Symphysis Pubis Dysfunction (SPD) and birth

[NolansMama]

I am due with my second chile in March and am planning a med-free hospital birth. With my first son, I accepted an epidural and things spiraled out of control from there. I ended up with a vaccuum delivery (it was either that or a c-section) and a 3rd degree tear. This time around I am determined to do things differently. The problem is, I have been dealing with severe SPD to the point that I can barely get out of bed and walking is painful. Has anyone dealt with SPD and had a natural birth? What positions did you use during labor and what, if anything, were you able to do during pregnancy to alleviate the symptoms?

[mwherbs]

there are belts you can wear that support your hips and belly so that it is less painful--
web examples--

scroll down to the maternity support on the second row of maternity supports is on for SI
http://supports4less.com/brace-type/...orts/index.htm

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http://www.supportsockshop.com/acb_s...jectGroup_ID=7

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http://www.maternitystop.com/supportbelts&hose.html
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http://www.selfcarecentral.com/Categories/display/203
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[akl7248]

I had horrible SPD with both of my pregnancies. It was worse with my first because I did not get treatment. I had to have help rolling over in bed. (With #2, I saw a chiropractor and did yoga with an instructor who specialized in prenatal and was also a physical therapist. She helped me tremendously.) Both of my children were born naturally with no problems. They were both well over 9 lbs, and I have a very small frame. I got immediate relief from SPD postpartum, even though the pain resurfaced in a minor way during intense weight bearing exercise. Not to the point that I had to stop though---I was able to play soccer competively. I just looked kind of funny when I would grab my crotch after a particularly hard shot on goal.

[MsBlack]

Yes, get chiropractic care and consider seeing some kind of exercise physiologist (er, term?). And a good support belt. This does not have to be so disabling, nor impact your birth and pp time.

[NolansMama]

Thanks for your input, ladies. My next doctor's appointment is on the 28th so I will definitely be asking for a referral to a chiropracter or physiotherapist that' familiar with SPD. I'll also be calling my health insurance company to find out if they pay anything toward a maternity support belt because, if they will, I'd much rather get one that also provides back support.

[balancedmama]

I had terrible SPD w/ DD, chiropractic care and being REALLY careful to keep my knees together at all times were the best support strategies for me. Oh, I also did prenatal water classes which were so so helpful. I was surprised that SPD did not factor into my labor at all. After birth the relief was not immediate but it was measurable and after 6 months or so it was nearly gone. I have not yet experienced it with my current pregnancy. Oh, and I had a homebirth with DD who was over 9 lbs.

[Mama Poot]

Another vote for see a good chiropractor! I spent most of my labor walking around/in an upright position and gave birth squatting. Being in any other position was just too painful. But I had a homebirth with a midwife and was able to choose the best position to birth in. At a hospital you won't likely have that option. I recommend you have a very honest and open conversation about this with your obstetrician and maybe you can get them to allow you to birth in a proper position ( ie-NOT on your back! or half-reclining or whatever they call it- its still on your back)

[mothercat]

plus_size_pregnancy

kmom has a great section on her site at www.plus_size_pregnancy about SPD. Strongly recommends chiro care but also has a lot of self-help info.

[Defenestrator]

I had SPD pretty severely toward the end of my pregancy with my second child and found that it didn't really impact my birth at all except that the midwives' listening with the doppler at the end of labor was painful (they pressed on the symphysis which was very sore already). I labored and pushed mostly standing and then in the McRoberts position (which is thought to make spd worse --I wouldn't recommend it, but it was what was needed to help get my baby out). Pushing was not painful, SPD-wise.

I second the recommendation of the plus-size pregnancy site.

The thing, postpartum, that was most helpful for me was to do exercises that worked the inner thigh muscles. Once they were toned they supported my whole pelvic floor and also helped close the gap for the spd. I occasionally feel (hear?) clicking when I move but do not have any more pain. It has been about the same since about 1 year PP.

