As the pelvis expands, and hormones prepare the body for birth by softening the pelvic ligaments and muscles, you may experience an ache or sharp pains in the front of the pelvic region. In some women the softened cartilage at the front of the pubic area may separate temporarily. This can be a really painful symptom of pregnancy, making even walking, or climbing stairs, extremely difficult. It is known as Symphysis Pubis Dysfunction (or SPD) because it affects the symphysis pubis joint, which is situated above your vulva.
Tell your carer if you are suffering from this type of pain, you will need to take some pain relief, and you are likely to be referred to a physiotherapist and fitted for a special belt that supports the pelvic area and eases discomfort. If not you should investigate what type of support belt or garment works best for you.
The area will be sore to touch. At times the pain can be excruciating and even walking is uncomfortable. You may even hear clicking or grinding sounds when you move. The pain occurs when you separate your legs. Movements that involve lifting one leg, such as climbing the stairs, or moving in and out of bed, usually aggravate it.
SPD can happen at any time during pregnancy – usually in the second or third trimesters - and may disappear again.
If you still have pelvic pain when you go into labour tell your midwife or doctor, as you need to try and avoid spreading your legs very widely. The way you give birth can affect your SPD. You may find that the "all-fours" position (on your hands and knees) or lying on your side may be the most comfortable birthing positions. You need to try and avoid separating your knees more than 20 cm.
If you have an epidural tie a scarf around your knees to remind yourself to keep your legs together, as you will be pain free and will not realise if you are doing yourself harm.
- Always wear any support belt that is recommended for you, or seek further advice if it is not helping.
- Sleeping on your side with a pillow between the knees can help.
- Sit down to get dressed, especially when putting on underwear or pants.
- An ice-pack placed on the pelvic area may bring some relief when it is very tender.
- Do not sit with your legs crossed.
- Do not squat.
- Sleeping in satin-type pyjamas, or on satin type sheets, can help you to “slide” getting in and out of bed.
- Swim if you can but avoid the breaststroke kick.
- Try and avoid carrying young children or even heavy bags
- Putting a slippery refuse bag on your car seat can make getting in and out of the car easier. When getting into the car, sit in backwards on the seat first facing out; put your legs together then swing them in slowly so you are facing the correct direction. Swing your legs out together when getting out of the car.
- Acupuncture may be helpful.