Symphysis Pubis Dysfunction (SPD)

During my first pregnancy I suffered from the 2nd trimester onwards with a debilitating and painful condition called Symphysis Pubis Dysfunction (SPD). The symptoms of which had me in agony day and night but particularly worse at night time when I would have to continually swap sleeping sides to alleviate the constant pain in my hips, glutes and pelvis. I did invest in a rather expensive pregnancy support sausage......or technically a pillow which my husband would often joke felt like a 3rd person in our bed and marriage!! This did help a little to support my pelvis during sleep whilst the weight of my pregnant belly would twist it uncomfortably. I also was lucky enough to have regular chiropractic treatment through the chiropractic company I worked for, which I think did help to keep me more mobile than I would have been, as well as help with my post-natal recovery from SPD. However it would have been great to have discovered a way to prevent it occurring in the first place. SPD can effect 1 in 5 women and is caused by the pelvic joints becoming more stiff and unstable as our body makes room to accommodate a growing baby. Symptoms can include:

• pain deep in the pubic area and groin (between the vagina and anus)

• the pain can be manageable or severe

• It can be brought on by some types of activity, such as walking, climbing stairs and turning over in bed

• you may also have pain across your lower back

• you might have a grinding or clicking sensation in your pubic area

• the pain can be made worse by parting your legs or by leaning on one leg.

For me the worst effects were those on my ability to sleep, my job, which at the time was fairly active maning a busy chiropractic reception and also at times my mental health as the lack of sleep, constant pain whilst walking and even having sex just really reduced my happiness at a time when I wanted to be enjoying and embracing this wonderful journey. Exercise wise during this 1st pregnancy I did very little, as I stopped running almost immediately and then cycling towards the end of the first the 1st trimester. What little movement I did consisted of walking slowly, which is still an important form of movement for pregnancy and 30 minutes a day can be excellent for your body, as well as mind. I also took a pregnancy pilates class in my 3rd trimester, but unfortunately due to the SPD, I spent most of the classes in tears as I found it very painful and exhausting to hold the poses.

Fortunately, in my 2nd pregnancy I didn't experienced anywhere near the same level of pain and stiffness and would go so far as to say I wouldn’t consider myself to have SPD. Part of this I wonder could be related to my being more aware and prepared for it to return and therefore I perhaps changed the way I do things to help lessen its effects earlier on. However, another key change I made between pregnancies was to invest some time in building strength training exercise into my week from a year before I conceived. This was originally in the hope to loose some weight, become fitter and also to help maintain good mental health during the Covid pandemic, but incidentally it has had an effect on my experience of SPD through focusing on building up core strength which id never had before.

This was achieved through working with an amazing PT Ellie who built me a strength/Hiit training program incorporating use of kettle bells and my own body weight to build muscle and core strength as well as overall fitness. When I got pregnant with my 2nd child, Ellie switched to building me a pregnancy support program, which enabled me to work at a pace that was right for me and included exercises which were appropriate for each stage of my pregnancy, often using lighter weight and a fitness ball. This helped me to continue building support for my lower back, core, and pelvis which are all super important for not only pregnancy itself, but for during labour and in the post-natal recovery period. I even saw a difference in my shape between the 1st and 2nd pregnancy and I felt more toned, and slimmer in the waist, which was a nice bonus aside from the lack of SPD

If you don’t have access to or the finances for a PT, there are loads of great online resources to help you prepare in the fertility/conception stage which include pelvic floor training, as well as building core and back strength which all can help prevent SPD. One quick resource I've discovered that has exercises specifically for SPD is https://mutusystem.co.uk/blog/exercise-for-symphysis-pubis-dysfunction-spd-and-pelvic-girdle-pain-pgp-in-pregnancy/ which is NHS approved, this can help to prevent onset of SPD but also if your’s is not severe these can help relieve and manage discomfort. It's also worth seeking out a qualified pregnancy Yoga teacher who can offer support in this too.

If you are experiencing severe pain though it is always best to seek professional help from a physiotherapist, osteopath or chiropractor, who can help with realignment and its important to let your Midwife know, so they can help you develop a birth plan that can ensure your SPD is supported through labour.