What is Pubic Symphysis Dysfunction and Can I Prevent It?

During pregnancy, a woman’s body undergoes numerous physical changes to accommodate a growing baby. While many of these changes are expected, some can bring about discomfort or even pain. One such condition is pubic symphysis dysfunction (PSD), which affects many pregnant women, especially during the later stages of pregnancy. If you are experiencing pelvic pain, particularly in the pubic area, you may be dealing with this condition.

In this article, we will explore what pubic symphysis dysfunction is, how it occurs, the symptoms to look out for, and most importantly, whether it can be prevented. Additionally, we will discuss how antenatal care and other support measures can help manage this condition.

What Is Pubic Symphysis Dysfunction (PSD)?

Pubic symphysis dysfunction, often referred to as symphysis pubis dysfunction (SPD), occurs when the ligaments that connect the two halves of the pubic bone become too relaxed or loose. These ligaments, which are usually quite tight, allow the pubic bones to move slightly in order to accommodate the growing baby and the birthing process. However, in some cases, these ligaments stretch or separate more than necessary, causing instability and discomfort.

Why Does Pubic Symphysis Dysfunction Happen During Pregnancy?

Pregnancy is a time of significant hormonal changes, and one of the hormones responsible for the relaxation of the ligaments is relaxin. This hormone is released to loosen the pelvic area in preparation for childbirth, allowing for the baby’s passage through the birth canal. While relaxin helps in this process, it can sometimes cause excessive looseness in the pubic symphysis, leading to pain and dysfunction.

Factors That Increase the Risk of PSD

While many women experience pubic symphysis dysfunction during pregnancy, some are more prone to it than others. The following factors can increase the likelihood of developing PSD:

Previous pelvic injury: If you have had previous pelvic trauma or injury, the risk of developing PSD may be higher.

Multiple pregnancies: Women who are pregnant with twins or multiples may experience more strain on the pelvic joints, making them more susceptible to PSD.

A history of pelvic pain: If you have had pelvic pain in a previous pregnancy or have a history of pelvic conditions, you may be at a higher risk.

Excessive weight gain: Gaining a lot of weight during pregnancy can place extra pressure on the pelvis, contributing to PSD.

Previous experience of SPD: If you had SPD during a prior pregnancy, you may be more likely to experience it again.

Common Symptoms of Pubic Symphysis Dysfunction

If you have pubic symphysis dysfunction, the symptoms can vary from mild discomfort to severe pain. Common signs include:

Pain in the Pelvic Area

The hallmark of PSD is pain in the pubic region, particularly at the front of the pelvis where the two pubic bones meet. This pain may feel sharp, aching, or grinding and may worsen with certain movements, such as:

Walking

Climbing stairs

Turning in bed

Standing on one leg (e.g., when getting dressed)

Radiating Pain

The pain may also radiate to the lower back, hips, and thighs. Some women report feeling pain that extends down their legs or into the groin area, making it difficult to perform normal activities.

Difficulty Moving or Walking

Due to the instability of the pubic bone, many women with PSD find it hard to walk, especially over longer distances. This can also make it difficult to perform regular activities like shopping, housework, or taking care of other children.

Clicking or Grinding Sensation

In some cases, women may hear or feel a clicking or grinding sensation when they move. This happens because the pubic bones are not aligning properly, causing friction as they move.

How Can Antenatal Care Help Manage PSD?

Antenatal care is essential for managing any discomfort during pregnancy, including pubic symphysis dysfunction. If you’re experiencing symptoms of PSD, it’s important to discuss them with your antenatal clinic or healthcare provider. They can assess your condition and offer tailored advice and treatment.

Treatment Options for Pubic Symphysis Dysfunction

Physical Therapy: Physiotherapists specialising in pregnancy-related issues can provide exercises to strengthen the muscles around the pelvis and improve stability. This can help relieve pain and improve mobility. Antenatal yoga or pregnancy yoga classes may also help with flexibility and strengthening the pelvic floor muscles.

Prenatal Massage: Prenatal massage or massage for pregnancy can provide significant relief for women experiencing pelvic pain. Relaxation techniques through massage can help reduce tension and promote better alignment of the pelvis.

Maternity Support Belts: Specialised support belts for pregnancy are designed to relieve pressure on the pelvis and support the abdominal area. These can help redistribute weight and alleviate discomfort caused by PSD.

Avoiding Certain Movements: Your healthcare provider may recommend avoiding movements that exacerbate the pain, such as standing on one leg, lifting heavy objects, or spreading your legs too wide. They may also suggest using cushions or pillows to support your pelvis when sleeping.

Pain Management: In some cases, your healthcare provider may recommend pain relief options, such as paracetamol. However, it’s essential to discuss the safe use of medication during pregnancy with your doctor before taking any medication.

Relaxation and Stress Management: Pregnancy can be stressful, and stress can exacerbate symptoms of PSD. Antenatal support through relaxation techniques like deep breathing, meditation, and relaxation during pregnancy can help reduce pain and promote overall well-being.

Can Pubic Symphysis Dysfunction Be Prevented?

While it may not always be possible to prevent pubic symphysis dysfunction, there are several steps you can take to reduce the likelihood of developing this condition during pregnancy.

1. Maintain a Healthy Weight

Gaining an appropriate amount of weight during pregnancy is important for your overall health and can also help reduce the strain on your pelvic joints. Speak with your healthcare provider about healthy weight gain and eating a balanced diet during pregnancy.

2. Stay Active and Engaged in Antenatal Fitness

Staying physically active during pregnancy can help keep your pelvic muscles strong and stable. Antenatal fitness activities like pregnancy yoga or swimming can promote flexibility, strengthen muscles, and help support the pelvic area. It’s essential to choose low-impact exercises that are safe during pregnancy. Always check with your doctor or midwife before starting a new exercise routine.

3. Be Mindful of Your Posture

Good posture can help distribute your body weight evenly and reduce the strain on your pelvis. Be mindful of how you sit, stand, and walk, and make adjustments if necessary. Your physiotherapist or midwife can offer tips on improving your posture during pregnancy.

4. Use Proper Lifting Techniques

Avoid lifting heavy objects whenever possible. When lifting, make sure to bend at the knees rather than the waist to avoid straining your pelvis. If you must carry something heavy, use your legs to lift, and avoid twisting your body.

5. Seek Antenatal Support

Regular antenatal appointments with your healthcare provider will ensure that any early signs of pelvic discomfort are noticed early on. If you experience any pain or discomfort in your pelvic region, don’t hesitate to raise these concerns with your midwife or doctor during your antenatal checkups.

Pubic symphysis dysfunction (PSD) is a common pregnancy-related condition that causes pain and discomfort in the pelvic area. While it can be challenging, especially during the later stages of pregnancy, it is typically manageable with the right approach. Working closely with your antenatal care team can help alleviate symptoms and improve your quality of life during pregnancy.

Though it’s not always possible to prevent PSD, maintaining a healthy weight, staying active with antenatal fitness activities, and practising good posture can help reduce the risk. Additionally, support from your antenatal clinic and healthcare professionals can make a significant difference in managing symptoms effectively.

If you are experiencing pelvic pain or discomfort, don’t hesitate to seek help from your antenatal care team. With the right support, you can navigate this challenging symptom and enjoy a more comfortable pregnancy.