Symphysis Pubis Dysfunction

Pregnancy is uncomfortable, am I right? Anyone who has been through it knows this as a universal truth! What happens, though, when your pelvic pain seems elevated from what your friends experienced (Or even what you experienced in an earlier pregnancy?) For about 32% of pregnant woman, this increased pelvic pain during pregnancy is caused by Symphysis Pubis Dysfunction, or SPD. 

So, what causes it? 

The front of the pelvis is made up of two halves, with a tiny gap between them. During pregnancy, this gap widens to allow for your growing uterus and baby. When this gap widens too much, it creates this painful condition. The excessive widening is caused by a normal pregnancy related hormone, called relaxin. The dysfunction happens when too much is produced, or it is produced too early in the pregnancy (usually before 14 weeks.) 

How do I know if I have it? 

You may notice that performing your normal daily activities is becoming increasingly difficult and painful. Things that might be uncomfortable are: 

  • Squatting
  • Rolling over in bed 
  • Lifting your legs 
  • Standing on leaning on one leg (such as to put on pants or shoes) 
  • Pivoting 
  • You may also notice a clicking sound in your pelvic region 

What can I do? 

You’ve identified the problem, so let’s discuss some things that could relieve some discomfort for the duration of your pregnancy. 

  • See a chiropractor – a Webster certified chiropractor can help keep your pelvis in alignment, helping to alleviate some of the pain. 
  • Acupuncture – An acupuncturist can help alleviate the pain my targeting the points that correspond to the pelvis. Acupuncture and chiropractic work are great when paired together! 
  • Sleep with a pregnancy pillow – A body length, contoured pillow will help support your legs and pelvis while sleeping. You should keep the pillow between your legs to help everything line up in the most supportive way. 
  • Always move your legs as one unit – Separating the legs can cause serious pain while suffering from this condition. To avoid further pain or injury, make sure to move both legs at the same time (such as when getting in or out of the car, or bed.) 
  • Stay on two legs – Never stand on one leg. Standing on one leg puts all the pressure on the supporting leg, which could prove to be too much for the weakened pelvis. 
  • Do not wear shoes with elevated heels – Heels cause an imbalance in your body, which forces it to compensate to keep you upright. Wearing them adds unnecessary extra stress to the pelvic region. 
  • Never cross your legs – This position moves the pelvic bones into an incredibly uncomfortable position. Trust me, try it once and you’ll know! 
  • No Jumping – Do not participate in any activities that are jarring. 
  • Wear a maternity support belt – You are going to want one that is nice and snug, to help lift your belly off the pelvis. 
  • Avoid stairs – This goes back to not standing on one leg. It just doesn’t feel good! 
  • Sit on a birth/fitness ball – Helps relieve the pressure created when sitting on a flat surface. 
  • Strengthen the pelvic floor – See suggested exercises below! 

Pelvic Floor Exercises 

  • Wall Pelvic tilts – While standing against the wall, arch the lower back and then slowly tilt it forward (hip thrust style!) Do 10-20 of these. 
  • Tennis Ball Squeeze – Hold a tennis ball between your knees while sitting very upright. Squeeze and hold it and then release. Repeat 15-20 times. Repeat this same exercise with tennis ball between the thighs. 
  • Bridge with ball – Lay down on the floor. Place tennis ball between the knees and raise hips into the bridge position. Hold for a moment and then slowly roll hips back down to the floor. Repeat 10-20 times. 

Do these exercises daily! 

Will it affect my labor?

Having SPD does not affect your ability to birth your baby! You may be more comfortable laboring in certain positions, such as hands and knees or side lying. Other than that, you would not notice a difference between a laboring woman with or without SPD. There is no increased risk to mother or baby! 

When will it go away, and will I get it again? 

I can speak from personal experience here, and I have pretty good news! Having SPD once does NOT mean you will experience it with every single pregnancy. I have personally been pregnant four times, and of those, I have only had this dysfunction twice. Thankfully, the pain should resolve a few weeks after birth, when your body stops producing so much relaxin. Until it does, continue with the self-care habits you created during your pregnancy, making sure to be delicate with your recovering pelvis. You’ll be back to yourself in no time!