Pregnancy and Pelvic Pain

Pregnancy can take its toll on a woman’s body. During this time, expecting women may experience different kinds of physical discomforts along with aches here and there. One of the most common is pelvic pain which may range from mild to severe pain at the pelvic area.

While pelvic pain during pregnancy is common, it is still a distressing condition especially when daily tasks get difficult. Experts share their views on the symptoms and treatments that may help to relief the pain.

“Pelvic pain can be devastating during pregnancy,” says Dr. Haw Wan Lye, Consultant Obstetrician and Gynaecologist at Hospital, Cheras. “Up to one in five pregnant women may be affected to some degree.”

According to Dr. Haw, “Pelvic pain can be largely divided into 2 categories, namely pregnancy related pelvic girdle pain (PPGP) and symphysis pubic dysfunction (SPD). Symptoms include having pain on one or both sides of the lower back, at the perineum (between vagina and anus) or around the pelvic bone in the centre or radiate to the thighs. It may also be characterised as pain at the soft bone (cartilage) in the centre of pelvic bone (pubic symphysis). It’s important to recognise these early symptoms so you can avoid long term discomfort and minimise the pain.”

Dutch physiotherapist Cecile Röst who suffered from this condition herself says that pelvic pain comes from instability and misalignment around the pelvic area. “Pelvic pain involves the bones, joints, nervous system and muscles of the pelvic and lower-back area. Although the pelvis appears to be a fixed circle of bone, it is actually made up of three separate bones joined together,” Röst says in her book Relieving Pelvic Pain During and After Pregnancy.

“The bones form a ring that is held together with ligaments and cartilage, which relax and stretch in response to hormonal changes during pregnancy in order to expand the birth canal during delivery. Sometimes, the bones may shift and become misaligned, causing pain – pelvic pain. Functional movements that were once taken for granted such as moving from sitting to standing, reaching to put things away, or simply getting out of bed may all become difficult and painful.”

Dr. Haw agrees and adds that there are many normal activities that may aggravate pelvic pain. “Walking upstairs or downstairs, standing for a long period of time or walking ‘long-distance’ may worsen the pain. In fact, sometimes changing sleep positions or turning over in bed can also intensify the discomfort.”

According to Röst, this condition usually affects women who have experienced lower back pain before pregnancy or who have demanding jobs that require them to stand for much of the day. “For instance, nurses or therapists are at a greater risk of experiencing pelvic pain while pregnant and also of having to endure a prolonged recover,” she says.

Fortunately remedies and relief are available.

“Get regular exercise to strengthen pelvic floor and back muscles. You may also consider physiotherapy that focuses on active joint and spine movements,” Dr. Haw advises. “Some women find comfort in hydrotherapy or swimming. Most importantly, always maintain correct posture and avoid long hours standing. Other forms of relief can be found in pelvic belt supports and pain relief, for example TENS (transcutaneous electrical nerve stimulation).”

Röst suggests that a simple symmetry exercise can sometimes effectively help to balance the pelvis and return pregnant women to a pain-free state. “Lie on your back with your knees bent, and your feet flat on the floor. Allow the bottoms of your feet to come together, as you slowly allow your knees to fall out to the side. Start by holding this stretch for 30-60 seconds; it is important to progressively hold this stretch for upwards of 3-5 minutes. This is similar to the butterfly pose in yoga if you are familiar with that. Do this exercise a minimum of 2 times a day, or every hour for several minutes, if you are really sore,” she advises.

Coping with pelvic pain

Do

• Wear flat and supportive shoes
• Avoid activities that aggravate the pain but
• keep active
• Rest adequately
• Sleep in a comfortable position
• Take stairs one at a time
• Get help with household chores

Don’t

• Lift heavy objects
• Stand for long periods of time
• Bend or twist to lift things
• Stand on one leg
• Push heavy objects

Many women with pelvic pain in pregnancy can have a normal vaginal birth. Plan ahead and talk about your birth plan with your birth partner and midwife. Write in your birth plan that you have PPGP, so the people supporting you during labour and birth will be aware of your condition.