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Avni Trivedi
Osteopath with MSc Paediatric Osteopathy and Bachelor’s degree in osteopathy (a BSc Hons, BOst Recognised) Doula with Doula UK. Special interest in antenatal osteopathy and supporting gentle births.
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Pregnancy ailments

Symphysis pubis dysfunction (SPD)

When you are pregnant your body produces a hormone called relaxin, which softens the ligaments that hold the pelvic bones together to allow it to gently open and stretch during labour. Unfortunately for some women, they can loosen too much, causing excessive movement in the pelvic joints, especially the pubic symphysis at the front, causing a condition called Symphysis Pubis Dysfunction or SPD.
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In Short
If you are concerned you might have SPD, see your Doctor and get help quickly. Pregnancy specialist osteopaths can help too.

There are a lot of exercises you can do to help manage this condition, and it's important that your birth team knows in advance that you have it.

What is Symphysis Pubis Dysfunction (SPD)?

Symphysis pubis dysfunction, or SPD, can become really painful and seriously curtail mobility. It’s really important to limit movements that can aggravate the pain.

SPD cannot be cured but has to be managed during your pregnancy. You may be referred to your local physiotherapy department; some hospitals run SPD clinics for pregnant women.

Is there any treatment that can help?
  • Try some core strength exercises that focus on your pelvic floor muscles and abdominal muscles. These are small movement exercises that tighten and stabilise the area to give extra support to your pelvis and spine. Don’t do any sit ups.
  • Wear a support bandage around the pelvis when you are walking. This straps the joint to give it extra stability and support during exercise.
  • Exercise in water can help but avoid lots of swimming, especially no breaststroke as the leg kick can really aggravate SPD.
  • Obstetric physio referral should be made – can be done by midwife or GP.

You should also be given advice on how to make daily activities less painful. Avoid cycling, limit walking, get in and out of bed without spreading your legs each time and keep a pillow between your legs as your sleep. It’s really worth making the effort to protect the joints even though it can be very frustrating, especially if you are used to getting lots of exercises.

  • Avoid movements and positions that will inflame the area such as crossing your legs, pushing heavy items like vacuum cleaners or shopping trolleys, twisting and lifting shopping in the supermarket. Ask someone help you pack your shopping and take it to the car for you, or try on-line grocery deliveries instead.
  • If you have severe SPD mention it in your birth plan as birth positions where your legs are very wide apart may be too painful. Discuss active birth positions that don’t aggravate it.
  • Some women try alternative therapies such as osteopathy and acupuncture. There are no good studies of the effectiveness of these treatments. Osteopathy is not offered on the NHS so make sure any practitioner is qualified to treat pregnant women.
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This article is for information only and should not be used for the diagnosis or treatment of medical conditions. Essential Parent has used all reasonable care in compiling the information from leading experts and institutions but makes no warranty as to its accuracy. Consult a doctor or other health care professional for diagnosis and treatment of medical conditions. For details click here.