Postpartum Pubic symphysis diastasis PPSD and diastasis recti during and long term for years after pregnancy.

[YourTaupeOne]

I’m posting about a health issue that I have had since pregnancy and beyond. During pregnancy around 20 years ago, as often normally happens there is diastasis (separation) in the middle of the abdomen, and the hormones that naturally normally cause the pelvic girdle which includes the pubic bone etc to be less stable to prepare for childbirth. So these two issues combined which usually happen normally in a lot of women’s pregnancies and I’m sure that being petite also contributed, made it impossible for me to walk up the stairs in the last few months of pregnancy and also difficult to generally walk at that time.
During labour it was about 12 hours from initial pains to childbirth and during the birth, it was a natural birth, it was extremely painful and when my baby was born it was so painful that I thought I had broken some bones or something. It was agony. I wouldn’t wish it on my worst enemy. After the birth, postpartum, I couldn’t walk at all for hours, the next day I could walk but it was very slow and painful and couldn’t walk far just a few metres and I had back pain for some time. It took a long time to ‘recover’. Although I got to walking again and can walk a few miles at a time now, I’ve never fully recovered from it. I have a scar about an inch wide from the pubic symphysis diastasis that happened during the birth, I have weak stomach muscles and still some diastasis recti where my stomach is pouchy and feels squidgy all over even though I am fit and slim. So my back feels like it is not supported - my body is very different because of pregnancy and the birth. So much weaker. I tried to do some exercises for my stomach over the years and managed to close the gap in the middle of the abdomen muscles somewhat but a gap still remains and weakness still.
After the birth, in hospital, even though I had suffered a painful birth, and had diastasis recti and pubic symphysis recti, and I couldn’t walk properly, a maternity nurse there actually mocked me for not being able to walk properly and accused me of having a mental issue - depression which I didn’t have. The real cause of my misery and pain was totally unrecognised and I felt misunderstood and sidelined. I tried to explain to her but she didn’t seem to care or listen to me. Over the 20 years since, I feel there is not enough stability as there was in my pelvic girdle or my stomach muscles so my back suffers. Occasionally there have been ‘flare ups’ if I can call it that - what I mean by that is that occasionally I can’t walk properly and get back pain, find it diffucult or impossible to walk up stairs, get in and out of bed, turn over in bed, do housework, it’s happened several times - sometimes for no obvious reason but other times from too much exercise or lifting things that sort of thing. But there’s no warning, I never know when I’m doing to much to cause the ‘flare up’. It makes me worried to do things generally because I don’t know when it will next cause the problems with walking etc. I think that our society expects this to get better if it happens shortly after pregnancy, but for me it hasn’t and I feel it isn’t recognised but should be. Has any one else experienced/ is experiencing this?

I’ve got another flare up at the moment, did some shopping, housework then a bit of gardening on the weekend and now haven’t been able to walk properly since 3 days ago. Lower back pain and girdle pain. Can’t walk up stairs, can’t turn over in bed easily or get into or out of bed easily, can’t bend down to pick things up off floor, difficult to lift legs into bed or move legs apart/lift legs to get dressed. Can’t get into the bath. Can’t go to work. Walking with a walking stick.

Did you get pelvic pain during your first pregnancy or during straight after the birth?
or did the pain and problems with walking only happen to you a few years after the birth?
was the physiotherapist at the NHS trained in women’s health? how did they find out your pelvis was misaligned?
yes I will think about who to ask, sometimes we need a friend to give support

So it started with my first child, when I was about 20 weeks. I would say it took about 18 months to feel ‘ok.’ But when was pregnant with my second child, it started at around 10 weeks. I ended up on morphine, diazepam, codeine, and yes while pregnant. I couldn’t get up the stairs, in the bath, getting in the car was difficult. I had crutches to start with, and a pelvic girdle. But nothing helped at all. The birth was bizarre. I was induced 2 weeks early. My son had been engaged from 30 weeks and I don’t think that helped my pelvis at all. Both my symphysis pubis and my sacroiliac are unstable.
After the birth the pain didn’t go away. I had to have so much help with my children. The consultant told me I absolutely must not have any more children. So I was sterilised when my son was only a couple of months old. I didn’t get better. I had steroid injections into my symphysis pubis which was horrific but it did give me a few pain free weeks. Those pain free spells got less and less as my body got used to the injections. As a last resort my gynae consultant said for me to have a hysterectomy. I was 33. He said it could be hormones that were making it so bad. Basically no one knew. So I had the hysterectomy and it took me about 18m/2yrs to feel much better. Over the years I’ve had flare ups but these past 2 years have been awful. I’m very fit and active. But I’m thinking it could be hormones impacting it so badly, along with my history and trauma that my body has been through.
My hips feel on fire, and I get terrible pains in my adductors in my groin at the top of my leg.
I was on HRT to see if that would help but it didn’t.
Sorry! I’ll stop now as this is a super long post!!

