This post is not medical advice. I am just a mama sharing my experience.

Pelvic pain and Lincoln giving me a RUN for my money.

I am no stranger to chronic pain. I've had neck pain for over fifteen years. I've dealt with hip pain since 2016 when I had surgery for hip bone impingement and a labral tear. I was diagnosed with endometriosis via laparoscopic surgery in 2020. Over the years and various ailments, I've tried countless treatments, but have had to accept pain will always be present and I can't let pain control my life.

This pregnancy my pelvic pain is giving me a run for my money. I have SPD, which stands for symphis pubis dysfunction. Some practitioners now call this Pelvic Girdle Pain, or PGP. All the names are pretty terrible, which match the condition. If you're curious why SPD occurs, I cover this at the end of this blog post.

What SPD it feels like:

Symptoms range from mild to mobility impairing. According to whattoexpect.com, the most common symptoms are difficulty when walking and wrenching pain, as though your pelvis is tearing apart.

The worst is pain in the pubic area (above vagina), lower back and upper thighs. Sometimes I feel a clicking sound in my pelvis. My symptoms started off gradually at the beginning of the second trimester. Now at 24 weeks, SPD is already causing a lot of problems. At the end of my pregnancy with Lincoln, walking was so painful that I had to use crutches to bear weight.

Challenges for mamas with SPD:

It can be hard to convey severity. Most mamas feel pelvic pressure or pain during pregnancy, usually in the third trimester. I felt pressure with Sawyer towards the end, and it was annoying, but in no way debilitating. I am not suggesting that nobody else has severe pain, but often times I feel like I cannot clearly communicate the level of pain caused by my pelvis separating.

Pain from SPD limits what I can do every day. It makes taking steps excruciatingly painful. SPD makes tasks like getting out of bed feel impossible. Rolling over in bed makes me cry. Last night when I got out of bed, I physically couldn't lift my leg to take a step. This morning I helped my four year old out of the car for one second and felt sharp shooting pain into my pelvis and lower back. These are the examples I give to my medical providers to help them understand.

Being open about pain that is in an area we don't usually talk about. My kids think it is hilarious that my vagina hurts. At the beginning of the second trimester when it first started, we were walking through Target, and the pain suddenly made walking very painful. I slowed down and told the kids why. Sawyer screamed at the top of his lungs in the middle of the store "my mom's vagina hurts!!!"

Totally understandable the kids think it's funny, but pelvic pain also makes lots of grown adults uncomfortable. It's also not always possible to walk around with ice on my vagina. I use ice packs at home throughout the day, but it's not feasible when out and about. I do use my portable heating pad when my lower back hurts.

Pain is self limiting. I can do all the things that make SPD worse, it just hurts more. Sometimes Lincoln will say "you CAN bend down, you just don't want to." I try to explain that bending makes me hurt more so that is why I don't want to.

After this day of shooting content was when my pelvic pain first made it’s appearance.

This is a tough concept for my kids, but also sometimes hard for me to limit myself. For instance, something simple like a photoshoot may require bending, moving and lifting. I love my job and feel so lucky to create content for a living, but hate that something seemingly so minor can cause such intense pain. Also I often don't realize what I am doing is going cause a problem until afterwards.

It's also hard to find the balance between movement and pain. In early January I had started taking short walks with Lincoln in the stroller. The pain was worse after, but just for about two days. The physical and mental healthy benefits were worth it. Hoping to get back to taking walks soon.

I am extremely lucky to be surrounded by people who are kind enough to help with the kids when I need it. I don't want people to pity me and I'm not always good at asking for help, but it's something I am working on, especially as the pain gets more severe.

Guilt for negative energy. When I am having a bad pain day and feeling down, it's hard not to feel guilty at the same time. I am SO thankful to finally be pregnant after two years of secondary infertility. I knew SPD was likely to happen and I still chose this path.

I know there are many mamas out there who would do anything to find their rainbow babies. So sometimes I feel bad that I am not enjoying every second of this pregnancy while those mamas are struggling. But the truth is none of that changes the fact that I am in pain. It's ok to be thankful and be struggling at the same time.

i have Spd. what will help?

Hurts SPD	Can help SPD
walking	take small steps
climbing steps	avoid steps, limit trips
putting weight on one leg / driving	keeping legs together / no road trips
bending and twisting	use a grabber, no laundry
carrying anything heavy	pelvic floor physical therapy to strengthen, no lifting kids
turning over in bed	sleeping a special slippery sheet, keep knees together, pillow between knees
getting dressed	sit down to get dressed
sitting or standing for too long	change positions often
pushing anything heavy	wear pelvic support belt (not belly support band)
getting out of car or bed	keep knees and legs together
sitting on the floor	sit on soft surface or donut
daily life	ice, heat, rest, pain meds, warm baths

If you're dealing with severe pelvic pain during pregnancy, you are not alone. I recommend joining a facebook support group like this one, researching like crazy, finding a pelvic floor physical therapist, a pain management doctor, and advocating for yourself to get the care you need. Sending gentle hugs.

medical background:

First Pregnancy with SPD

I had hip surgery in May of 2016, when my son Sawyer was 15 months old. After extensive PT, my ortho surgeon cleared me to try for second baby. Of course this is the only time I got pregnant right away, in December 2016. About half way through the pregnancy I started to develop bad lower back, glute and pelvic pain. I eventually ended up in physical therapy at around 6 months pregnant for SPD.

What caused my SPD

SPD and PGP happen when the ligaments that normally keep your pelvic bone aligned become too relaxed during pregnancy. These ligaments are supposed to get stretchy as delivery nears, but with SPD it happens too soon, making the joint that holds the pelvis together, the symphis pubis, unstable. This instability and movement in the joint causes pain.

I believe I got pregnant too soon after hip surgery. I think my hip joint was strong clinically, which is why I was cleared. But the hip and pelvic floor are connected. I never had pelvic floor rehab as part of my physical therapy program or after I had Sawyer. My pelvic floor was way too weak to support pregnancy.

Sometimes it helps to see a diagram. Image via: What to Expect.com

Diagnosis

SPD is only diagnosed in 1 out of 300 pregnancies although experts think it may occur in up to 20% of pregnancies.
Pelvic pain is a normal part of pregnancy, but SPD and PGP are not normal. It can be really frustrating to be told it is normal and then not being able to walk. This level of pain requires a trained physical therapist to help manage the pain so we can make it though pregnancy. I found my physical therapists understand the condition way more than any physician. I know some mamas are put on bed rest, but I believe total bed rest should be a last resort.

When I was pregnant with Lincoln I had to print out info on SPD and bring to my OB. Luckily she was open to being educated. We even brainstormed safer ways to deliver with my physical therapist. (I ended up delivering Lincoln on my side, with my painful hip down and nurses holding up my right leg as low as possible as to not hurt my pelvis. My OB had never delivered a baby like this but she was amazing.)

I hope this blog has helped anyone suffering from or trying to understand severe pelvic pain. I am happy to answer any questions.