I Have Symphysis Pubis Dysfunction (SPD/Pelvic Girdle Pain)
It always feels a bit strange for me to talk about a pain that isn’t my trigeminal neuralgia. In January 2021, I gave birth to my beautiful little girl and my body has never quite recovered from pregnancy.
When I was about six months pregnant, I was diagnosed with symphysis pubis dysfunction (SPD), which you might know as pelvic girdle pain. It occurs when the ligaments in your pelvis, which normally keep everything aligned, become relaxed during pregnancy, causing your pelvic joints to move unevenly. It can happen if you’re overweight, if you’ve had a previous injury to your pelvis, if you’re hypermobile (my issue!), or sometimes, it just happens and they’re not quite sure why.
On top of the ligaments loosening, your body is changing and everything is moving, your hips are widening and your bump is getting bigger and heavier, with an incredible amount of pressure on your hips, back and pelvis. That combined with the fact that you’re unevenly balanced.. Ouch.
So, how do you know you’ve got SPD?
Well, to put it nicely, you will have a really strong pain in your pelvis, your legs, your lower back and even in your vagina. I rang my community midwives office and announced I felt like I’d taken a blow to the vagina whenever I opened my legs and she knew exactly what was wrong with me, even before I was seen.
The movements that involve moving your pelvis are the ones that hurt, so getting in and out of the car, climbing the stairs, getting out of bed. Mine was limited to pretty much any movement I did, so that was convenient, especially considering I worked right up until I gave birth! You don’t realise how much you use your pelvis, until you have to think about it every second of the day.
What can you do about it?
If you’re going to get SPD, you are pretty much stuck with it until after you’ve given birth. I wore a support belt around my bump, but I’m only 4’10 and I got really big really fast, so I’m not sure how much it helped. Actually holding under my bump as I walked seemed to do more, but not much. You’ll be advised to do as little as possible, less stairs, get in and out of bed without opening your legs. Sleeping with a pregnancy pillow or cushion between your legs can help, kegal exercises and gentle stretches (but I couldn’t even move, nevermind get on the floor to stretch!)
You may also been referred to physiotherapy.
My community midwife told me she was referring me for physiotherapy when I was 6 months pregnant. I was told that there might be a wait for an appointment, so I waited patiently, but I was in agony.
I understand that the NHS is always stretched, that I was pregnant in a global pandemic and that I wasn’t urgent priority, so I struggled through. I struggled getting in and out of my mum’s car, I struggled with the stairs to the kitchen at work, I struggled rolling over in bed at night and, suddenly, I was 8 months pregnant, still in pain, and going into labour.
What does it feel like to give birth with SPD?
I didn’t quite make it to my birth plan appointment, before I gave birth. I went into labour in the early hours of Sunday morning and my birth plan appointment with a consultant wasn’t until Wednesday.. and the baby was not waiting!
I’ve spoken to a physiotherapist since giving birth and been told that I should have laboured on my side and that my midwife should have been aware to limit my legs opening. It was written on my file that I had SPD and the community midwife team had been aware how much I’d been struggling. I didn’t communicate this very well to the midwife who was with me when I was in labour, but if I’m honest, she wasn’t the best midwife, she wasn’t very attentive and I feel very let down by the low level of care I received from her.
I remember telling her how much it hurt to open my legs and her responding that it was pretty much tough and I needed to get the baby out. I don’t think she understood that it wasn’t the labour pain that was hurting me. The contractions were painful, but it was the pain radiating down my legs, from my pelvis, that was causing me the most pain. Eventually, a consultant came to see me, who understood the pain I was in and I had an assisted birth.
I did feel a pressure off my pelvis and hips when I’d given birth, but I still couldn’t part my legs properly, lift anything heavier than my baby, or walk for anything other than small periods of time.
I was really distracted after giving birth, so didn’t chase my physio referral until my daughter was a couple of months old. She was premature, I was living with my mum and there was too much going on for me to even think about myself. My partner encouraged me to phone up the midwives to confirm when the referral had been sent. I was told that they couldn’t find a record of it and would refer me immediately.
I’d been let down by my community midwife team and I’d been let down by the midwife I was assigned in labour. The only medical staff I’d seen during my pregnancy had ignored a massive problem I was having, as if I didn’t have enough pain in my life already. I felt really depressed.
I eventually got to see a physiotherapist around 5 and half months after my daughter was born, so I’d been in pain for around 8 months by this point, some of it quite severe at points. The physio confirmed that absolutely everything about my pelvis was now out of place and I hadn’t adjusted to the new placement of my hips, so every movement I was making was putting pressure on my hips, legs and back. I was told that it was going to take months relieve me from the pain.
How does it affect my day to day life?
I’ve written a blog post about how SPD affects me day to day – you can read it by clicking here.
Did I recover?
I’m still working on it. You can read about my journey to recovery from SPD by clicking here.
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