because your pelvis was already weakened and separated at your first pregnancy, the second pregnancy was more difficult because it hadn’t healed after the first pregnancy yes I understand. For both of my pregnancies I found it difficult to walk by the end few months and couldn’t walk up stairs etc. sometimes a pelvic belt helps some people - I didn’t have one but I know it wouldn’t have helped because there was too much pressure and weight. My doctor also told me it would be unsafe for me to have more children so I haven’t. My SI joints, and symphysis pubis and also my abs are all unstable. I can still hear clicking when I walk just like I did during pregnancy and now it’s 20 years later. I heard it several times today. But I’ve got a flare up at the moment. Do you ever hear your pelvis clicking? I had to have help with my children, some of my family helped but nowadays unfortunately they blame me for my health issues tell me it was my fault that I needed help with things and have been very nasty and some of them ostracised me completely. Lots of professionals probably don’t know as much as we sometimes think they do. There is so much to learn about it’s not surprising. Hormones are part of it I’m sure. hormones are a bit like switches in some ways. Yours was bad because had been damaged and, although hormones contribute to the separation and laxity in the pelvic region during pregnancy, the actual damage or injury is aside from hormones isn’t it. So it wasn’t just hormones. There is often a more holistic reason and approach to things. You think that it could be hormones now but don’t forget that hormones are a part of ageing naturally and it’s not just hormones then. Ageing itself which none of us can stop causes deterioration. The HRT probably didn’t help because as you say, the trauma and injury caused it to be as it is and also now ageing causes it to be worse probably. Often as things go on, they can get worse. Other women have said that their pelvic pain from pregnancy has got worse over the years as they get older, not better. Did you have a flare up lasting two years at the moment or is it on and off with the painful problems with walking etc?

I’m so sorry that your family and friends have been that way. It’s in no way your fault at all. It is such a debilitating condition and there is so little know about why we are suffering all over again.
I don’t hear a clicking in my pelvis but I do feel it… erm I ca only explain it as it feels like my pelvis pulls apart sometimes when I move in a certain way.
My family weren’t able to offer a lot of help but I had to have adult services involved in my life to help with putting in aids at home such as railings in the shower and an amazing bed handle which I wish I had kept as turning over in bed is once again proving tricky at times. It feels like the left and the right sides of my body don’t always work in tandem together with things like rolling over.
And I don’t mean I’m depressed. I find it depressing as it can take my headspace to that time in my life which should’ve been full of newborn joy but instead was full of crippling pain and guilt.
The flare ups now and more frequent than the have been for years. But I don’t mean I’ve been in pain for 2 solid years, I mean that these last 2 years I’ve had so so may flare ups. They can last months or a day. There is no rhyme or reason. I worry about being fit in my old age because of this problem.
Over the years I have paid privately for a physio, on and off. I can’t afford to have weekly appointments or ‘maintenance’ appointments. She is fabulous but she has never seen someone my age with issues relating back to pregnancy.
Going back to those days, there was talk of fusing both of my joints, taking bone from my thigh or my hip. But it was unprecedented here where I live and the consultant was going to have to speak to someone in America. It was all too much. And then my marriage fell apart and my mum died and I just tried to carry on. As we do.

No it is not FND. This issue is a pregnancy issue that started in pregnancy I had no difficulties with walking at all before that. The difficulty walking up stairs started during pregnancy, as I said. I couldn’t lift legs up stairs this was a real physical structural thing not neurological. This was caused by the normal pelvic processes during pregnancy to make sure there was room for the baby to be born. Not being able to lift legs up to walk up the stairs during the latter stages of both my pregnancies was absolutely only due to structural physical limitations of my body and any flare ups after being pregnant over the years postpartum have been caused by me doing too much putting pressure on my body and pelvis probably by lifting or exercise that sort of thing - it happens from movement. For example, on weekend, I did too much housework it’s happened before the same way. Thanks for your thoughts though.

Thanks for your reply, my mother used to tell me that I still walked like I was pregnant years after the birth but in a sarcastic way.
I’ve got a bath but haven’t been able to get in it for a week.
Turning over in bed has been difficult this past week for me. It’s gradually improving every day though at the moment for this flare up.
why did you feel guilty? There is no reason for you to feel guilty for having a health problem that isn’t your fault.
can you think when you have a flare up do you do more than you usually do or something your body isn’t used to regarding moving or exercise?
I find it happens to me if I’ve been doing too much but I never know what is too much because there’s no warning. I have been worried about old age too worried it might get worse. Sorry about your marriage and your mum