Pregnancy related pubic pain, what to do about it and birth positioning.
Pelvic pain (any pain around the pelvis) in pregnancy is reported to be around 48-71%…That is a lot of women with pelvic pain! The pubic bones are the part in the front of the pelvis below the navel. See the blue line on the pelvis below. And pregnancy related pubic pain is reported 31.7%…again still no joke!
Photo courtesy of Primal Pictures
Pubic pain occurs during pregnancy mainly due to increased ligament stretch or what is known as laxity. Everything from those crazy hormones to the change in your posture to the size and the position of the baby can contribute to pubic pain.
During pregnancy, if the pubic symphysis is becoming problematic then you can experience the following symptoms:
-shooting pain in the pubic region
-Radiating pain into the lower abdomen, groin, back, perineum, thigh or leg
-pain with movement, especially with walking and standing on one leg, getting out of a chair, going up and down stairs, turning in bed
-click or popping in the pubic area
-painful intercourse
-pain with having a bowel movement
Now what to do about it! So many physicians may say that rest, take Tylenol, a belly support or some gentle stretching may help…while this can help most women find that they do not know specifically what to do. There is a lot more that can be done to help. Everything from gentle repositioning the joints and hands on muscle release techniques can significantly improve alignment of the bones, followed by specific supports (based on what is going on) around the joints to adding specific stabilization techniques (basically getting you to use muscles to improve the joints integrity) can help with symptoms and make pregnancy much more tolerable and pain-free. A skilled pelvic floor physical therapist that understands pregnancy related pubic pain can help address these issues and get you much more comfortable.
Now the BIG question? What is the best birth position. Well I have to ask you a question first. Will you be giving natural birth or having an epi-dural. This will make a difference. If you choose to have an epi-dural then your options are significantly limited unfortunately. Most health professionals will only deliver in the lithotomy (or on your back with legs up towards your chest position). If this is the case then you may want to talk to your physicians prior to your delivery about your concerns and talk to the staff helping you on that day. Limiting the amount of range your hips move out to the side or how wide your hips move during the delivery can help. Also if you health care professional is open to a side position then that is an option.
If you are delivering naturally then the best position is in quadraped. This is the position on your hands and knees. You do want to avoid delivering in the squat position as this increases the stress on your pubic bone.
So I hope that sheds some light for some of you struggling with pubic pain. Remember our therapist are trained in treating pubic symphysis related pain and if you are experiencing unrelenting pain then it might be worth coming in and having us take a look!
Hina
