Reply To Hooi Hooi

Dr, I am HooiHooi. I search frm internet, knowing that got a thing call 耻骨联合分离症 (Diastasis of Symphysis Pubis). Read through the symptoms, quite similar to those I faced these few months. I know as you mentioned, it is due to our pregnancy hormone and baby's weight. What else can we do during natural birth process to minimize the pain? The pain will still continue after give birth?

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Hi, Hooi Hooi,

As the doctor taking care of your pregnancy, I am glad that you have taken extra effort to read and learn more about your pregnancy. A better informed pregnant mother usually has a better pregnancy outcome and I would like to share with you my own experience.

Diastasis of Symphysis Pubis is a common problem during pregnancy. It is estimated about 30% to 40% of pregnant mothers suffer from this condition. Luckily, most of them only troubled by mild pain and usually it will recover within 2 weeks after the delivery.

Symphysis pubis is located just above your private part, about 3 cm above your clitoris. Symphysis pubis is a joint to merge the two pelvic bones from both side.

During the pregnancy period, your body produces a hormone (relaxin hormone). The function of this relaxin hormone is to soften your skin and muscle. Your skin must be softened so that it can be stretched to accommodate the growing baby. This relaxin hormone also soften your vaginal muscle so that the birth tunnel can be stretched to allow the baby to go through during normal delivery.

Unfortunately, this relaxin hormone not only soften your tummy skin and vagina tunnel, it also causes other structure in your body to soften as well. For examples:

1) The gum in your mouth is softened. As a result, some pregnant mothers complain of toothache and gum bleeding while brushing the teeth.

2) The skin inside the nose. Some of you may experience bleeding from the nose during pregnancy.

3) Diastasis of symphysis pubis as mentioned by you. This condition is caused by softening of the symphysis pubis joint. Due to the joint softening, it can’t hold your pelvic bones probably. As a result, every time when you walk or exercise, you will experience pain above your private part. To make the problem worse, your baby will grow in weight as pregnancy advance. The weight of the baby will compress downward and worsen the pain in symphysis pubis.

There are few things you can do to reduce the pain :

• Use a pillow between your legs when sleeping; body pillows are a great investment!
• Use a pillow under your 'bump' (pregnancy tummy) when sleeping
• Keep your legs and hips as parallel/symmetrical as possible when moving or turning in bed
• Some women also find it helpful to have their partners stabilize their hips and hold them 'together' when rolling over in bed or otherwise adjusting position
• Some women report a waterbed mattress to be helpful
• Silk/satin sheets and nighties may make it easier to turn over in bed
• Swimming may help relieve pressure on the joint
• Keep your legs close together and move symmetrically (other sources recommend a very small gap between the legs with symmetrical movement)
• When standing, stand symmetrically, with your weight evenly distributed through both legs
• Sit down to get dressed, especially when putting on underwear or pants
• Avoid 'straddle' movements
• Swing your legs together as a unit when getting in and out of cars; use plastics or something smooth and slippery (like a garbage bag) on the car seat to help you enter car backwards and then turn your legs as a unit
• An ice pack may feel soothing and help reduce inflammation in the pubic area; painkillers may also help
• Move slowly and without sudden movements
• If bending over to pick up objects is difficult, there are devices available that can help with this
• Really severe cases may need crutches, although these should probably only be used as a last resort
• Some women report that pelvic binders/maternity support belts are helpful for pelvic pain
• In severe cases, pain relief medicine may be helpful.