so i’ve never received any help).
My mw observed at my 36 week appt that i couldnt carry on as i was for another potential 6 weeks, she arranged for an obs to call me. Who did a week later, he advised there are no inductions available at all for any reasons other than medical for mum/baby (i.e not just pain). So that’s not happening.
In the meantime I spoke to PGP support group and they strongly advise against inductions anyway, for PGP. So I wasnt convinced it was the right answer.
Essentially I am just stuck waiting like every other low risk pregnant person. Which is fair enough given its not life or death...
In my trust (london) there are no inductions* or sweeps allowed at all.
*other than the medical ones

If you look at PGP partnership website you’ll see the the reasons they dont recommend inductions purely to get the baby out to ease the pain. Makes sense. I also had a successful induction with my first so i’m the same in that i’d like a repeat of my first birth - currently, this isnt an option to me

Hi ladies,

Firstly I’m really sorry to read you’re struggling too 123456kent. That sounds awful and I’m really sorry help isn’t available to you right now.

I have read through the PGP partnership website. Their reasons for not recommending inductions appear to be as follows:

-more monitoring and no birthing pool option with an induction. I will be having an epidural so will need increased monitoring and won’t be able to have a birthing pool anyway.

-induction is more likely to lead to intervention. Intervention is less likely having already had a successful induction, could happen anyway and again, my epidural increases the risk of that anyway I would think.

-reasons related to having your first baby so not relevant to me

-usually, more time for extra physio is more useful and effective than an induction. Me wanting an induction is based on the assumption I will still not be able to receive physio, so again, this point is not valid.

-giving birth won’t automatically cure all my symptoms and I could have long standing issues anyway. True, but this is less likely the earlier she is born and last time this was the case for me, so I have to atleast hope it will be this time.

I hope I’ve covered everything, and explained why I feel like the current situation means that the usual advice perhaps isn’t as relevant at the moment.

The point about the NHS being overstretched is a good one. I’m hoping that in 5/6 weeks time that situation will be better rather than worse, but obviously none of us can know for sure. Xx

I had dreadful PGP during my first pregnancy, I can't comment on the likelihood of induction but I gave up sitting on the sofa at about 26 weeks and sat on an exercise/brith ball which really made a difference.
This time its arrived earlier at 23 weeks but only on one side so its ok so far and I don't get any chance to sit down with a toddler now!

Our induction criteria have become much stricter since the Covid pandemic. Unfortunately I don’t think the idea would even be entertained by the obstetric team. Induction carries additional risks and in the light of current circumstances any small risk needs to be mitigated where possible.

Agree with PP above but given that your due date isn’t for some time prob best not to get hung up on what’s available right now as things will be different, for better or worse by then. All I know is for me, the fact I’m in pain does not open up the option of an induction for me (where i want it or not) and even a sweep isnt available to potentially bring it forward.
I keep having really frustrating conversations with people re PGP that only have advice to give outside of the pandemic - obviously totally understandable, but for me, totally useless. The health visitor advised on the phone ‘you need to demand a csection’ - this is categorically not an option for me!