A pain in the pelvis

Mother & Baby
Monday, August 9, 2010
A pain in the pelvis. Image: Getty

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Around one in 35 pregnant women get symphysis pubis dysfunction — this is what you need to know about it.

So what is symphysis pubis dysfunction?

SPD (symphysis pubis dysfunction) is a condition that can affect any pregnant woman and can start as early as 12 weeks. The two halves of your pelvis are joined at the front by a joint called the symphysis pubis. This joint plays an important part in holding your pelvis steady when you move your legs. If this joint isn't firm, it puts excessive stress on all the joints in the pelvis, making it painful to move your legs.

During pregnancy the ligaments around the pelvis soften in response to the hormones relaxin and progesterone, allowing the pelvic bones to move more freely to accommodate pregnancy and labour. It's unclear why some women experience problems and others don't, but one theory is that the pelvis may be out of alignment, causing a restriction in movement and pulling on the cartilage at the symphysis pubis (where the pelvic bones join at the front).

What are the symptoms?

Severe pain at the front of the pelvis, which can be extremely sore to touch. You also get pain in the hips, groin and lower abdomen and sometimes you can even hear (and feel) a clicking noise. The pain gets worse when walking or moving, and especially when climbing stairs.

How is it treated?

Treatments include looking at any underlying problem, such as malalignment, and dealing with the symptoms. Research indicates that alternative treatments, such as osteopathy or chiropractic, probably have the best effect. Reflexology may help the symptoms (but will not treat the cause).

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The following may help:

  • Sleep with pillows between your legs and under your bump to help stabilise the pelvis
  • Try swimming (avoid breaststroke) and deep-water aerobics
  • Avoid bending whenever possible try using something to pick things up off the floor and sitting on a chair when getting dressed.

If necessary, your GP or midwife can refer you to an obstetric physiotherapist, who can advise you and may fit you with a support belt. In severe cases, you might need crutches to remain mobile.

Will it affect the birth?

Unless your condition is severe, you'll be able to give birth naturally, but you will need to be aware of how far you can part your knees. You may like to consider alternative positions, to find which is most comfortable for you.

Is it gone after birth?

For most women the problem will resolve following delivery or at the most six months after giving birth.

Written by Genevieve Quigley, article first appeared in the September/October issue of Pregnancy & Birth

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