Q: Hello Dr ketch. Please, I have a question. How do a woman cope with symphysis pubis dysfunction (SPD) in pregnancy? Mine is so bad, I can’t walk anymore. I went to the hospital, was admitted but had no improvement. I’m 35 weeks pregnant and in pains. I need help
A: Symphysis Pubis Dysfunction is a condition that is now more commonly known as pelvic girdle pain or pregnancy related pelvic girdle pain (PPGP). From the name, this condition would usually occur during pregnancy, during childbirth or can even happen after delivery. It does not affect the baby in the womb, though. It is more common in people who have had previous pelvic injury and can also be influenced by weight and position of the baby. People with this condition in pregnancy experience symptoms like pain over the front of the pelvis, pain on one or both sides of the lower back, pain in the perineum (the area between the vagina and anus), pain in the thighs, grinding and clicking in the pelvis etc
The pain experienced is usually worsened by standing, walking, standing on one leg, moving your legs apart, poor posture etc
What causes this pain? Well, as part of the process of pregnancy, the body produces a hormone called Relaxin. As the name implies this hormone relaxes the tissues of the body in preparation for the baby that will pass through. It relaxes and softens the ligaments of the pelvis and the cervix (the mouth of the womb) such that they can stretch easily and allow baby an easy passage out of the womb. You know those heart burns that women experience in pregnancy too? Well, you can also blame this hormone which relaxes the lower esophageal sphincter such that there is reflux from the stomach back into the esophagus. This reflux contains acid and so this can lead to the burning sensation in the throat typically described as heart burn.
How is this treated? Well, until you put to bed and the level of relaxin returns to normal, all your doctor may do is really just manage the symptoms. In some few instances, the woman may require treatment for this after pregnancy. A pelvic belt may help hold things in place down there preventing funny movements of bones when you move around 😀 Kegel exercises are also helpful.
For more on kegel exercise, please click on this link: https://chatwithdrketch.com/2014/04/09/daily-health-tips-when-is-a-good-time-to-resume-sexual-intimacy-after-childbirth/
Pain relief and use of crutches, if necessary may also help relieve the pain..
To prevent this pain as much as possible:
• Avoid positions that aggravate the pain and adjust to positions that reduce the pain eg dress while sitting instead of standing, keeping your knees together when getting in or out of a car
• Wear low heels and take the stairs, one at a time.
• Be sure to avoid:
o Standing or sitting for long periods
o Standing on one leg
o Carrying bags with one hand
o Lifting heavy stuff
o Crossing legs
o Any other position that brings on the pain
Vaginal delivery is still very possible with PPGP and rarely does a woman need to have a C-section on account of this condition.
Your medical team needs to know that you have this condition and they will work with you to ensure that delivery is not problematic.
I hope you feel better soon. On the bright side, you’re almost there 😀
Have a goodnight, y’all 😀