Pregnancy Related Pelvic Girdle Pain (PGP)

What are the causes of PGP?

The pelvic bones are held together by strong tissues called ligaments; however, due to the normal hormonal effects of pregnancy, the ligaments become more flexible. This procedure is crucial because it enables the pelvis to expand during childbirth. It does, however, imply that your joints are more mobile, which can be uncomfortable and is one theory for how PGP develops. The ligaments and joints gradually return to normal following delivery. Your pelvis is under more strain as your baby grows, and the additional weight of your child and how this may affect your posture may also be factors in PGP. If you experienced pelvic pain or low back pain before getting pregnant, as these conditions may result in changes to muscle length or stiffness in the joints, you may be more likely to develop PGP. Working a job that requires manual labor, lifting, or long periods of standing or walking could also be a factor.

Simple adjustments and considerations, according to many women, can ease PGP symptoms:

  • Sit on a firm chair with a rolled towel or cushion to support the lower back
  • Do not cross your legs when sitting
  • Directly face your computer screen (avoid sitting in a twisted posture)
  • Place a pillow between your knees and ankles when lying on your side at night
  • Roll onto your side before getting out of bed, keeping your legs together
  • Keep your legs together when turning over in bed and when getting in/out of the car
  • Keep your back straight when moving from sitting to standing and use your arms to push up.
  • Daily activities:

  • Avoid lifting heavy weights
  • Avoid twisting/bending movements like vacuuming or pushing heavy supermarket trolleys
  • Ask for help from your partner/relatives/friends
  • If you have to vacuum, then reduce the amount you do in one session and come back to it the next day
  • Consider online grocery shopping
  • Sit down to get dressed/undressed
  • Climb the stairs one step at a time
  • Sit down to prepare food or to do the ironing
  • Walk more slowly and with shorter strides
  • Wear comfortable supportive shoes with a good sole (avoid high heels)
  • Avoid prolonged sitting or standing; avoid sitting on the floor.
  • Toddlers (if you have a young child to care for):

  • Try to avoid lifting your toddler too often and avoid carrying the child on one hip
  • If they want a cuddle, sit down and ask the child to sit beside you or on your lap
  • Remember to let the cot side down when lifting the child in/out (bend your knees, keep back straight)
  • Kneel to bath your child (do not bend over the bath) or preferably ask a partner/relative to help
  • Keep your child close to you when lifting him/her into a car seat (have the front seat pushed well forward to allow more room).
  • Rest.
  • Try to take at least 30 minutes of daily rest, ideally while lying on your side with a pillow between your knees and ankles. Pacing Plan your daily activities to keep you moving but avoid doing too much.

    Request from your manager a risk analysis of your workstation and tasks at work. If you work in an office, you should have a comfortable, adjustable chair, and you should attempt to stand up or take a short walk every 30 minutes. Every 30 minutes, if your work requires standing or walking, you should take a few minutes to sit down and relax.

    Does PGP affect labour and birth?

    It is advised that you and your baby benefit from a normal vaginal delivery. There is no proof that an elective (planned) caesarean has any additional benefits, improves healing, or reduces the likelihood of PGP reoccurring in subsequent pregnancies. Find out from your physiotherapist or midwife which positions during labor and delivery of your baby may be more comfortable for you. You can include these in your birth plan and ask your birth partner to assist you in finding positions that support your back and legs. Sometimes the midwife or obstetrician will ask you to adjust your position for specific procedures or to ensure your and your baby’s safety. This will always be discussed with you first. The best chances of having a routine delivery are when labor begins on its own and you adopt cozy positions. According to research, if you can use more upright positions, your labor will probably be shorter and you won’t need as many interventions. A shorter labor is associated with a lower risk of postpartum PGP symptoms.

    It is not standard procedure to induce (start) labor early for PGP-positive women. There may be additional causes for you to consider inducing labor. Your midwife will refer you to an obstetrician if you are experiencing severe PGP symptoms and want to talk about induction so they can determine whether the risks and benefits are balanced for you and your unborn child.

    The same options are available to all pregnant women for pain management during labor. Warm water, such as that found in baths or the birth pool, may be soothing to some women.

    The bones that make up the pelvis (the pelvic girdle) can cause pain during pregnancy.

    These pains arise from the sacro-iliac and symphysis pubis joints. During their pregnancy, some women experience pain in their lower back, buttocks, thighs, hips, groin, or pubic bones. Most women’s symptoms are mild, but some are severe and incapacitating. Despite the fact that PGP can be uncomfortable and upsetting, your baby won’t be harmed.

    You may have pain or difficulty with activities such as:

  • Walking (especially for prolonged periods)
  • Climbing stairs
  • Turning over in bed
  • Putting on socks/tights/shoes/trousers
  • Getting in/out of the car and driving
  • Sex
  • Other PGP symptoms may include sensations of clicking or grinding with movement or a sense that the pelvic joints are loose or unstable. The joints are not damaged; PGP is usually a self-limiting condition and most women recover completely within the first month following birth, although 1-2% may experience pain for up to one year

    What Causes Pregnancy Pains Video

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