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Symphysis Pubis Dysfunction (SPD)

The pelvis is made up of three bones: the sacrum at the back, and two coxal (hip) bones. At the front of the pelvis the two coxal bones meet at the Symphysis Pubis and are all held tightly in place by ligaments. The Symphysis Pubis helps to maintain the solidity of the pelvis to allow activity such as walking, sitting and swimming.

During pregnancy, the hormone relaxin softens the ligaments of the pelvis in preparation for the birth of your baby. It is common to experience some level of pelvic pain either during pregnancy, the immediate period after the birth of your baby, or both. Pain can be experienced in your hips, legs, back or in your groin. You may also notice a 'clicking' noise on walking. This pain is given the term SPD which basically means that your pelvis isn't really working as effectively as it should be.

Occasionally the gap between the two coxal bones (which can be anything up to 9mm in pregnancy), extends beyond the normal range to over 10mm/1cm. This can only be diagnosed by means of x-ray, ultrasound or MRI scan, and if detected, would be termed DSP. The gap will begin to diminish following the birth of your baby gradually, and can take between 3-5months before the Symphysis Pubis has regained all of its original strength.

Many women find it hard to get a diagnosis of either SPD or DSP and frequently feel ignored, or not listened to which can cause great distress. If you believe you may have either of the two conditions always seek the advice of your midwife. There are many self-help techniques which can greatly diminish the effect of SPD including:

1. Listening to your body- if it hurts, stop what you are doing and rest
2. Ensure you get plenty of rest at frequent points throughout the day
3. Try to minimise the amount of additional stress to your Symphysis Pubis by keep your knees as close together at all times, E.g. Try walking up the stairs sideways, get out of your car and bed with your legs closed (place a carrier bag on your car seat to help you slide easily out), at night use a pregnancy pillow to not only enable a solid nights sleep but to maintain the natural gap between your pelvis.

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