SPD, PGP & Pregnancy

The other day I noticed a pregnant woman on crutches, desperately struggling to climb a single stair without moving above her knees whilst simultaneously not twisting her hips and upper body. As I rushed to her aid, in my own mind I was catapulted back to my own pregnancies and I felt her agony.
 
While you are pregnant, for some reason the expectation from
non-pregnant people is that you should be a picture of blooming health, sailing around with that lovely pregnancy glow once the morning sickness has eased off. In fact even some pregnancy books say that once the first few months are passed that you will feel healthier and that you should take advantage of this time before the heaviness of the 3rd trimester kicks in.
 
So what if pregnancy, morning sickness aside, leaves you unable
to walk, unable to move in bed, climb stairs, get in and out of the car, sit up for any length of time, sit down for any length of time… what then? Welcome to the excruciating world of Symphysis Pubis Dysfunction, or as it is more commonly known as now – Pelvic Girdle Pain.
 
I did in fact sail through my 1st pregnancy without a pelvic hitch, my son was born at 37 weeks via caesarean section as he was in a breech position. The fact I didn’t suffer with SPD/PGP in my first pregnancy is unusual but I prefer to call it a glorious miracle.
 
Argh, pain!
 
So imagine my surprise when at around 25 weeks pregnant I
start to get twinges in my pelvis which within a week degenerated to the point where I couldn’t walk unassisted and without horrible indescribable pain. One evening, out of usual working hours I was in tears and rang the local midwife team and was told to “take a paracetamol, ligament pain in pregnancy is normal and to just take it easy”. Crying now with pain and frustration I turned to the internet, typed in my symptoms, something I always said I would never do, and up pinged SPD. My symptoms matched to the letter.
 
Symptoms
 
Symptoms include difficulty in scissor movements, so going
upstairs, walking/running, aerobics... Extending your knees apart is extremely difficult so breaststroke in swimming and some intimate positions are a no-no. The pain itself is generally at the very front part of your pelvis, right
behind your ‘bits’. In my case it felt like someone was twisting a
screwdriver into the bone whenever I moved. Yes I saw you wince.
 
The Pelvic Partnership (www.pelvicpartnership.org.uk) say that “Pelvic girdle pain is usually caused by an asymmetry or change of normal movement or alignment in your pelvic joints – a
mechanical joint problem not a hormonal one” and while I technically agree, yes the pain is caused as described, but the movement or asymmetry is caused by the fact that the hormone ‘relaxin’ increases in the body
during pregnancy. Relaxin causes the ligaments in the body to become more mobile and ultimately help the body to be able to birth the baby however with some women there is too much Relaxin and the ‘Symphysis’ becomes
too loose and so has too much movement, causing the pain.
 
In some women the movement becomes so severe that permanent damage can occur and this is why it is so so important that if you suffer with this,
that you get treatment immediately and look after yourself carefully.
 
Get Treatment
 
I got an appointment with the doctor who while was
sympathetic, didn’t know anything about it and told me to go to my
midwife. She saw immediately that I was in horrible pain and got me a physiotherapy appointment for the following morning. At 4pm that day,
it was quite an achievement and a testament to how urgent she saw the problem to be. The physiotherapist gave me a kind of tubigrip body sock and a set of crutches. She also did some manual manipulation on my back as where I was walking ‘funny’ I had all sorts of referred pain in my back, legs,
neck and shoulders. She also sent me away with a list of self help measures and a recommendation that I contact the doctor for stronger painkillers if
necessary.
 
Self help…
 
* Take it slowly
* To get in and out of the car, sit on a plastic bag so that you swivel easily – keep your knees together
* To roll in bed or to get out of bed, keep your knees together too and your pelvic/hips region as still as possible
* Support yourself in bed with plenty of pillows. A thin one between your knees may help
* Do keep moving a bit. Don’t sit down for the rest of your pregnancy. Don’t overdo it though
* Accept help
* Think about how you move around your home – avoid
the stairs where possible
* DO NOT PUSH TROLLEYS AT SUPERMARKETS!
* DO NOT VACUUM!
 
During vaginal examinations, don’t over extend your knees, get a piece of string and measure how far comfortably you can extend, then use that piece of string as a gauge. Don’t go beyond it and importantly give it to your midwife when you go into labour. Just because you cant feel the pain when/if you have an epidural, doesn’t mean it isn’t doing
damage and your goal is to minimise the damage to your pelvis so that you can make a full and fast recovery post birth.
 
With my daughter, I did develop SPD/PGP earlier in pregnancy
but I saw it coming a mile off and was able to manage it a bit better, I’m not saying there weren’t days when you’d have to peel me off the ceiling with the pain, but I was better prepared and knew that there were things I could do to help myself.
 
Post Birth
 
The magical thing about this condition for many women is the
way it disappears after the baby arrives. Not everyone is so lucky but you should expect to see significant improvement. 10 months down the line I still should not be pushing supermarket trollies/carts but in this age of online grocery shopping, it is avoidable. Still, don’t take it too fast, accept help, and it will improve.
 
Emotionally Speaking
 
When I was pregnant with Daisy and suffering with this condition, I did get very low, to the extent that I went to the doctors in a state, not able to cope and feeling like a failure. I was desperately trying to carry on through the pain caring for my two young children, look after the house, carry on with a very stressful job, and I wondered why it was all starting to get on top of me. If you are a PGP sufferer then please, be kind to yourself.

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