“I’m pretty uninhibited with my husband,” Sally tells me. “But that doesn’t mean I’m comfortable with him putting my knickers [panties] on.”
Sally’s recalling the humiliation she felt during pregnancy eighteen months ago. She developed symphysis pubis dysfunction (SPD), which means her pelvic joints became inflamed and unstable. The illness made simple tasks—like putting on underwear—too painful to contemplate without her hubby’s helpful hands.
“Any movement when I had to separate my legs was agony—take that to mean just about everything,” she explains.
“Every day, Mark lays my knickers on the bedroom carpet. I stepped in to them, and then he pulled them up. The next challenge was walking downstairs, one slow, sore step at time. SPD made the rest of my pregnancy an absolute nightmare.”
The pain went off the charts at the end of her second trimester. “Until then, the pregnancy had been text book,” Sally says. “I barely even had any morning sickness. Then I got out of bed one morning, and screamed in pain. It was like my groin was on fire.”
SPD is named after the pubic symphysis, the joint at the front of the pelvis where the two hips bones meet. Normally the pelvis is a tight, closed system of bone (comprising the two hip bones plus the tail end of the spine, called the sacrum). These bones are reinforced by lots of ligaments, making the pelvis stable.
Sometimes however, this stability is compromised during pregnancy when the hormone relaxin kicks in. Its job is to loosen those pelvic ligaments to prepare for birth.
Although the exact mechanics of SPD are unknown, it seems SPD causes an over-loosening of the ligaments, leading to misalignment and in some women, excruciating pain. And of course, the problem is exacerbated by the weight of a growing baby.
“A physiotherapist diagnosed SPD immediately,” Sally explains. “She presented me with a pelvic girdle—essentially a big nylon band which strapped under my bump and held my hips together. I hated the way my bum [butt] squidged over and under, but it made walking less painful.”
“The physiotherapist warned that the pain would be worse whenever my legs were apart, so I immediately started panicking about birth, because that’s when you imagine your legs will be as far apart as they’ll ever be,” Sally says.
Turns out, Sally needn’t have worried so much as her baby Ella’s birth was pretty straightforward.
“The doctors and midwives knew about my SPD and I’d mentioned it in my birth plan. They knew I couldn’t go in stirrups because my hips would have been too far apart then. In the end I had a fabulous epidural and didn’t feel a thing. And the next day, when I got out of bed, my pelvis didn’t hurt anymore.”
For Sally and many other women, the end of pregnancy spells the end of SPD. But Alexandra’s SPD began during her labor.
Her labor was long and well…laborious, and midway through, she felt a monumental pain in her pelvis. Her baby, Niamah, was born after thirty-six hours with forceps and stitches.
“That night, the pain in my pelvis was intolerable,” Alexandra remembers. “I couldn’t sleep and cried out every time I moved my legs.”
“A doctor came and checked my reflexes, said they were fine and I should expect some pain after delivery. He made me feel silly.”
But the next day, concerned his wife was still weeping with pain, her husband James demanded she see a physiotherapist, who arrived later that afternoon.
“The physiotherapist said I had SPD, which had probably happened during delivery,” Alexandra explains. “She also said lots of old school obstetricians reckon [believe] SPD doesn’t exist, partly because there isn’t a definitive test. But what more evidence do they need but me?”
Alexandra was discharged after a week, with crutches “which weren’t exactly conducive to cradling a new born baby.”
