The pelvis is greatly affected during pregnancy, and it’s not uncommon for the expectant mom to experience aches and pains in this area. Many times, women just accept these pains as annoyances that will go away after the baby is born, which is most likely true, but there are some things that can be done to deal with these discomforts.
It so happens that this month’s issue of Midwifery Today (yes, it brightens my day when I fish it out of my mailbox!) features a short article about symphysis pubis disorder (SPD) and some wonderful suggestions for dealing with it. Here’s a quick anatomy lesson: The pubic bone is not actually a single bone. It’s the point at which the two halves of the pelvis join in the front via a piece of cartilage. This cartilaginous joint is the pubic symphysis. During pregnancy, because of the presence of the relaxin hormone (which is responsible for softening the tendons and ligaments) in the body, all joints become more flexible, including this one. Sometimes the bony portion of the pubis (left or right pubic tubercle) separates slightly from the cartilaginous joint causing pain. Pain can range from slight, which indicates just minor overstretching of the joint, to extreme, due to full-on separation (diastasis) on one or both sides of the joint.
To help alleviate pain, the author of the article, Barbara E. Herrera, LM, CPM suggests tight binding for SPD, during both pregnancy and labor itself. “Use a long wrap or rebozo (tie two or three together if needed) and have someone help you tie the wrap tightly around your hips. In labor, you might need two people to do the work. Wrap the cloth as if you are going to make a knot, having each person pull an end after that first step. Once the cloth is very tight around your hips, have them tie a knot. After this is in place, you will feel less pain and be able to try different positions,” Herrera says.
A common birthing position is lying supine, drawing the knees to the armpit area. This is a huge pelvis opener, which is useful for making more space and is among the easiest positions for a doctor or midwife to get a good view of what’s going on. However, this may not be the ideal position for a mother who is suffering from SPD. In fact, lying supine can cause more pain through the healing process. The mother may not notice the pain during labor since many other things are going on, but she’s likely to feel the pubic pain afterwards if the pubis has spread even further. Other options for birthing positions include: coming onto an all-4 position, standing, kneeling, gentle squatting, or side lying. It’s best to avoid any position or situation where someone is likely to pull the legs far back.
After the baby is out, the mother still has the relaxin hormone in her body for up to six months. So it’s not uncommon for the new mother to continue to feel pubic pain. Herrera suggests continuing to bind the hips until the new mother feels the pain subside and more stability in the pelvis. In my postnatal yoga practice, we specifically address this common discomfort and work on poses that help create stability in the pelvis. Luckily, over time this issue usually corrects itself.
As far as prenatal yoga practice goes, I suggest avoiding deep pelvic-opening poses that would likely to exacerbate the situation. I encourage students to take shorter, wider stances in standing poses and to be gentler with their hip-opening poses.
Debra Flashenberg is the founder of the Prenatal Yoga Center. After spending much of her life in musical theater, she was introduced to yoga in 1997 and has since become a certified doula, Lamaze coach, midwife, and certified vinyasa yoga instructor. She is continuously in awe of the beauty and brilliance of birth and is the proud mother of baby boy Shay.
