★★★★★ Good Day ★★★★★
I was diagnosed with symphysis pubis dysfunction around 34 weeks of pregnancy, and it turned out to be a real challenge. The pain in my pubic bone area was severe, and my doctors initially told me it was just my pelvis preparing for labor. But as the weeks went by, the pain only got worse, so I decided to look it up online.
What is symphysis pubis dysfunction during pregnancy, and how is it dangerous?
Symphysis pubis dysfunction during pregnancy is a condition where the cartilage joint in the pelvis (pubic symphysis) becomes unstable due to a hormone released during pregnancy that prepares the body for labor. As a result, the joint becomes mobile, and you may experience pain in the pelvic area, which can limit your mobility.
There are three stages of symphysis pubis dysfunction:
first – the pubic bones have separated by 5-9 mm;second – by 10-19 mm;third – by 20 mm.The biggest risk is the possibility of damaging the ligament that holds the pubic bones together during labor. This can lead to a long and painful recovery process that may take months or even years, and in some cases, surgery may be necessary if the tear is severe. On the other hand, symphysis pubis dysfunction often resolves on its own after childbirth.
To avoid serious complications, the second and third stages of symphysis pubis dysfunction may be an indication for a cesarean section – in other words, a C-section. The indications for this are:
the pubic bones have separated by more than 10-15 mm;the pain is too severe;the baby weighs more than 4 kg;the pelvis is anatomically narrow.I was surprised that none of my doctors mentioned it, but I started complaining about the severe pain in my pubic area, and it's a serious complication of pregnancy, especially with a second- or third-stage symphysis pubis dysfunction, which means you're not allowed to have a natural birth – they do a C-section instead.
I was initially set on giving birth naturally, but after the 30th week, my baby turned into a head-down position and there were no more contraindications for a natural birth. Although I was terrified of giving birth myself, I was even more scared of giving birth via C-section (those are my personal demons).
Symptoms of Symphysis Pubis Dysfunction
The most intense symptom is the pain – a strong, aching pain in the pubic area. Even when I was walking, I could feel my pubic bones moving. But lying down, the pain still made itself known whenever I rolled over from one side to the other, and with a big belly, that was quite a challenge, let me tell you. Another symptom was the pain I felt when trying to lift my straight leg up while lying down (or both legs).
Ultrasound of the pubic symphysisIs this treatable?
Nope! If you've been diagnosed with this, it's just something you have to live with. And if you have a second or third-degree diagnosis, you'll be sent for a C-section. The biggest risk with symphysis pubis dysfunction during natural birth is the intense strain on the pelvis, which can cause the ligaments to snap.
Sometimes, the clitoris, urethra, and bladder can get damaged during the trauma. Women who experience this may struggle to walk or use the bathroom on their own.
I mean, come on, that's not exactly the most appealing prospect, especially when you have a newborn to care for.
Where and how much
I made an appointment with a doctor at 36 weeks, and immediately told her about the pain issues and my suspicion of symphysis pubis. She told me to rush to CITO im. Priyova to see a traumatologist-orthopedic specialist for a consultation and ultrasound. There were only 2-3 weeks left before the birth. I called them and they said that the schedule was packed, and they could only take me in 2 weeks later. I was worried I wouldn't be able to give birth by my desired date.
The consultation was paid, 2000 rubles.
Ultrasound of the pubic symphysisI arrived on time, registered, paid, and went to the waiting area. It was a mess: they were letting people in without an order, and they were taking patients in a disorganized manner. I finally got to see the doctor after an hour. There were a lot of pregnant women there, and the problem is indeed common. I explained my situation to the doctor, saying that I needed a conclusion that I could give birth naturally, without a C-section, as I suspected symphysis pubis. She sent me for an ultrasound.
I had to pay for it again, then go to another building, and there was a long queue there too *sigh*. The cost of the ultrasound was 1020 rubles.
Ultrasound of the pubic symphysis
Anyway, the ultrasound process was no different from other types of ultrasounds. I lay on the examination table on my back, exposed my pubic area, and the doctor started scanning it with the probe. As the ultrasound technician explained, pregnant women in the later stages are only scanned externally, while those in the early stages can be scanned vaginally. Men, of course, are only scanned externally.
I want to give credit to the ultrasound technician, she did it for a long time, about 15 minutes, and I had already started to feel uncomfortable lying on the table with a big belly. The scan result showed the separation of the pubic bones in red.
Pelvic Joint Ultrasound (Pubic Symphysis) I waited outside for about 5 minutes, and then I headed back to the orthopedic and trauma doctor. The ultrasound results showed I had symphysis, but not a big one. The numbers looked normal, but the diagnosis was still there. It was a bit confusing.
Pelvic Joint Ultrasound (Pubic Symphysis)The doctor looked at the ultrasound report and asked if I wanted to give birth naturally or have a C-section. She mentioned my age (34) as a reason for a C-section, but I'm not sure why that's a thing – many women give birth naturally in their 40s. I have symphysis of the first degree, but that's not a reason for a C-section. I asked her to write that I have no contraindications for a vaginal delivery, and we decided on that.
Pelvic Joint Ultrasound (Pubic Symphysis)How my labor and postpartum period went
I went for the ultrasound, and the next day I headed to the hospital to give birth! I made it just in time, exactly at 39 weeks, with the ultrasound results in hand. Labor wasn't easy, even though my baby isn't big. We had trouble getting the head out, and I ended up needing an episiotomy.
I have to say, the real fun started after giving birth. I'm not sure if it's just me, but it felt like everything down there had come undone or was severely strained (I hadn't had a pelvic exam since my last one). For two weeks after delivery, the pain in my perineum was excruciating – I'd get up from bed, chair, or couch, and stumble out of the car in tears. I was moving like a duck with a broken wing. I didn't take any pain meds because I was breastfeeding, but my concern for the baby helped distract me from the discomfort. Thankfully, the pain subsided around a month after giving birth.
Takeaways
If you're pregnant and experience symptoms like mine, it's crucial to get a pelvic exam and see your doctor – it might prevent a lot of problems down the line. My experience was mixed – the ultrasound suggested I was in the early stages of symphysis pubis dysfunction, which is supposedly safe for vaginal delivery, but my postpartum pain was a different story. Still, this exam is a must!
Wishing all pregnant women an easy and pain-free journey!
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Thanks for reading my review, Anja. Hope it was helpful!
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Review on Hysteroscopy after which I got Pregnant
Review on Hysterosalpingography