Pelvic Pain During Pregnancy

Pelvic Pain During Pregnancy

Pelvic pain is common during pregnancy. This is sometimes called “Pregnancy-Associated Pelvic Girdle Pain (PGP)” or “Symphysis Pubis Dysfunction (SPD)”. PGP is a collection of uncomfortable symptoms caused by stiffness of your pelvic joints or irregularly moving joints in the back or front of your pelvis.

Symptoms of PGP

PGP isn't harmful to your baby, but it can be painful and make it difficult to get around. Women with PGP may feel pain at:

- In the center above the front pubic bone, roughly level with your hips

- On one or both sides of your waist

- In the area between your vagina and anus (perineum)

- On the thighs

Some women feel or hear clicking or squeaking in the pelvic area.

Pain may be worse if:

- Walk

- Going up or down the stairs

- Standing on one foot (for example, when getting dressed)

- returning to bed

- Spreading your legs (for example, when you get out of the car)

Most women with PGP can have a vaginal birth.

Call your midwife or doctor if you have pelvic pain and:

- If you have difficulty walking

- It is painful to get out of the car or turn over in bed

- If going up or down stairs is painful

These may be symptoms of pregnancy-related pelvic girdle pain.

PGP Treatments

Getting diagnosed as early as possible can help keep pain to a minimum and prevent long-term discomfort. You can request a referral from your midwife to a physical therapist specializing in obstetric pelvic joint problems. Physiotherapy aims to relieve pain, improve muscle function, and improve your pelvic joint position and stability. This may include:

- Manual therapy to keep the joints of your pelvis, hips and spine moving normally

- Exercises to strengthen your pelvic floor, stomach, back and hip muscles

- Exercises in the water

- Advice and advice, including birthing positions, baby care and sex positions

- Use of a pain relief device such as TENS

- Equipment such as crutches or pelvic support belts if needed

These problems tend to resolve completely by the time the baby is born, but treatment by an experienced doctor can improve symptoms during pregnancy.

Dealing with pelvic pain during pregnancy

Your physical therapist may recommend a pelvic support belt or crutches to help you move around to ease your pain. It can help you plan your day so that you avoid activities that cause your pain. For example, don't go up and down stairs more often than necessary.

- Be as active as possible within your pain limits and avoid activities that make the pain worse

- Rest when you can

- Get help with household chores from your spouse, family and friends

- Wear flat, supportive shoes

- Sit down to get dressed - for example, don't stand on one leg while wearing jeans

- Keep your knees together when getting in and out of the car - a plastic bag on the seat can help you turn

- Sleep in a comfortable position - for example, turning on your side with a pillow between your legs

- Try different ways of rolling in bed - for example, your knees twist together and squeeze your hips

- Take the stairs one at a time

- If you use crutches, have a small backpack to carry things

- If you want to have sex, consider different positions like kneeling on all fours

You should avoid:

- stand on one leg

- cross your legs

- Sitting on the floor or sitting cross-legged

- Sitting or standing for long periods of time

- Lifting heavy weights such as shopping bags, water buckets or a toddler

- To sweep the floor

- Pushing heavy objects like a supermarket trolley

- Carrying anything in one hand (try using a small backpack)

The physical therapist can offer advice on dealing with the emotional effects of living with chronic pain, such as using relaxation techniques. If your pain is causing you serious distress, you should inform your doctor or midwife. You may need additional treatment.

Birth with pelvic pain

Many women with pelvic pain during pregnancy can have a normal vaginal delivery. Plan ahead and talk to your birth partner and midwife about your birth plan. Write in your birth plan that you have a PGP so that the people who supported you during and during labor are aware of your condition. Think about the birthing positions that are most comfortable for you and write them in your birth plan. Being in the water can reduce the strain on your joints and allow you to move more easily, so you may want to consider giving birth in water. You can discuss this with your midwife.

Your pain-free range of motion

If you have pain when you open your legs, learn about your pain-free range of motion. To do this, lie on your back or sit on the edge of a chair and spread your legs as much as possible without pain. Your partner or midwife can measure the distance between your knees with a tape measure. This is your pain-free range of motion. Try not to spread your legs more than that during and during labor to protect your joints. This is especially important if you had a pain relief epidural during labor, as you won't feel the pain that warns you that you've spread your legs too far. If you have an epidural, make sure your midwife and birth partner are aware of the pain-free range of motion of your legs.

You may find it helpful to lie on one side as you push through the second stage of labor. This prevents your legs from separating too much. If you wish, you can stay in this position for the birth of your baby. Sometimes you may need to spread your legs wider than your pain-free zone to deliver your baby safely, especially if you need assisted delivery (for example, with vacuum or forceps). Even in this case it is possible to limit the separation of your legs. Make sure your midwife and doctor are aware that you have PGP. If you go beyond your pain-free zone, your physical therapist should evaluate you after delivery.

Who gets pelvic pain during pregnancy?

PGP is estimated to affect 1 in 5 pregnant women to some degree. While it's not known exactly why pelvic pain affects some women, it's thought to be linked to a number of issues, including previous damage to the pelvis, irregularly moving pelvic joints, and the weight or position of the baby. Factors that may make a woman more prone to developing PGP include:

- History of low back or pelvic girdle pain

- Previous injury to the pelvis (for example, from a fall or accident)

- Having PGP in a previous pregnancy

- A physically demanding job

- Being overweight

- Having given birth many times