Symphysis Pubis Dysfunction (SPD), Pelvic Girdle Pain (PGP)

Obstetrics & Gynaecology Women & Children’s Group

This leaflet has been designed to give you important information about your condition and to answer some common queries that you may have.

Introduction in some cases the symptoms will go completely. However, in a small percentage This leaflet has been given to you to explain of women SPD/PGP may persist longer after and advise you about SPD/ PGP, related to birth, particularly if left untreated. your pregnancy. SPD/PGP is a term used to describe pain experienced in the front, back Management and side of your pelvis. This leaflet will help you understand more about it, how you can During pregnancy you will need general adapt your lifestyle, and how you can look advice to help you to self- mange your after yourself during the labour process. condition, see list below:  Be as active as possible within pain limits What is SPD/PGP?  AVOID activities that aggravates pain SPD/PGP describes pain in the front of the pelvic girdle. The discomfort is often felt right  Ask for help and accept help with over the pubic bone at the front, below the household chores, involve your partner, tummy, around the sides of your hips or family and friends lower back.  Rest when you can-you may need to sit You may also have: down more often  Difficulty with walking  Sit down to get undressed  Pain when standing on one leg, e.g.  AVOID standing on one leg climbing stairs, dressing or getting in and  Wear flat supportive shoes out of the bath  AVOID standing to do tasks such as  Pain and/or difficulty moving your legs ironing apart, e.g. getting in and out of a car  Try to keep knees together when moving  Clicking or grinding in the pelvic area- in and out of the car-plastic bag on the you may hear or feel this seat may help you swivel  Limited or painful hip movements e.g.,  Sleep in a comfortable position, e.g. lie turning in bed on your side with a pillow between your  Difficulty lying in some positions legs  Pain during normal activities of daily life  Try different ways to get in and out of bed e.g. turning under or over with your  Pain and difficulty during sexual knees together and squeeze your intercourse buttocks With SPD/PGP these symptoms can all be  Roll in and out of bed keeping knees varied and wearing, intermittent, upsetting together and irritating. There is a wide range of symptoms and they vary in some women and  Take the stairs one at a time (go upstairs this does not mean it is going to get worse. If with your less painful leg and downstairs you get the right advice during your with more painful one, or go upstairs pregnancy, it usually can be managed well, backwards, of on your bottom)

 Plan your day-bring everything you need progress and AVOID further strain on the downstairs in the morning and have pelvis everything to hand  Try to AVOID lying on your back or  Consider alternative positions if you sitting propped up on the bed because desire sexual intercourse, e.g. lying on these positions reduce the pelvic your side or kneeling on all fours opening and may slow labour AVOID activities which make the pain  The squatting position and birthing stool worse: maybe an uncomfortable position for labour  Standing on one leg  Please note: it is important as you reach  Bending and twisting to lift or carry a term to record how far apart your knees toddler or baby on one hip can separate when lying on your back  Crossing your legs (your pain free range). The distance should be recorded in your birth plan so  Sitting on the floor that during the birth care is taken not to  Sitting or standing for long periods move your legs further apart than this  Lifting heavy weight (shopping bags, wet washing, vacuum cleaners, toddlers) Postnatal Most women’s SPD/PGP disappears within  Vacuuming the week following birth. If symptoms still  Pushing heavy objects like supermarket remain 10-14 days following birth, you should trolleys, or pushchairs, especially uphill refer to GP for further treatment and follow up care.  Carrying anything one handed Looking after baby: Also you can see your GP for medication for pain relief.  When breast feeding, ensure comfortable position with your lower back Labour and Birth well supported and good circulation to lower legs Women with SPD/PGP can have a normal vaginal birth. Women worry that the pain will  change nappies on a flat surface at waist be worse if they have to go through labour, height but this is not the case when good care is  do not lift baby often taken to protect the pelvic joints from further trauma.  carry baby in front of you, not on one hip During Labour:  kneel at the side of the bath rather than  Use gravity to help the baby move leaning over it downwards by as staying upright as  lower the cot when lifting or lowering possible: kneeling, on all fours, standing. your baby These positions can help the labour  keep baby close to you when moving him or her in and out of a car seat

 do not lift your baby in and out of high Northern Lincolnshire and Goole NHS shopping trolleys Foundation Trust  continue pelvic floor exercises Diana Princess of Wales Hospital Scartho Road  AVOID high impact sports for a few Grimsby months 01472 874111  AVOID any activities which bring on back Scunthorpe General Hospital pain Cliff Gardens Scunthorpe Reference Section 01724 282282 Pelvic Partnership Goole & District Hospital www.pelvicpartnership.org.uk Woodland Avenue Association of Chartered Physiotherapists in Goole Women’s Health 01405 720720 www.acpwh.org www.nlg.nhs.uk Chartered Society of Physiotherapy (CSP) Date of issue: September, 2014 www.csp.org.uk Review Period: September, 2016 Concerns and Queries Author: Operational Matron DPOW If you have any concerns / queries about any IFP-771 v1.1 of the services offered by the Trust, in the first instance, please speak to the person © NLGFT 2014 providing your care.

For Diana, Princess of Wales Hospital Alternatively you can contact the Patient Advice and Liaison Service (PALS) on (01472) 875403 or at the PALS office which is situated near the main entrance. For Scunthorpe General Hospital Alternatively you can contact the Patient Advice and Liaison Service (PALS) on (01724) 290132 or at the PALS office which situated on C Floor. Alternatively you can email: [email protected]