Symphysis Pubis Dysfunction

SPD usually occurs in pregnancy due to the pregnancy hormone relaxin softening the ligaments in your body, allowing the joints in your pelvis to open up and make room for your baby to be born. Later in the pregnancy, the symptoms - which can include mild, moderate or severe pain in the pubic bone area as well as pain in the hips, groin, lower abdomen, buttocks, lower back or inner thighs - can be aggravated by the increasing weight of the baby, changes in the body’s centre of gravity, and posture (there may occasionally be other contributory factors). Some women only have this condition in one pregnancy, while others may also have it in subsequent pregnancies.

The pain of SPD is often made worse by weight bearing activities including standing and walking, turning over in bed and by any movement that involves separating the legs such as walking up stairs, getting in and out of the bath or car etc. Sometimes a clicking sensation can be felt or even heard.

The condition is usually diagnosed by its symptoms and by a thorough assessment of the pelvic joints and spine (which can include an ultrasound scan).

There are a number of treatment options available. Your GP may be able to refer you to an Obstetric, Women’s Health or general physiotherapist for a proper assessment and to provide appropriate care. Some women find a qualified osteopath or acupuncturist helpful. Mention of maternity girdles, TENS machines and possibly crutches for those with a severe form of the condition could possibly be included here.

There is no reason why you should not be able to give birth to your baby vaginally and no evidence that this makes the condition worse. You may find labour and birthing in a birthing pool will help both with severe pain and with moving around. Other helpful positions include kneeling, all fours and standing. If you need to lie down, try to avoid the traditional lithotomy position (lying down with legs spread and raised) as this can slow down your labour and strain your symphysis pubis. Great care needs to be taken not to open your legs too wide ,if you have an epidural in place and cannot feel if the joint is being put under too much strain.