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A. The pelvic girdle is a ring of bones around your body at the base of your spine. PGP is pain in the front and/or the back of your pelvis that can also affect other areas such as the hips or thighs. It can affect the sacroiliac joints at the back and/or the symphysis pubis joint at the front. PGP used to be known as symphysis pubis dysfunction (SPD).
The pelvic girdle showing the sacroiliac joints and the symphysis pubis joint
PGP is common, affecting 1 in 5 pregnant women, and can affect your mobility and quality of life. Pain when you are walking, climbing stairs and turning over in bed are common symptoms of PGP. However, early diagnosis and treatment can relieve your pain. Treatment is safe at any stage during or after pregnancy.
A. The three joints in the pelvis work together and normally move slightly. PGP is usually caused by the joints moving unevenly, which can lead to the pelvic girdle becoming less stable and therefore painful. As your baby grows in the womb, the extra weight and the change in the way you sit or stand will put more strain on your pelvis.
You are more likely to have PGP if you have had a back problem or have injured your pelvis in the past or have hypermobility syndrome, a condition in which your joints stretch more than normal.
A. No.
Although PGP can be very painful for you, it will not harm your baby.
A. PGP can be mild to severe but is treatable at any stage in pregnancy and the sooner it is treated, the more likely you are to feel better. It is more common later in pregnancy.
Symptoms include:
A. Tell your doctor about your pain.
You should be offered an appointment with a physiotherapist who will make an assessment to diagnose PGP.
This will involve looking at your posture and your back and hip movements and ruling out other causes of pelvic pain.
A. The following simple measures may help:
You should avoid anything that may make your symptoms worse, such as:
A. Your doctor will suggest the right treatment for you. This may include:
For most women, early diagnosis and treatment should stop symptoms from getting worse, relieve your pain and help you continue with your normal everyday activities. It is therefore very important that you are referred for treatment early. PGP is not something you just have to ‘put up with’ until your baby is born.
A. Being in severe pain and not being able to move around easily can be extremely distressing. Ask for help and support during your pregnancy and after the birth. Talk to your doctor if you feel you are struggling. If you continue to have severe pain or limited mobility, it is worth considering:
If you are in extreme pain or have very limited mobility, you may be offered admission to the antenatal ward where you will receive regular physiotherapy and pain relief. Being admitted to hospital every now and then may help you to manage your pain.
A. Yes.
Most women with pelvic pain in pregnancy can have a normal vaginal birth.
Make sure the team looking after you in labour know you have PGP. They will ensure your legs are supported, help you to change position and help you to move around.
All types of pain relief are possible, including an epidural.
A. Caesarean section will not normally be needed for PGP. There is no evidence that a caesarean section helps women with PGP.
A. Going into labour naturally is better for you and your baby.
Most women with PGP do not need to have labour started off.
Being induced carries risks to you and your baby, particularly if this is before your due date. Your midwife or obstetrician will talk to you about the risks and your options.
A. PGP usually improves after birth although around 1 in 10 women will have ongoing pain. If this is the case, it is important that you continue to receive treatment and take regular pain relief. If you have been given aids to help you get around, keep using them until the pain settles down.
If you have had severe PGP, you should take extra care when you move about.
Aim to become gradually more mobile. You should continue treatment and take painkillers until your symptoms are better.
If your pain persists, seek advice from your doctor, who may refer you to another specialist to exclude other causes such as hip problems or hypermobility syndrome.
A. If you have had PGP, you are more likely to have it in a future pregnancy. Making sure that you are as fit and healthy as possible before you get pregnant again may help or even prevent it recurring. Strengthening abdominal and pelvic floor muscles makes it less likely that you will get PGP in the next pregnancy.
If you get it again, treating it early should control or relieve your symptoms.
A. Pregnant women have a higher risk of developing blood clots in the veins of their legs compared with women who are not pregnant. If you have very limited mobility, the risk of developing blood clots is increased. You will be advised to wear special stockings (graduated elastic compression stockings) and may need to have injections of heparin to reduce your risk of blood clots.