Pelvic girdle pain (SPD)

Pelvic girdle pain (PGP) — also called symphysis pubis dysfunction (SPD) — is pain around the front or back of your pelvis in pregnancy. It’s common, sometimes really limiting, and — importantly — it’s treatable. You don’t have to just grit your teeth and put up with it, so this one’s worth acting on.

What it is. PGP is pain and stiffness in the pelvic joints, caused by the way pregnancy loosens your ligaments (via the hormone relaxin) and shifts your posture and weight as your bump grows. The joints of the pelvis move a little unevenly, which triggers pain. It’s a mechanical problem — not a sign you or your baby are in danger.

What it feels like. People describe pain over the pubic bone at the front, across the lower back or one or both sides of the pelvis, or radiating into the hips, groin, buttocks or thighs. It’s typically worse with activities that involve parting your legs or standing on one leg — walking, stairs, turning in bed, getting in and out of the car, or getting dressed. You might also hear or feel a clicking or grinding. It ranges from mildly annoying to genuinely debilitating.

The most important step: get referred to a physio. The single best thing you can do is ask your GP or midwife to refer you to a women’s-health physiotherapist. They can assess you, provide a support belt if helpful, teach you exercises to stabilise the pelvis, and give tailored advice. PGP responds well to treatment, and early help makes a real difference — so don’t wait it out.

Everyday things that help. Alongside physio, small changes ease the strain:

• Keep your knees together getting in and out of bed or the car (a plastic bag on the seat helps you swivel), and sit down to get dressed and put on shoes.
• Take stairs one at a time, and avoid standing on one leg.
• Move little and often rather than long walks or standing; rest before you’re in agony.
• Sleep with a pillow between your knees, and roll over keeping your knees together.
• Avoid heavy lifting, wide leg movements, and pushing through pain.

Pain relief and support. A pelvic support belt, warm packs, and simple pain relief like paracetamol (check with your pharmacist) can all help you cope. A physio can advise on what’s safe, and in more severe cases may suggest crutches or other aids — needing them is nothing to feel bad about.

Will it affect the birth? Usually not — most people with PGP have a normal vaginal birth. It’s worth noting your comfortable range of leg movement in your birth plan and to your midwife, so positions can be chosen that don’t strain your pelvis. PGP is rarely a reason on its own to change how you give birth.

After the birth. For most people, PGP improves significantly in the weeks after birth as hormones settle and the load lifts, though it can take a little time. Keep up any physio exercises, and if pain persists beyond the early postpartum weeks, go back to your GP or physio — ongoing PGP can and should be treated.

You’re not doing harm by moving. It’s reassuring to know that although PGP hurts, gentle movement within your comfortable range isn’t damaging your pelvis or your baby — pain is a signal to modify how you move, not a sign of injury. Staying as active as your comfort allows, in pain-free ranges, is actually part of managing it, so try not to freeze up entirely out of fear.

Pelvic girdle pain is common and can be miserable, but it is not something you simply have to endure. Get a physio referral early, protect your pelvis with the everyday tweaks above, use a support belt and pain relief as needed, and lean on your team — most people get real relief with the right help, in pregnancy and after.