This is a question a lot of expectant mums tend to ask us here at MummyNatal, especially when they inquire about attending a class. Our advice is that as long as you’re comfortable attending a class, you can most definitely attend. It’s important that you make your local MummyNatal teacher aware of your discomfort or pain, so that they can guide you through movements that will support your joints and keep you pain-free, rather than put additional strain on your pelvis.
In case you want to find out more about SPD and how to manage it, here’s some advice that you may find useful.
What is SPD?
SPD stands for Symphysis Pubis Dysfunction. In essence, the condition causes excessive movement of the pubic symphysis, which is the stiff joint at the front of the pelvis. This causes a misalignment of the pelvis.
Why does it happen?
During pregnancy, a woman’s body produces a hormone called relaxin, which softens all supporting ligaments. This is necessary so that the pelvis can stretch and make room to birth the baby, but for some women, this can mean that the ligaments that are meant to support the pelvis are unable to do so properly. As a result, pelvic joints move more during and just after pregnancy, causing inflammation and pain.
SPD is also related to another pregnancy condition called PGP, or Pelvic Girdle Pain, and often the two are even referred to as being the same thing. Although SPD and PGP do affect women during pregnancy, up to 7-8% of women continue to experience some symptoms even after the birth of their baby.
Who can get SPD?
SPD is thought to affect 1 in 4 of all pregnant women, so it is quite common. It can occur at any stage of the pregnancy and to any woman, although it’s more likely to occur in women who have babies quite close together.
What are the signs and symptoms?
Different women will experience the condition in different ways, but signs and symptoms that someone may be suffering from SPD include:
- Discomfort or pain in the pelvis – this pain will normally be felt at the front of the pelvis.
- A popping or clicking noise when walking or moving about.
- Pain that might extend to the hips, groin, perineum, bottom, or even lower back.
- Walking ‘with a waddle’.
- Finding it hard to lift things or climb stairs.
- Having difficulty standing or carrying out many other normal day-to-day activities, including walking, getting in and out of the car, and turning over in bed.
If you think you may have SPD, it is important to seek help early, as this will minimise the effect in the medium-to-long term. Unfortunately, not all medical professionals are fully aware of the scope of this condition, so if you feel that your concerns are not being fully addressed, you can always ask for a second opinion or ask to be referred to a specialist.
How do you manage SPD?
Unfortunately, there is no research available on how to cure the condition, but, if and when diagnosed, and depending on the severity of the condition, there are ways to manage and minimise the pain. And sometimes, with the right care and attention, some women even report feeling no pain at all.
If you experience symptoms of SPD, it is important that you tune into your body and notice what movements and activities seem to aggravate your pain and discomfort. Try and limit these types of activities to the absolute minimum and rest when you need to. Small adjustments to your everyday activities can really make all the difference, so consider things like:
- Avoiding hoovering if this causes a problem (ask someone to help you with that!)
- Avoid pushing a heavy buggy if you can or manoeuvring heavy supermarket trolleys around corners, as this causes the pelvis to twist and puts excessive strain on it.
- Sitting down when getting changed.
- Keeping your legs close together when getting in and out of the car – you can put a plastic bag on your seat, which will help you swivel.
- Never squatting when you go to the toilet.
- Sleeping in a comfortable position with a pillow between your legs.
- Wearing flat, comfortable shoes.
- Sitting on a birth ball at least some of the time, if you find it comfortable (most women with SPD tend to).
- Avoiding crossing your legs when sitting down.
If you do get referred to a specialist, methods currently used for managing and reducing SPD-related pain and discomfort are:
- Physiotherapy carried out under the supervision of a maternity physiotherapist who specialises in obstetric pelvic joint problems. Exercises will be aimed at strengthening your pelvic floor, back, and hip muscles and making sure that the joints of your pelvis, hip, and spine move normally.
- Exercises in water.
- Pain relief, such as mild painkillers or using a TENS machine.
- Providing you with equipment, like a support belt, or even crutches.
In addition to the above, you may want to see a specialist osteopath or reflexologist, who in different ways may be able to help you find some relief from your discomfort. This usually needs to be organised privately, but it can be a useful option for you to be aware of.
What about SPD and birth?
Although women aren’t normally aware of the condition during labour, it is important that you take SPD into account when writing your birth preferences, as it may influence the choice of positions you may want to labour or give birth in. Plus, it’s important that the people who will support you during labour and birth are aware of the condition, so they can advise you accordingly and not do anything that may accidentally cause you more discomfort.
Positions that you may want to experiment with during labour and birth, if you are suffering from SPD or PGP are:
- Kneeling – either upright or leaning forward (for example, over a birth ball or a bean bag etc.)
- In water, which supports your mobility and eases any aches.
- Lying on your side, so that your legs don’t have to be separated too much.
Before the birth, it may be helpful for you to test the maximum width your legs can be apart without discomfort or pain. You can do this by laying on your back, with your knees bent and opening your leg as far as you can, until you feel discomfort. When you do, stop, and take note of how far you can go, so that you don’t over-extend your legs during labour and birth. This becomes particularly important if you decide to have an epidural, as you won’t be able to feel the pain in your joints, but opening your legs too wide could cause damage to your joints.
If you would like further information or you can check out the Pelvic Partnership or the NHS Choices website.
Over to you. Did you find this useful? Have you experienced SPD? What did you find worked best for you?