Symphysis Pubic Dysfunction: Pelvic Pain in Pregnancy

Statistics show that 1 in every 5 woman experience symptoms of symphysis pubic dysfunction and that women who started their periods before 11 or are overweight are more likely to develop SPD. Many pregnant women complain about pain yet dismiss and continually endure the pregnancy discomfort because some uninformed doctors are unaware or perhaps forgot that the condition exist and suggest a cesarean section. The fact still remains that there are medical practitioners who do not know the causes, and the symptoms which makes it difficult for them to offer treatment to the dysfunction.


The pelvis bone is a circular bone that goes around in the middle in front but the two sides do not touch each other. The small gap in between connective by fibro cartilaginous tissue braced by ligaments is called the Pubic Symphysis. This area is important during and after pregnancy because it helps your pubic bone move freely, and stabilizes the pelvis which allows a pregnant woman move in different ways. However, this can cause inflammation and pain in the pubic area which explains why moving around, opening your legs after pregnancy seem painful and uncomfortable.

The flexibility of the pubic symphysis and the sacroiliac joint located at the back of the pelvis are vital during the pregnancy because it allows the bones to move freely and expand to help the baby fit through easily. The hormones called relaxin and progesterone are released by the body during pregnancy to loosen the ligaments and make it more flexible. Although this is a good sign that your body is ready for childbirth, extra looseness and pelvic pressure in pregnancy due to excessive levels of hormones make the pubic symphysis too relaxed and stretchy and give rise to weird and alarming sensations after pregnancy.

SPDWith this anatomy and structure in mind, we can say that the pain in the pubic area can be caused by one or two factors and maybe a combination of them – excessive levels of hormones, of hormones, misalignment of pelvis, or interaction of the this two. Symphysis Pubis Dysfunction or SPD is most commonly known as pelvic pain or pelvic joint syndrome. It also has other medical names like pelvic girdle relaxation of pregnancy, pubic symphysis separation, pubic shear (a term used in osteopathy), separated symphysis and more. The severe form of SPD is called Diastasis Symphysis Pubis or DSP which can only be identified by X-ray. In this condition, the pubic symphysis actually separates causing serious pain and discomfort on the hips, buttocks and pelvis.


SPD can happen to every pregnant woman. Although the symptoms can vary from person to person, its most distinguishable characteristic is the pubic pain that often feels like its inside. The pain makes a lot of movements difficult like lifting one leg at a time especially when putting on clothes, parting the legs especially when getting out of the car or walking up the stairs, bending over, standing on one leg and even walking in general. The excruciating pain reported by women often comes on even as early as 12 weeks and many women find the pain still present after pregnancy that sticks around for a long time. Symptoms of the mild form of SPD include one or more of the following:

  • Discomfort and pain in the pelvic region
  • Lower back pain, especially the hips, groin, lower abdomen, legs, and knee
  • Waddling gait
  • ‘Clicking’ or ‘popping’ in and out of sacroiliac, the lower back when walking
  • Sensation that the hip is out of place and hip joint when walking or changing positions
  • Difficulty standing, climbing stairs, and carrying out other everyday activities
  • Pubic tenderness or sensitivity when touched
  • Difficulty getting out of bed and started walking
  • Bladder dysfunction

Coping with SPD

Resolving chronic SPD can be made through realigning the pelvic girdle and soft tissues. There are also other simple ways on how to cope with Pubic Symphysis Pain which include:

A. Exercises that focus on the pelvic muscles (e.g. resting backwards over a large gymnastics ball, deep water aerobics, swimming)

B. Use of body pillows between legs when sleeping, especially under the bump

C. Evenly distribute weight through both legs when standing

D. Avoid sudden movements

E. Use of crutches or wheelchairs when the case is severe

F. Osteopathy and chiropractic treatment

G. other alternatives (e.g. Acupuncture, Pelvic support, Homeopathy)

Although not every type of treatment works for every SPD patient, early intervention is important to improve or significantly reduce the discomfort. The key is look for additional help in the early days of the pain in order to find what works best in the situation.

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