Symptoms of PGP (Pelvic Girdle Pain) in pregnancy
The main symptom that women report when they have pregnancy-related pelvic girdle pain (PGP) is pain in and around their hips and pelvis, especially when:
- walking/standing for long periods,
- bending down,
- climbing stairs, and
- turning over in bed.
This means that it can affect virtually everything you do in a day, which has a major impact on your life! From personal experience, as I had it in my 2nd pregnancy, it can affect work, caring responsibilities, exercising, sleep and even intimacy with your partner. The pain can be an ache, a sharp shooting pain or a deep muscle pain. You may also have a clicking or grinding feeling in your pelvic joints or in your hips. PGP can affect different women in different ways and it’s not a one size fits all problem. So, choose useful tips that help you, which are not necessarily the same that will work for someone else.
As a yoga teacher, specialising in pre & postnatal yoga, I’ve guided many pregnant clients within my classes to manage the condition by working in a relaxed and comfortable way to build strength and stamina in the surrounding muscles of the legs and pelvis to prepare for an active labour. So, adopting a more mindful movement exercise modality when pregnant can really help to ease the discomfort and manage the condition.
If you have PGP, you may be worried about how it will affect you during birth and how you will cope with the pain. You may have limited mobility and difficulty moving your legs because of your PGP. It’s important to plan ahead for your birth, thinking about your PGP and how it affects you.
Speak about your PGP with your care provider. It’s important that your birth team understands your PGP so they can support you in your choices. For most women, having PGP does not mean you have fewer options on where you give birth or the type of birth you have. However, your PGP may become worse if it’s not managed carefully during pregnancy.
As a doula, I have supported women with PGP who have had positive birth experiences at home, in hospital and in midwife-led units, with both vaginal and caesarean births. So, I always work with my doula clients, beforehand, to find a way for them to remain as active in labour as possible, to allow gravity to assist as labour unfolds whilst being mindful of their limitations.
Most women with PGP give birth vaginally. You may be concerned that this will not be possible for you because you are having difficulty moving your legs and changing positions. With the right support, a vaginal birth can be a good option with PGP, as in my experience when I suffered with PGP in my last pregnancy, I didn’t actually feel the pelvic pain once labour began and it literally disappeared completely after the birth. Apparently, it’s usually quite normal for the condition to disappear once baby arrives.
When you meet up with your midwife, explain how PGP affects you, and what you can and can’t do. For instance, how wide is your pain-free gap? Your pain-free gap is the distance you were able to move your legs apart before labour without causing pain. Try not to go beyond this gap with any sudden movements or over exertion, as you get closer to labour day.
A good way to look after your pelvis during pregnancy is to control the position of your legs. Can you lie comfortably on your back or side, stand with support, walk with or without crutches or remain in one position for some time? This will help you and your birth partner to work out which positions maybe more comfortable in labour. Make sure PGP is added to your medical notes and include this information in your birth preferences and personalised care plan. I discuss the condition, in depth, with my doula clients. Together, we explore what works for clients within their range of movement and then I can prescribe gentle mat-based exercises to help build strength in the legs and lower back in order for clients to be more active in labour.
Make use of anything that anyone offers in terms of help at home. This could include shopping, looking after children, or housework. Recognise your limits and adapt your expectations of what you can do while you’re experiencing PGP. People who care about you usually want to help but don’t always know what to do. Little things like maybe popping a do list on the fridge can help direct them on how they can help. I always welcome clear instructions on how I can best support my doula client, so she can be well rested for labour.
Before giving birth:
- measure how far you can move your knees apart without pain and record this in your birth plan
- make sure your birth partner and care providers know about your pain-free gap
- know that the pain-free gap can change when you go into labour.
Labour and birth positions with PGP
It’s helpful to try and stay upright and active in labour. Many women with PGP find it helpful to change position regularly, as this reduces stress on their pelvic joints. Mainly not lying on your back which can enable your baby to move through your pelvis with the help of gravity.
I’ve found these are positions that many women with PGP find helpful:
- in a birthing pool where you can move and change position easily
- standing or leaning forward on a supported surface like a birthing ball or back of the sofa/hospital bed.
- on your knees or on all fours
- lying on your side with your top leg supported either by a peanut ball or a willing birth partner to hold your leg in a comfy place.
Water birth
Birthing pools are very popular with women with PGP. The support of the water allows you to move around with ease as gravity is reduced by 60%, and the warmth of the water provides pain relief. In a pool you’re also in control of the position of your legs, so you’re unlikely to move beyond your pain-free gap. Most hospitals and midwife-led centres have birthing pools. Don’t be discouraged from using a pool because you’re worried about getting in and out. There are ways you can slide into the water with help of birth partners or doula, from the pool’s edge, such as using a high stool or a transfer turntable (which can be turned to give you the right angle to get in).
Even better, giving birth at home means you can be somewhere familiar, surrounded by all your creature comforts, using any helpful equipment you’ve acquired and having your chosen people to support you in a way that feels right for you. You can hire or buy a pool for a water birth at home (and sit in it for pain relief in the days before labour). Enjoy a practice run before labour day.
Additional options for pain relief without medication:
There are many other options to relieve pregnancy-related pelvic girdle pain. You can try these alongside or instead of medication.
Massage
Heat and cold
TENS pain relief
Mindfulness and meditation/Deep relaxation
Homeopathy
Acupuncture
Reflexology
Hypnotherapy
In my experience, as a yoga teacher, my clients usually find that a combination of mindful movement -like yoga, manual therapy -like remedial massage and complementary therapies – including Homeopathy can be better treatment for PGP because, in combination, they will treat the underlying cause of the problem. Also, complementary therapies may help you in feeling calmer and more relaxed and might make it easier to sleep or deal with the discomfort alongside manual therapies undertaken.
PGP can be safely and effectively treated with manual therapy from an experienced physiotherapist, osteopath or chiropractor to restore symmetry of movement. It can be treated at any stage during or after pregnancy with no risk to baby. Sometimes failing to treat the pain promptly may result in delayed recovery and on-going symptoms which could last for months or years postnatally. It can also have a significant impact on a woman’s emotional and psychological well-being both during and after pregnancy. SO getting the support you need is key in helping to manage the discomfort to be able to prepare for labour and birth in a way that feels right for you.
If you are experiencing PGP, please know you are not alone. It’s a very common condition in pregnancy.
There are a range of different support services available to women and birthing people. So please do get in touch with me today and see how I can support you with the therapies I offer or you can find some links here for helpful groups and organisations that specialise in PGP support:
The Pelvic Partnership.org.uk offers support and information about pelvic girdle pain (PGP)
Pelvic Partnership Facebook Support Group
https://www.facebook.com/groups/400989677114263
(Their group is moderated by frontline volunteers, it’s a closed group for women experiencing PGP to connect with other women with PGP, to support one another and share tips and information about managing their pain and getting treatment).
Or call me today to discuss your needs. I’m always happy to help
https://www.headtoheal.uk/contact/
Love Dani xx
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