In a recent conversation with expectant mothers, we came across a woman on her 4th pregnancy who was experiencing symptoms that are new to her. She’s had 2 healthy baby girls, 1 miscarriage, and is now expecting a baby boy on her current pregnancy. Quoting part of her statement, she said, “for the last few weeks, I’ve had this horrible painful pressure in my pubic bone. It’s gotten to the point where walking and even standing has become quite challenging.” She is looking for answers from anyone else who might have experienced the same problems as well and to figure out if these are normal developments in the course of her pregnancy. To solve the confusion for her and people like her, we compiled this article for the reference.

What Causes Pubic Bone Pain During Pregnancy?

Pain in the pelvic area during pregnancy may be due to what is known as symphysis pubis dysfunction or SPD. This is a problem in the pelvis, particularly to the part where the pubic bones meet in the front of the pelvis. This firm joint is called the symphysis pubis.

During pregnancy, a hormone called relaxin is produced, which causes the ligaments in the symphysis pubis to soften and loosen up. This happens to help the mother deliver the baby by making sure that the bony structures of the birth passageway can give way and accommodate the baby that is coming out. This change in your pelvis is the most likely source of pubic bone pain you are having.

What are the Signs and Symptoms of SPD?

So you start having some problems in your pubic bone during pregnancy that you never imagined you’d have. That is when the relaxin kicking in, and relaxing your pelvis, giving you SPD.

When that happens, the pregnant mother may experience the following too:

• Wrenching pain while walking as if your pelvis is tearing apart.
• Pain that moves or reaches the thighs and the perineum.
• Some swelling in the pubic area
• Pain with a grinding or clicking sensation in the pubic area
• Pain when carrying heavyweights
• Pain when climbing stairs
• Pubic bone discomfort while putting on or getting out of clothes
• Pain when getting in and out of a vehicle
• Pain when turning over in bed

Most of the pubic bone pain during pregnancy you may experience is triggered by straining and exerting effort. It will be hard to move around when this happens.

How Is SPD Treated?

The management of SPD is the same as that of any pain that occurs in the pelvic girdle. These are what should be part of your treatment plan:

• An exercise regimen that targets strengthening the muscles involving your spine, abdomen, pelvic girdle, hip, and those that belong to the pelvic floor muscles can help. The exercises aim to improve the stability of your pelvis and back.  Gentle, hands-on treatment of your hip, back or pelvis can help correct stiffness or imbalance. Water gymnastics is thought to be of great help.
• A physiotherapist can give you guidance on how to go about carrying out your daily tasks in a manner that produces less pain. He/she can also give advice on how you can make delivering your baby easier. Your doctor or midwife can help you draw up a birth plan which takes SPD symptoms into account.
• Traditional medicine such as acupuncture may help relieve you of pain and is considered safe for pregnancy. Make sure your practitioner is well versed in the practice involving pregnant women.

How to Relieve the Pain?

You don’t have to carry on these pubic bone pain during pregnancy all the time. Just because it is a natural process of your pregnancy doesn’t mean you’d have to endure all of that. There are ways to at least minimize these problems if it is difficult to get rid of them in the first place. Here are the things you can do:

• Wear a pelvic support belt which stabilizes the joints of your pelvis which prevents them from getting too loose, lessening the chances of the pain to recur.
• Do pelvic exercises which strengthen the pelvic muscles, which also aid in the stability of your pelvic area.
• Avoid activities that can trigger the pain especially those which require some effort and straining or do them in a manner that requires less effort, such as sitting down when getting dresses.
• Avoid standing for long periods, and if it can’t be avoided, wear comfortable shoes and move around as much as you can.
• You may check with your obstetrician about taking pain relievers especially if the pain seems to be out of proportion or has progressed and has become too much for you to bear.
• Apply some heat in the form of using a hot water bottle to help ease the pain. You may do this as many times as you want throughout the day.

Will It Stop After Giving Birth?

The pubic bone pain during pregnancy does not stay with you after giving birth. Your body tries to go back your non-pregnant state after your baby has come out. The changes that happen while you carry your baby in the womb help you give birth, once your baby reaches term, this will revert back to how things are before you got pregnant.

After giving birth, mothers usually recover from SPD within weeks, but this may also last for a few months. Extending your physiotherapy beyond giving birth can help.

Once you’ve had SPD, you are most likely to have it again on your next pregnancy. You can ask your doctor or midwife to refer you to a physiotherapist early on so that you can plan your treatment and support throughout early. Early intervention can make the experience less traumatic

Try to give yourself time in between pregnancies. This will give your body a chance to recover fully. And you can also try to lose excess weight, get fit, and wait until your baby can walk to reduce the symptoms of SPD on your next pregnancy.