Expecting and experiencing pelvic pain? It could be symphysis pubis dysfunction. Here's what you need to know about this uncomfortable pregnancy condition, including potential risks and treatments.

What is symphysis pubis dysfunction?

medical illustration of symphysis pubic dysfunction (SPD)

Symphysis pubis dysfunction (SPD), or pelvic girdle pain (PGP), happens when the ligaments that normally keep your pelvic bone aligned during pregnancy become too relaxed and stretchy soon before birth (as delivery nears, things are supposed to start loosening up).

This, in turn, can make the pelvic joint — aka the symphysis pubis — unstable, causing some pretty strange sensations, including pelvic pain.

How common is SPD in pregnancy?

The incidence of diagnosed SPD is about 1 in 300 pregnancies, though some experts think that up to 25 percent of all pregnant women will experience SPD (though not all have it diagnosed).

What are the signs and symptoms of SPD?

The most common symptoms are difficulty when walking and wrenching pain (as though your pelvis is tearing apart). Typically, the pain is focused on the pubic area, but in some women it radiates to the upper thighs and perineum.

The pain can worsen when you're walking and doing weight-bearing activities, particularly those that involve lifting one leg like climbing stairs, getting dressed, getting in and out of a car, or even turning over in bed.

What causes symphysis pubis dysfunction?

The culprit behind SPD is the aptly named hormone relaxin, which makes your ligaments stretchy so your baby can ease his way into the world.

Sometimes relaxin does its job too well, loosening the ligaments around your pelvic bone way before baby is ready to come out, which causes movement (and unfortunately, pain) in the pelvic joint.

What you need to know about SPD

In very rare cases, the joint may gape apart, a condition called diastasis symphysis pubis or symphyseal separation, which can cause more serious pain in your pelvis, groin, hips and buttocks. SPD can also worsen after delivery and require medical intervention, but this too is very rare.

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For most moms, once your baby is born and relaxin production ceases, your ligaments (and dance moves) will return to normal.

Treating symphysis pubis dysfunction during pregnancy

There are some things you can do to ease your discomfort if you're suffering from this pregnancy symptom, including:

  • Avoid triggers as much as you can. Sit down to get dressed, and avoid heavy lifting and pushing (which you should be steering clear of anyway!).
  • Apply a heating pad or ice pack to the pubic bone. If you use a heating pad, don’t leave it on for more than 10 minutes at a time, since longer can can raise your baby’s temperature. (You can safely cycle the pad on and off every 10 minutes.)
  • Wear a pelvic support belt. They're readily available online and "corset" the pelvic bones back into place during pregnancy.
  • Do your Kegels and pelvic tilts. Regular practice helps strengthen the muscles of the pelvis.
  • Ask for pain relief. If the pain is severe, ask your practitioner about pain relievers.
  • Consider physical therapy. Your obstetric provider can help you decide if it's a good option.  
Try to take comfort in knowing that this, too, is temporary and will likely disappear after you have your baby. So hang in there!