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Treating Symphysis Pubis Dysfunction (SPD) During and After Pregnancy

What’s that? Another daunting symptom of pregnancy? Whether it’s nausea, back pain, or “mommy brain“, there’s more than a few conditions for pregnant women to look out for, not to mention the baby! The good news? Symphysis pubis dysfunction (SPD) is a condition you can mitigate with some stretching and exercise. We spoke with Kristal Scott, a physical therapist at Banner Physical Therapy in Gilbert, Arizona.

What is SPD?

Also referred to as pelvic girdle pain, SPD refers to discomfort caused by instability in the pubis symphysis joint in the pelvic region. It is especially common during pregnancy as a result of increased pressure on the region and the body’s natural softening of ligaments prior to birth. Some women have described the pain as if the two sides of their pubic bone are rubbing against each other (clicking and grinding). Scott commented that “the discomfort each woman feels can vary greatly, so the best approach is preventive exercise of the pelvic area, even starting prior to pregnancy.”

Can SPD be treated?

Yes, SPD symptoms can be treated. But you may not be able to prevent it. “I encourage women to start strengthening prior to pregnancy,” said Scott. “The healthier you are leading into the pregnancy, the more likely you are to stay healthy through the pregnancy.”

Unfortunately, we cannot control hormonal changes during delivery and as you near the due date, your ligament laxity will increase to prepare for the delivery.  When your ligaments are less supportive, you’ll rely on the pelvic muscles even more to maintain stability of our joints, making your pre-pregnancy exercises even more important.

Is it too late for treatment?

If you are already experiencing the symptoms of SPD, it’s not too late. At the very least, physical therapy can help prevent further progression of your symptoms through the remainder of the pregnancy. Additionally, you’ll learn techniques to lessen movement pain, and improve strength and coordination for a quicker postpartum recovery.

Does SPD make delivery more difficult?

“Labor and delivery is unpredictable and can be scary for someone already experiencing pelvic girdle pain (PGP) during pregnancy,” said Scott. “SPD can add additional pain to delivery but doesn’t necessarily guarantee that the delivery will be more difficult. Many, many women with SPD have very successful vaginal deliveries. The biggest factor I address with my patients is birthing positions.”

Scott explained that pulling knees apart and towards the chest beyond a comfort level can create more separation of the already painful pelvic joint. With an epidural, it can be hard to know how hard you are pulling. To prepare for a safer and more comfortable delivery, you can discuss safe birthing positions with your obstetrician, midwife and/or a physical therapist specializing in pelvic floor.

Does SPD lead to long-term issues?

For many, symphysis pubis dysfunction can resolve in the weeks after the baby is born. For other women, SPD can become a lingering issue that affects quality of life if it’s not addressed. Over time, untreated SPD may contribute to additional pelvic issues such as urinary incontinence, pelvic organ prolapses, chronic pelvic pain, diastasis recti (abdominal muscle separation), and low back/hip pain.

If you are experiencing SPD discomfort or if you are planning a pregnancy, don’t wait to speak with an expert. Visit to find a specialist near you.

Check out these related articles to learn more about pregnancy before and after your delivery:

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