Pelvic girdle pain (PGP) and SPD in pregnancy

Many women will suffer from Pelvic Girdle Pain during and sometimes after their pregnancy. 

What is Pelvic Girdle Pain (PGP)?

PGP is also known as Symphysis Pubis Dysfunction (SPD); a condition which affects the pelvic joints, making them stiff so that they stop working normally.

It can occur at any stage of pregnancy, or during childbirth, and may come on suddenly, or start gradually. The good news is that it usually resolves very quickly after birth, with some women noting immediate effects, and other women noticing it improves over a couple of weeks.

One in five women are affected by this during pregnancy.

What causes PGP?

During pregnancy you gain weight which puts extra strain on your pelvis, you also stand differently as the weight of the baby changes your posture. Pregnancy hormones such as relaxin and progesterone can also loosen the ligaments and muscles making the pelvis less stable, all of these things can contribute to developing PGP.

What are the symptoms of pelvic girdle pain?

The main symptom is pain, which most commonly occurs while walking, climbing the stairs and turning over in bed.

Sufferers may feel pain in their pubic area, groin, hips, on the inside of their thighs and in one or both buttocks. Often, the pain can be concentrated on one side or might appear to jump from one side to the other.

There can also be instability of the joints, which makes day-to-day activities, difficult.

When does pelvic girdle pain occur?

The condition usually starts in the second trimester but in some cases can begin during labour or occasionally even after the birth.

Pelvic floor exercises will improve the stability of your pelvis and back. Exercising in water may also help, but avoid swimming breaststroke. Take care when sitting down and getting up. Don't lift or push anything heavy. If you are climbing stairs, take one at a time, stepping up with your best leg and bringing the other one up to meet it. Your GP may also refer you to a physiotherapist.

Treatments for pelvic girdle pain

PGP is very treatable, both during pregnancy and afterwards, and it’s important to seek help as soon you get symptoms.

Treatment involves assessing the joints and muscles in and around the pelvis and returning them to normal function, usually using manual therapy techniques.

A physiotherapist will advise on a range of exercises and positions to help ease the pain, as well as what exercises to avoid, and your GP will be able to give you information about which painkillers are suitable to take during pregnancy.

Here are some general pointers to help: 

• Your physio may recommend a pelvic support belt
• Avoid heavy household chores such as hovering or ironing
• Take one stair at a time
• Don’t try to lift anything heavy – this includes toddlers and other children
• Avoid pushing a heavy trolley
• Put a pillow between your knees at night to keep your pelvis in line
• Exercise your stomach and pelvis floor to improve stability in the pelvis and back
• Rest regularly throughout the day, ideally by sitting on a large birthing ball or by resting on your hands and knees
• Wear flat shoes and avoid high heels
• Try to keep your knees together when getting into and out of bed, or into and out of the car. Parting your legs can make PGP worse.

Exercise with PGP

It is important to try and stay active during pregnancy, even if you have PGP. Try and find some exercises that are manageable for you – many women find swimming helpful as the water takes some of the weight off the pelvis. Avoid breaststroke as this can exacerbate symptoms. The important thing to remember is to stop any exercise if it is causing you any pain.

How will PGP affect my labour?

Having PGP doesn’t  mean you are more likely to have problems during labour, just as long as you follow the right advice.

Make sure you put ‘PGP sufferer’ in your birth plan and make the midwives aware of this straight away.

Try to avoid lying on your back to give birth – it is far better to be upright or kneeling as this protects the pelvic joints.

If you have an epidural, make sure someone measures the width you can comfortably open your knees to before it is administered as this will avoid any lasting damage in the future. A birthing pool is an excellent way to ease pain as it allows you to move about freely and takes pressure off the pelvis.

PGP does not mean that you will need to be induced or have a caesarean.

Will PGP come back again?

In most women, the pain stops after giving birth, however, there are a few rare cases where it can continue on afterwards.

Sufferers are advised to carry on with any treatment until they have returned to their pre-pregnancy fitness.

Unfortunately, if you do suffer from PGP in one pregnancy, it is likely the problem will reoccur in following pregnancies and without treatment, may be more severe.

What is SPD in pregnancy?

SPD stands for; Symphysis Pubis Dysfunction (SPD); this is a condition which affects the pelvic joints, making them feel stiff so that they stop working normally.

When does SPD start in pregnancy?

SPD can start at any point during your pregnancy but is most common during the third trimester, with many women experiencing it during their second trimester.

Can SPD cause early labour?

SPD doesn’t directly impact your baby and whilst it may cause your labour to be a little more difficult, specifically if you’re having a vaginal delivery, it isn’t known to cause early labour.