[TurboClaudia]

the plus size pregnancy site is here:
www.plus-size-pregnancy.org

and here's a direct link to the spd page.

[Romana]

I had a lot of pain/discomfort with SPD my first pregnancy and I had no problems with it during labor/birth. I was not able to find anything during pregnancy that helped.

My symptoms resolved within 3-6 months of giving birth. Being able to sleep on my back again was bliss. They're back now (although, so far, not too bad <crosses fingers>) that I'm 7+ mos pg again.

[Cheshire]

I had it with my first pregnancy. It started around 14 weeks and lasted until 18 months post partum. UGH!!! I clicked when I walked, if you were next to me you would have heard it, too.

I didn't get any care before birth but after I saw a D.O. who did osteopathic manipulative therapy and made a world of difference.

I gave birth on my back and thought I was going to split in two. It was awful. This next time I plan to be on my hands and knees or kneeling. Anything but on my back.

The one other thing I found to be very helpful and that I still do is keep a thin pillow between my knees, calves and feet while I sleep. I tried a regular pillow and it didn't help. By chance I tried a thinner one and it did the trick!

Best wishes.

[homewithtwinsmama]

Originally Posted by NolansMama

I am due with my second chile in March and am planning a med-free hospital birth. With my first son, I accepted an epidural and things spiraled out of control from there. I ended up with a vaccuum delivery (it was either that or a c-section) and a 3rd degree tear. This time around I am determined to do things differently. The problem is, I have been dealing with severe SPD to the point that I can barely get out of bed and walking is painful. Has anyone dealt with SPD and had a natural birth? What positions did you use during labor and what, if anything, were you able to do during pregnancy to alleviate the symptoms?

I get this every pregnancy--pregnant for the fourth time with sixth child right now and SPD is starting to rev up again. I feel for you. I would not get though them upright without regular chiropractic care. I go in once a month when it gets started and by the very end of the pregnancy I sometimes go in twice a week to be able to keep walking comfortably. Personally I like Gonstead chiropractors, but anyone with a large practice of pregnant patients (check area midwives for referrals) will probably have dealt with this.

[ZoeyZoo]

I have it wth this pregnancy too but I have not gone through labor with it.

From what I have read on it chiropratic adjustments are supposed to be the most helpful but people resort to everything from painkillers to acupuncture. Only adjustments tot he pelvic/back region seen to "fix" the problem. Everything else is concerned with covering up the pain.

As far as positions on your back with legs apart is the worst position to give birth in. Forcepts and vacuum deliveries can also cause a lot of damage.

[mothercat]

managing SPD

I know this is on kmom's plus_size_pregnancy site but I haven't heard anyone mention here.

Has anyone used a very snug wrap around the hips to help stabilize the pelvis? I usually tell moms to use either a really long scarf or a similar piece of fabric and wrap it twice around and tie snugly. It helps to keep the pelvis from torquing too much with normal movement.
The prenatal cradle people also offer the same thing in elastic with velcro. It just goes around the hips and does the same thing. They call it a hip brace. Stabilizes the SI joint so may also be helpful in dealing with sciatica. http://www.prenatalcradle.com/hipbrace.htm

[Jennisee]

OMG, I read the Plus-Size Pregnancy SPD page, and that describes exactly what I've been going through this pregnancy. I have had every single symptom on the checklist, and it described my first labor perfectly. I am in shock. I knew I would benefit from seeing a chiropractor, but I had no idea how much...

[crazy_eights]

Had it in my 6th pregnancy very badly toward the end. Chiropractic helped a lot and seemed to prevent the problem from reccuing in my 7th pregnancy. It did not interfer with the birth.

[DreamsInDigital]

I agree, chiropractic care helped a lot with my SPD. Birthing in an upright position, without coached pushing was my SOP for birth anyway but you should definitely not labor on your back, it's the worst. My labor was wonderful and birth was without any issues related to my SPD. And I started to feel better shortly after birth and my SPD symptoms vanished within a couple of months.