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Old 10-25-2005, 05:00 PM   #1
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Question Symphysis Pubis Dysfunction

Does anyone have any information, websites, books, etc on this condition that midwives/obs/docs seem to blow off but seems to happen in more people that I initially realized (including myself right now)?

Anything I have heard so far is not encouraging for treating this. I have 16 weeks remaining in this pregnancy and would love to find ways to keep it from increasing in severity, and then be able to pass the information on especially to my midwife who just blew it off as "we need to keep an eye on it", and then to clients who should run into it.
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Old 10-25-2005, 10:58 PM   #2
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Ohhhh OOOOWWWW Chiropracor! Find one that knows about it, perhaps one that treats pregnancy related things in general. Alternating hot and cold packs, 15 minutes of each. Really, there isn't a lot that can be done. Sorry.
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Old 10-26-2005, 07:55 AM   #3
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I agree- chiro, potentially acupuncture... HUGS ouch!
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Old 10-26-2005, 11:01 AM   #4
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I really DO know how to spell. Really.
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Old 12-18-2006, 08:56 PM   #5
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Wink Reviving this thread to add info

I realise this thread is old, but I found a few websites with some information that might help others (one of my current clients is dealing with this right now)...

From the plus-size-pregnancy website: Pelvic Pain (Symphysis Pubis Dysfunction)
Birthsource's take: Symphysis Pubis Dysfunction (SPD)
The WellMother site: Symphysis Pubis Dysfunction
And this, from ivillage (uk):
Quote:
Symphysis Pubis Dysfunction (SPD)
What is the common condition that makes standing on one leg or climbing stairs unbearable for some pregnant women? Christine Hill examines SPD

What is Symphysis Pubis Dysfunction?
The symphysis pubis is the name given to where two bones meet at the front of the pelvis. The pelvic bone is roughly in the shape of a heart, and is actually formed by three bones, which are held together by very strong ligaments.

The bones meet to form three 'fixed' joints - at the front (the symphysis pubis) and at each side of the bottom of the spine (the sacro-iliac joints).

Normally, these joints are not designed to allow movement. However, when a woman becomes pregnant, a hormone called relaxin is produced which loosens all the pelvic ligaments in order to allow the pelvis slight movement at the time of birth.

For some reason, the ligaments occasionally loosen too much and too early before birth. This means they can't keep the pelvic joints stable so the pelvis moves, especially on weight bearing. All this is made worse by the increased weight of the growing baby and sometimes the symphysis pubis joint actually separates slightly. The result is mild to severe pain, usually in the pubic area, and is called SPD.

What are the symptoms?
The most common is pain and difficulty when walking. Some women describe the feeling of their pelvis coming apart. The pain is made worse when turning in bed or doing something that involves standing on one leg, such as climbing up stairs, getting dressed and getting in and out of a car.

The pain is generally felt in the pubis and/or the sacro-iliac joints, but can also be experienced in the groin, the inner side of the thighs, the hips and in one or both buttocks.

When is it most likely to start?
At any time from the first trimester onwards. Some women can be fine during their pregnancy, but get the condition a few days after their baby has been born.SPD sometimes occurs following a period of immobility, an unusually busy overactive period or a particular activity such as swimming breaststroke or lifting something incorrectly.

Is there any treatment?
Unfortunately there is no way of tightening the ligaments again during pregnancy, so no treatment will be able to cure SPD. This includes any sort of osteopathy, reflexology or acupuncture. However, after the birth the body stops producing the hormone, so the ligaments tighten up and (for the majority of women) the symptoms gradually disappear.

So what can be done?
The most important thing is to avoid doing anything that aggravates the condition, such as standing on one leg.
  • Sit on a chair to get dressed.
  • Be very careful to get into a car by putting your bottom on the seat first, and then lifting your legs into the car.
  • When you get out, lift your legs onto the pavement and then lift your bottom off the seat.
  • If you go swimming, don't swim breaststroke.
  • Always turn over in bed with your knees firmly together.
  • Make sure you get a rest (in bed) every day.
  • If you already have a child, you will need help, as you will find it difficult to lift him or her.
  • If the pain is severe, ask your GP for a referral to a physiotherapist, ideally one who has specialist training in obstetrics and is called a Physiotherapist in Woman's Health. She or he will be able to assess you and may fit you with a pelvic support belt, which helps to stabilise the pelvis. Your GP will also be able to prescribe painkillers that are safe to take in pregnancy.

During labour and delivery
It's not really possible to decide in advance what position you will deliver in, because it all depends on how your labour goes and what you find comfortable at the time, but it is useful to have a few ideas. The most important thing is that the doctor or midwife who is delivering you knows you have SPD.

You will need to keep separation of your legs to a minimum - which is the tricky bit during delivery. If everything goes smoothly and you don't need an epidural, you might find it comfortable to deliver on all fours, kneel up against the back of the bed or lie on your side with your upper leg supported.

If you push in a sitting position during the second stage, do NOT let your feet be placed on your attendants' hips.

If you need an epidural, remember it will mask the warning pain of SPD as well as the contractions and the above is even more important.

If by any chance you need an assisted delivery, which requires you to have your legs in stirrups (lithotomy position), it is vital that your partner reminds your midwives that you have SPD. They will be very careful to lift your legs up together symmetrically. The same applies if you need stitches after your baby has been born.

Most women recover spontaneously soon after birth, but you will need to rest (as much as possible) and avoid doing anything that provokes the pain.
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Old 12-19-2006, 12:06 AM   #6
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I'd be absolute toast without my chiropractor. The family "loose ligaments" are not particularly helpful in this department. I feel your pain. Mine was really bad around 16 weeks also. I have noticed it improving with regular chiropractic care, though.
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Old 12-19-2006, 12:31 AM   #7
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I heard Penny Simkin speak on it briefly during a DONA conference tape. Maybe you should check their website, if you haven't already. Or google Penny since she's a PT she may have more info on it than any others.
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Old 12-19-2006, 12:44 AM   #8
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I know it sounds silly, but walk up the stairs backward.
And forget the squat or tailor sitting, ouch that just hurt to no end.
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Old 12-19-2006, 08:58 PM   #9
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I hope your SPD does not get any worse! Someone already posted the link to the plus-size pregnancy site. That has the best info around about SPD. I had it with my last 2 pregnancies. With the twins it was awful. I could not move for several weeks both before and after the birth. I had excruciating pain any time I changed positions. I tried everything and what helped the most was chriopractic care, using a TENS unit, rocking on my hands and knees, and going to the pool. It was about 6 weeks post partum before the pain subsided.
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Old 12-22-2006, 12:53 AM   #10
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Oh, my goodness! I knew that I had BAD pain during both of my pregnancies in that area but mostly just tender to touch or when I did do something like climb stairs or get in or out of the car. I didn't realize there was such a severe problem that could occur, though! I am so sorry for you ladies! I would say FOR SURE to see a GOOD chiropractor. It is amazing how your body can heal when you're "aligned" this is very interesting...I'm gonna ask my chiro about it...maybe he cal help me have less pain this time around. I couldn't stand even to lean agains a counter or for my pants to be too tight on my pubic bone where they separate, and when my dr would check my fundal height, I wanted to cry every time she touched that bone, and she'd just say, "Sore? Yeah, that's normal!" So I thought it was normal to actually HURT!
I'm sorry you guys! s
Thanks for the info!
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