Symphysis pubis dysfunction (SPD) is pelvic pain in pregnancy caused by stiffness or uneven movement of the pelvic joints. It is now usually called pregnancy-related pelvic girdle pain (PGP).
The pelvis has three joints that normally move slightly. In pregnancy, the growing baby's weight and changes in posture put more strain on them, and the joints can move unevenly. Past back or pelvic injuries and joint hypermobility can raise the chance of PGP. The RCOG estimates it affects about 1 in 5 pregnant women.
Pain is often felt over the pubic bone at the front, across the lower back, in the area between the vagina and anus, or spreading to the thighs. Some women hear or feel clicking in the pelvis. Walking, climbing stairs, standing on one leg and turning over in bed can make it worse. PGP is not harmful to the baby, and most women with it can still have a vaginal birth.
Early diagnosis can help keep pain lower. A midwife or GP can refer you to a physiotherapist who specialises in pelvic joint problems. Treatment may include exercises, advice on movement and, if needed, crutches or a support belt.
Long periods of standing, walking or climbing stairs can be painful. A chair with good support, fewer trips around the building, parking close to the entrance and permission to change position often can help.
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