With the joys of pregnancy there can also be a lot of aches and pains. It’s normal to get stretching pains and pelvic pain, in fact 1 in 5 women will experience some pelvic pain, but sometimes it affects you so much that you can be hobbling around on crutches and it severely limits your day to day activities. It used to be called symphysis pubis dysfunction (SPD), but not everyone who has pelvic pain has SPD, so now it all comes under the umbrella term of PGP (pregnancy-related pelvic girdle pain).
Why does pregnancy cause PGP?
There is conflicting evidence as to the cause of pelvic pain in pregnancy, but one of the culprits are those pregnancy hormones. Our bodies need to adapt to the growing baby, plus to prepare for the birth. The hormone relaxin causes joints to literally relax, so the body can change. Other risk factors are a history of previous low-back/pelvic girdle/joint pain and/or previous trauma to the pelvis. The weight of the baby and the pelvis moving unevenly are also factors.
Earlier research found that poor muscle function in the back and pelvis at the beginning of pregnancy is related to severe pain and disability throughout pregnancy. Some believe the pelvic floor strength and core strength are all related. So the fitter you are before pregnancy, the better.
Symptoms of PGP
- Pain over the pubic bone at the front in the centre, roughly level with your hips
- Pain in your lower back, one or both sides
- Pain in the tail bone
- Pain in the perineum
- Pain spreading to thighs
- Clicking or grinding in the pelvic area
The pain can be more intense when walking, opening your legs, going up stairs, and turning over in bed. I remember having to take little dolly steps everywhere.
How do I get relief from pelvic pain in pregnancy?
This is the million dollar question. You may not get complete relief until after the birth. I had it during my last pregnancy from around 19 weeks, and the relief just after giving birth was immense. You may still experience some discomfort postnatally, but the weight of the baby and imbalance of the bump plays such a big part. Having said that, there are lots of ways to relieve the pain and to prevent it worsening or occurring.
If you’re experiencing PGP, get an urgent referral to physiotherapy from your Doctor or Midwife. They will advise you on exercises and positions to do. This is the sort of thing they will tell you:
When you’re sitting, use a small cushion or rolled towel in the small of your back, sit right at the back of the chair and place a footstool under your feet to support your legs.
When standing, keep your weight even over both feet, try not to push your hips forward or over arch your back.
When you sit down or come up to standing from sitting, keep the weight even on both feet, stick your bottom out and do it in one fluid motion.
When you get into bed, sit on the bed with your bottom far back, cross your ankles and then lie down on your side. Come up the same way, using your arms to push yourself up.
When sleeping or lying down, use a body pillow. This one is the pregnancy pillow I recommend for value and comfort, plus it can double as a feeding pillow when the baby is born. Use it between your legs to keep them open, and stop you from twisting, plus it also supports your back and your bump.
When you’re turning in bed, move your body to one side of the bed to allow room without twisting. With your legs bent up, roll bit by bit, keeping your knees and shoulders pointing in the same direction.
Avoid heavy lifting, if you need to carry something, bend your knees and keep yourself upright.
Keep active as much as possible, but rest when you have pain.
Avoid activities that involve asymmetrical positions of the pelvis, such as sitting cross-legged, reaching, pushing or pulling to one side, and bending and twisting to lift or carrying anything on one hip.
When you’re getting in and out of the car, do it in stages so as not to widen your legs too much.
Sit down when you put on your clothes and shoes.
It is still possible to have a vaginal birth with PGP, and to have sex, you just need to be creative with positions. Side lying, all fours are good ones.
Support garments for PGP
Your physio may recommend a support girdle or support belt for your pelvic pain. If you are struggling to get an appointment, there are some commercially available support wear. Make sure the one you buy is comfortable, secure and supports your pelvis and bump. Here are some recommended by experts:
Other Forms of Pain Relief for PGP
You can use simple analgesia (pain relief) like paracetamol, but it’s not usually that effective, however it can take the edge off. Use an ice pack or even frozen peas wrapped in a tea towel over the affected areas. Conversely, a heat pack can help in the form of a hot water bottle, wheat bag or store bought heat pack. You shouldn’t use deep heat when you’re pregnant. You can alternate between hot and cold packs, which can be very effective.
Get some help and support, particularly if you have other children. Tasks like hoovering, loading and unloading washing can take their toll, so try and delegate where possible. If you have a clingy toddler, try different ways of comforting, like sitting and getting them to crawl into your lap. If your job is demanding, they should be able to make reasonable adjustments for you.
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