Pelvic Girdle Pain (PGP)
During pregnancy, the placenta produces a hormone called relaxin which softens your ligaments to loosen up your joints.
It will come as no surprise to you that your body expands while you're pregnant, but you may be interested to know it's not just your tummy that stretches.
Your whole rib cage has to open up to make room for all the extra baggage you're carrying in the later stages of pregnancy.
Even your arteries have to get bigger to accommodate the extra blood pulsing through you. Relaxin has a very important job, because loosened joints allow your baby to pass through more easily during childbirth.
It's not all fun and games though. Chances are, if you're reading this, you suspect you may be suffering from Pelvic Girdle Pain (PGP) in which case, far from being impressed by how amazing it is that relaxin widens your arteries, you probably want to punch relaxin in the face.
What Causes Pelvic Girdle Pain?
Science has not yet determined an exact cause for pelvic girdle pain during pregnancy. It is unclear whether it is caused by too much or too little relaxin, or whether it is to do with changing posture, or even something entirely different. However research is starting to point at pre-existing pelvic dysfunction (prior to becoming pregnant), which becomes worse under the influence of relaxin – so it is very important to start treatment as soon as possible to get to the root cause.
What is known is that around 20 per cent of pregnant women suffer from pelvic girdle pain. So, take solace in the fact that you're not alone. Some mums may suffer from early in the pregnancy, whereas others may not encounter any difficulties until the last few days.
Symptoms of Pelvic Girdle Pain
Symptoms of pelvic girdle pain include hip pain, back pain, pelvic pain and shooting pains in the buttocks. You may only experience one of these symptoms, or you might be unlucky enough to suffer them all.
The pain is worsened by a whole host of everyday activities including lying down, walking and standing up. Good luck avoiding those. Basically, anything that causes an imbalance in the pelvis will make the pain worse. So activities like turning over in bed or getting out of a car – things that are difficult for most heavily pregnant women – become very problematic for pregnancy girdle pain sufferers.
Treatment for Pelvic Girdle Pain
If you think you may be suffering from pregnancy girdle pain, it is important to speak to your midwife, GP or a trained therapist as soon as possible. Early diagnosis can be beneficial for pain management and avoiding long term problems after things have gotten worse.
The therapist who treats you will be able to assess your pain levels, offer advice and any further assistance necessary. For some women, simply learning how best to sit – with a straight back, not slumped – can make all the difference, whereas some women may find they need crutches to get about comfortably.
The following tips may help you in the meantime:
- Ensure your back is well supported while you sit down. This can be achieved by placing a rolled up hand towel between the curve of your spine and the chair back.
- Wear flat shoes.
- Try to ensure any weight you carry is evenly distributed – this means no shoulder bags and, unfortunately, no lifting your toddler up onto your hip.
- Be careful and take your time when doing any activity that may put strain on your pelvis (eg, getting out of a car).
- Sleep with a pillow between your legs to allow you to get comfortable.
- If using the stairs is painful, take them one at a time.
- If you're uncomfortable, move position. Try moving about and see if that helps.
If I Have Pelvic Girdle Pain, Will I Need A C-Section?
No, you do not need a caesarean if you have pelvic girdle pain. Most sufferers of pelvic girdle pain are able to have a normal birth.
Ultimately, it is your choice if you wish to have a caesarean section, and its understandable being in so much pain can leave you wishing for things to be over with. But its important to make an informed decision before you choose a caesarean section. Remember, a caesarean section is major surgery and poses serious risks to both you and the baby – and the more caesareans you have, the significantly riskier they get. On top of that, you will have a caesarean recovery on your hands at a time when wound infections are not uncommon, and bugs are becoming more resistant to antibiotics. Golden Staph is of particular concern in hospitals and can cause serious damage.
Water births are particularly good because the water supports you and takes pressure off your hips and pelvis during labour. Speak to your midwife about the options available to you.
What About An Induction Of Labour?
Again, this is not necessary and something you should make an informed decision about. Induced labour contractions tend to be longer, stronger and closer together, so coupled with the pelvic girdle pain, it tends to be more difficult to cope with for PGP sufferers. While you can opt for pain relief in the form of an epidural or other, you may become comfortable but the baby will still be under the effect of the longer, stronger and closer together contractions – this compresses the blood and oxygen supply to the baby and increases his risk for fetal distress, resulting in a caesarean section. For more information, check out our article on induction of labour.
Unfortunately for most pelvic girdle pain sufferers, the only thing which completely makes the symptoms disappear is childbirth. However a small percent of women will still have pain – in which case, keep seeking treatment until its resolved.
If you are suffering with pelvic girdle pain, make sure you take things easy. Remember, it will pass eventually.
Therapists That Treat Pelvic Girdle Pain
There are several modes of therapy that help with pelvic pain. Two important ones include:
Some women are lucky and only require one treatment to help solve pelvic girdle pain, but others will require more treatments, especially if the pain has been going on for a while. If you notice that the pain starts to come back after initially feeling better, don’t worry that it appears not to have worked – it just needs more work. Make another appointment and keep going regularly until the treatment starts to make a difference. If you don’t notice an improvement, perhaps try another therapist or mode of therapy.
Make sure you visit a trained and licensed practitioner, ideally with experience treating women in pregnancy. You may also like to see your GP if you would prefer more medical options.