Symphysis Pubis Dysfunction (SPD) in Pregnancy

Introduction: Understanding SPD Pregnancy

Symphysis Pubis Dysfunction (SPD) during pregnancy is a common yet painful condition affecting many expectant mothers. SPD, also known as pregnancy-related pelvic girdle pain (PGP), occurs when the pelvic joints become stiff or move unevenly, resulting in discomfort and limited mobility. While not harmful to the baby, SPD can significantly impact daily activities and overall well-being.

Here’s what to know about SPD during pregnancy:

• What it is. Pelvic pain is caused by changes in the pubic symphysis joint.

• Causes. Hormonal changes (especially relaxin), pressure from the growing baby, or a prior pelvic injury.

• Symptoms. Pain in the pubic area, lower back, or thighs; clicking or grinding in the pelvis; discomfort with walking, climbing stairs, or turning in bed.

• Management. Physiotherapy, pelvic support belts, safe movement techniques, and avoiding long periods of sitting or standing.

With the right support, SPD symptoms often improve after childbirth. In this article, we’ll explore the causes, signs, treatment options, and simple ways to manage SPD and stay as comfortable as possible during pregnancy.

What Is Symphysis Pubis Dysfunction (SPD) in Pregnancy?

Symphysis pubis dysfunction (SPD), also known as pelvic girdle pain (PGP) can happen during pregnancy when the joint called the pubic symphysis that connects the two halves of your pelvic bone moves too much.

The symphysis pubis joint is normally very stiff and doesn’t move much at all, but during pregnancy, a hormone called relaxin is released in your body to help relax the muscles and joints as your body prepares for giving birth. As part of this, the symphysis pubis joint is also loosened.

As the pelvic joint moves more than usual, and even potentially becomes uneven, you may experience pelvic pain.

Be sure to contact your healthcare provider if you have any pelvic pain during pregnancy, as the cause of your discomfort may not be SPD. Your healthcare provider can both diagnose SPD and rule out something else like an ectopic pregnancy, a urinary tract infection, or pelvic inflammatory disease, for example.

Symphysis Pubis Dysfunction (SPD) Symptoms in Pregnancy

These are some of the potential symptoms of symphysis pubis dysfunction:

• Mild discomfort, shooting, throbbing, or burning pain in the lower pelvis are

• Lower back pain that radiates into the abdomen, groin area, thigh, and/or leg

• Pain when you make certain movements like putting weight on one leg or when spreading your legs apart

• Pain with regular daily movements like walking, rolling over in bed, going up or down stairs, bending forward, or getting up from a seated position

• Hearing or feeling a snapping, clicking, or grinding in the lower pelvis area

• Pain during sex

• Unexplained fatigue.

Keep in mind that the pain you might feel because of SPD can range from mild to severe.

The pain from SPD is often worsened by:

• Lifting

• Movements involving using your hips such as walking, bending forward, or getting up from a chair

• Sexual intercourse

• Sitting or standing for long periods.

Symphysis Pubis Dysfunction Treatment

If your healthcare provider diagnoses symphysis pubis dysfunction, there are several treatment methods to help ease the pain they may recommend. On top of that, keep in mind that SPD pain usually goes away after you give birth.

Here are some SPD treatment methods your provider might suggest to give you some pain relief:

• Taking pain relief medications

• Taking NSAIDs (nonsteroidal anti-inflammatory drugs)

• Physical therapy. Your provider or physical therapist might show you safe exercises that help strengthen your back and abdomen. This may also include doing Kegel exercises to help strengthen your pelvic floor

• Using a wheelchair, crutches, or a walker, per your provider's recommendation, if the pelvic girdle pain is severe and effects your mobility during pregnancy

• Using a TENS unit (transcutaneous electrical nerve stimulation).

How to Relieve Pelvic Pain During Pregnancy

Here are some home remedies you can try to help relieve SPD pain in pregnancy. Remember to consult your healthcare provider for a diagnosis and recommendations before trying the following:

• Wearing a pelvic support belt

• Resting

• Applying an ice pack

• Sleeping on your side with a pillow between your knees

• Getting a massage

• Using supportive pillows while you rest or sleep

• Doing Kegel exercises to help strengthen your pelvic floor

• Try not to sit for prolonged periods

• Avoid lifting heavy objects

• Learn how to bend and move around safely.

How Can You Prevent Symphysis Pubis Dysfunction

Although you can’t entirely prevent pelvic pain during pregnancy, there are ways to reduce your risk and help avoid injuring your pelvic area. Here are some things you can do:

• Wear comfortable shoes with good support

• Maintain a healthy weight for you throughout your pregnancy. Your provider can help you stay on track

• Move in safe and mindful ways and maintain a good posture

• Don’t overdo it. Listen to your body and rest if you feel pain or discomfort.

Pelvic Pain by Trimester

If you’re experiencing pelvic pain during your first, second, or third trimester, it’s always best to consult your healthcare provider for a diagnosis and treatment options. Here are some possible causes and concerns related to pelvic pain in each trimester:

First Trimester

• Causes. In the first trimester, pelvic pain may be related to hormonal changes, such as the hormone relaxin, which loosens ligaments in the pelvis. Round ligament pain can also occur as the uterus expands. Light cramping may be due to implantation.

• Concerns. Severe or persistent pelvic pain could be a sign of more serious conditions, such as ectopic pregnancy or miscarriage. It's important to contact your healthcare provider if the pain is intense or accompanied by bleeding.

Second Trimester

• Causes. As well as symphysis pubis dysfunction being a potential cause of pelvic pain, as the baby grows, the expanding uterus may put pressure on surrounding ligaments and organs, leading to discomfort. This is commonly known as round ligament pain. As the growing uterus presses on the sciatic nerve, this may also cause pain in the lower back and pelvic area during the second trimester.

• Concerns. If the pain is severe or associated with other symptoms such as fever or abnormal discharge, it could signal infections like a urinary tract infection (UTI) or preterm labor.

Third Trimester

• Causes. In the third trimester, pelvic pain can be due to the baby’s position as they prepare for birth, increased pressure on the pelvic bones, and the loosening of the pubic symphysis joint. Braxton Hicks contractions, which are practice contractions, may also contribute to discomfort.

• Concerns. Sharp, constant pain or pelvic pain/pressure associated with contractions may be a sign of preterm labor or placental issues. Always report severe or unusual pain to a healthcare provider.

For any concerns, consult with your healthcare provider to rule out serious conditions.

The Bottom Line

Although symphysis pubis dysfunction might be causing you some discomfort during your pregnancy, try to remember that the pain might be helped by the treatment recommended by your healthcare provider or, eventually, by the birth of your little one.

Yes, there’s quite an A to Z of body aches and pains that you might experience while pregnant but try to bear in mind that it will all have been worth it once you’re holding your baby in your arms.