Symphisis Pubis Dysfunction (SPD or PSD)

[AnyDream]

Hi ladies, just a very quick post to say there are a few us on here at the moment with SPD - both ante and post natally. Mayaness, like you I was utterly dismayed when the condition recurred 3 months after baby was born (I expected it to resolve itself, based on my reading). I"m now seeing a physio each week who has me doing pelvic and abdominal exercises daily to strengthen all my muscles, to hold the bones in the correct place so the ligaments can finally tighten like they are supposed to. Other ladies have had success with clinical pilates.

Sorry, Leeloo, can't help you with the active birth advice, I had a CSection this time round.

If you google the Pelvic Instability Association you will find plenty of useful information there.

[Rigga]

I had this with my last pregnancy and ended up in hospital and brace and crutches.
It never really went away after bub was born although it was better than it had been.
This time it arrived earlier and luckily the midwife/dr sent me to the physio early, after over an hour with him, he seem to think it started after a fall I had in my last pregnancy that the drs didnt follow up as bub was fine. So this time at 19 weeks I am already in a tube thing from bottom of belly to bottom of breasts, a brace and crutches with the advice to get a c section so I dont damage my pelvis anymore. As its really quite unstable and out of alignment by a lot.
Physio said 12 weeks after bub is born we try and start to make it better. Im hoping he can do something, its so painful and sex is just a no go

[Traveller]

I had SPD badly with DS2 and severely to the point on needing crutches and occasionally a wheelchair with the twins. When it came to giving birth there was no extra pain, and in fact birth is often easier with SPD as your pelvis is already open a bit.

The only word of warning is try to avoid an epidural as this will rob you of your pelvic sensation. The pain you currently have is a warning system to go no further, so without that you may open your legs too wide (or have them hoisted into stirrups by a midwife) thereby damaging your pelvis on a much more serious basis.

Giving birth on all fours or in a pool is generally a good way to do it with SPD.

Good luck!

T
xx

[alioops]

Rigga - I had diastasis of the symphisis pubis with my 3rd pregnancy. DD3 was born vaginally with only the gas. I was wheelchair bound for the final month of pregnancy. If anything the separation made a vaginal birth quicker and easier. I was advised by my Ob (there are stacks of threads around about it) that she would not recommend a CS, but that if my pain increased during labour she would take me in for an emergency CS. I would recommend you do a lot of research prior to arranging a CS because the recovery from a CS is worse than I have found the recovery from the diastasis. I was walking (very gingerly) 3 days after she was born. With a CS they will not discharge you until you can walk around, and it will be harder for you to walk around with the combined pain.

I do know you pain, I was on panadiene forte for months, so believe me when I say that you may be able to have this baby vaginally. It may also help to align your pelvis having even pressure on it. Do avoid drugs, and if your pelvic pain increases in labour tell your caregivers.

[fionas]

Unfortunately, this is not a science and no-one can give you a guarantee. I'm weighing up my options right now but will probably have an elective caesarean.

With DD the pain started at 28 weeks. Everyone told me it would go away after the birth. I wasn't careful, was in a lot of pain, was still standing to cook dinner every night for half an hour and worked up to 38 weeks. This was completely nuts but I thought it was just one of those things that I had to put up with. I saw a physio who advised a belt and icing, neither of which I was good at doing.

I had a vaginal birth with an epidural. The pushing phase lasted almost three hours with me instructed to hold my knees against my shoulders for that entire time.

I think that's the primary reason why it took 18 months to recover.

Yes, EIGHTEEN FRICKEN MONTHS.

So when obs/physios now tell me that the recovery is longer with a caesar, I tell them I don't know anyone who has taken eighteen months to recover from a caesar.

[Traveller]

I had a vaginal birth with an epidural. The pushing phase lasted almost three hours with me instructed to hold my knees against my shoulders for that entire time.

I think that's the primary reason why it took 18 months to recover.

Yes, EIGHTEEN FRICKEN MONTHS.

how horrendous for you, that is exactly the position you must avoid if you have SPD. Without an epidural your body would have been screaming at you to stop but with one you rely on your caregivers to consider your SPD when advising positions and in too many cases they don't think about your hips.

If it is any consolation almost the exact same thing happened to my friend (except she ended up with a c-section after the 2 hours of pushing which damaged her pelvis). She went on to birth twice more, both times vaginally, and by avoiding the pushing on her back with an epidural she recovered much faster from the births with no post birth physio required.

[fionas]

how horrendous for you, that is exactly the position you must avoid if you have SPD. Without an epidural your body would have been screaming at you to stop but with one you rely on your caregivers to consider your SPD when advising positions and in too many cases they don't think about your hips.

I know that now but unfortunately I didn't know that at the time!

Mayaness, it's great that you had good births but I did not have a great first birth. I had a very long prelabour with the first two nights rolling around alone on my concrete floor with very little sleep with a posterior baby (no, I had not discovered Spinning Baby) to be followed by hospital where a long labour ensued with an 8lbs 10oz baby. I don't care whether this baby is born via caesarean or vaginally. I just want the best outcome for my pelvis. Having to go through 18 months of post-natal pain almost cost me my relationship, resulted in me being housebound for much of that time and has now resulted in me moving to Woodend so that at least I can get used to driving and won't be housebound any more. In addition, I have spent almost $30K on getting my kitchen reconfigured to be more pelvis-friendly. That's how big an impact this has had on my life. I feel like a cripple and I'm not happy.

So, I don't trust my body. Why would I? It has let me down. If I try another vaginal birth and have a long recovery, I will feel incredibly dumb.

The Pelvic Instability Association recommends that you measure how far you can comfortably separate your legs and then advise your caregivers. At 17 weeks I can't even open my legs wide enough to put a pillow inbetween them at night without experiencing pain and after two minutes walking I need to sit down. I honestly don't see how a vaginal birth could possibly be good for my pelvis.

As I said before, this is not an exact science. Obs will tell you different things, physios will tell you different things. The only thing I care about is what my body and my mind are telling me and both are telling me not to do a vaginal birth because I've done it before and it's ended in absolute disaster.

And by the way, the two midwives that I've spoken to have told me to have a caesar.

[Smoke Jaguar]

I've had it through two pregnancies now, had fantastic births both times and having managed it so much better 2nd time round can't for the life of me see how a CS is going to make anything better. Pelvis is unstable in premature preparation for vaginal birth, it's not going to get much worse than carrying to term is and, as others say, there are positions you can use to protect the pelvis. I found all fours in water was ace. Squatting on land is the worst, anecdotally. Birth won't damage the pelvis if you're careful, as those ligaments have already pulled you out of alignment.
I recommend Osteo and gentle yoga.
Also, a must visit is to google the pelvic instability association - fantastic links and information
BTW, since my OP, I have discovered that it's not hormones still in my system - it's just mismanagement of the pelvic misalignment. My osteo and yoga kept me fairly even

[Rigga]

Thanks for the advice but I will be following the advice of dr and physio. The physio wont touch my pelvis as its damaged from the previous fall and it was left, so there is more than just spd. The physio thinks vaginal delivery will damage beyond repair. I wish everyone the best :-)