QuestionI have had Symphysis Pubis Dysfunction with each of my four pregnancies, each time worse than the last. After my last birth I couldn't walk better than a shuffle for a month. I would very much like to have a fifth, and last, baby but am very worried about the SPD becoming something chronic if I push my luck any further. Are their preventative measures I can take? Would a C-section alleviate the post pardum trauma? All of my babies have been big (8-10lbs) and facing up instead of down which adds to the stress on the pubic bone. I have asked my Dr all of these Qs in the past but he doesn't get how painful this problem really is.
Thanks!
AnswerHaving a c-section would only replace one recovery pain with another. During a c-section, your abdominal muscles are sliced apart. You can't sit up, roll over, or even pick up your older children without excruciating pain. Ideally, you should not have any pain at all after you deliver, or at most some mild twinges. I suspect that the position of your baby combined with your methods of delivery are responsible for the prolonged postpartum discomfort.
First, you need to get your baby into an anterior position. Check out www.spinningbabies.com for some ideas on Optimal Fetal Positioning. My personal routine starts at 26 weeks. I ban myself from the couch, except for sitting on the very edge with my knees apart so my belly can fall between my legs. Mostly, I aim for sitting tailor-style on the floor. No recliners, no rocking chairs, no lounging. Always sit up straight and lean forward a little. Think of "good posture". Also, I practice pelvic rocks, doing a set of 40 four times a day, then resting on my tummy for 15 minutes afterward to give baby a good chance to settle. What all of this does is use gravity to swing your baby into position. Your baby's back is the heaviest part of his/her body, and by keeping the front of your belly lower than your back, you will encourage that heavy back to fall to your front, where you want it.
Your second concern needs to be during labor and pushing. With SPD, you want your knees to be as close together as possible, and you want to push only when your body feels the urge. Do not use coached pushing, where you are told to push for a count of 10, etc. Push when your body pushes. This will result in less stress on your pelvic bone, and will allow more time for your baby's head to mold, allowing a smaller presentation through the pelvis. Also, you should push on your hands and knees, rather than on your back or semi-reclined. This widens your pelvic outlet by up to 30%, and also keeps your knees together to reduce the strain on your pubic symphysis joint.
I completely understand where you are coming from. I was also virtually disabled the last months of my last pregnancy. But I followed my own recommendations, and delivered my 8 lb 10 oz son (with a 15" head!) in only 30 minutes of pushing, and as soon as he was born my pain was 99% gone. I am now 14 weeks pregnant again, and I'm dreading the return of the pain, but I know that if I manage my delivery properly, it will be gone after the birth.
Good luck!
