So, you've had a great pregnancy; made it through morning sickness and were busy glowing your way through the second trimester, when it started - pelvic pain. This piece is to tell you more about PGP or 'Pelvic Girdle Pain' and let you know some things you can do to ease it, what to avoid and where to find more help.
PGP is the name for pain in the joints of the pelvis. Normally this happens either at the sacrum (above your coccyx) or at the pelvic bone (sometimes called 'Pubis Symphysis Dysfunction' or PSD / SPD). It can also be used to talk about other pain in the pelvis, e.g. hip joints.
Why do I have it?
We all have a tendency towards a preferred side to balance, foot to initiate walking with etc. This can cause asymmetry in the pelvis which is put under extra stress during pregnancy. You may have had a past pelvic injury that resurfaces when pregnant. PGP is pain and inflammation caused by these stresses and muscle tension. About 1 in 5 women will experience it some some extent in pregnancy. Symptoms can be fairly minor or very painful. This does not mean it is 'normal' and something you need to 'put up' with.
What can I do?
As soon as you notice pelvic pain - speak to your midwife.
Taking preventative steps and getting early treatment can help ease the pain and improve your experience significantly. Sometimes you'll be referred to a physiotherapist for appointments.
What makes it worse?
You might have noticed that pain is worse when you're doing things that cause asymmetry in your pelvis - e.g. climbing stairs, getting in and out of the bath, standing on one leg, getting in and out of a bath or car and turning over in bed are examples.
What can improve it?
As I mentioned before - it's about alignment. Please get help with some manual adjustment or exercise that's specific for PGP. This could be physiotherapy, seeing an osteopath or getting massage treatment.
Day-to-day there are some simple adjustments that can help:
In general, positions where your pelvis is equally balanced will be beneficial. Obviously, that's not always possible so here are some ideas with how to adapt a few activities.
- Avoid standing on one leg wherever possible. Try dressing and putting your shoes on while seated to put less strain on your pelvis.
Pillows - the secret weapon for pregnancy comfort.
- Make yourself a supportive nest with a pillow under your bump to ease abdominal pressure. The other vital pillow position for PGP is between your knees. This will not only help keep your legs in a more parallel position, which will keep stress on your pelvis to a minimum, but it will remind you to keep your knees together when you need to move. When you turn over, hold the pillow in place between your knees. Remember to support yourself with your hands and move your body to a position where you can get out of bed with legs together.
- Notice which hip you tend to push out to the side and which leg you put most of your weight on. Getting your weight even across your feet will help tremendously. It's worth thinking about what you're putting your feet into as well, flat shoes will also help.
- Support yourself as you get in and out of the car. You'll need to shift round on the seat and put both feet out together. Somewhere between the following videos instructions. No pashmina required, this is to prevent pain, I'm not so worried about you flashing your pants.
Some people find support belts helpful. Harimake can be useful for this too and again can act as a reminder that you need to take care of yourself.
How will PGP affect my birth?
Generally - it won't (phew).
Please make midwives aware that you have PGP so they can make sure you're taken care of. Write it in your birth plan to make sure they know in case it's a midwife you haven't met before that attends your delivery.
What about after the baby is born?
Give your body time to adjust, PGP won't disappear overnight. It used to be thought that PGP was hormonal and would go away after the birth, this is no longer what evidence suggests. Because it's mechanical it may be some time before you return to normal. The same advice as above goes - get treatment, get support, get advice and move with care.
There's some great info on the Pelvic Partnership's website on how to adapt to life with a baby and PGP. Try this link for their info on nappy changing - you'll find more links to useful advice on their page below the article.
Physiotherapy, an Occupational Therapist or a postnatal doula may provide the practical advice and support you need.
Where to find out more...
Here are a couple of great PDFs that will tell you loads more about PGP.