The Pregnancy Mini-Series, Part 1

My (very) Personal Journey Through Pregnancy with Pubic Symphysis Dysfunction & Pelvic Girdle Pain

Pink lines

The moment those two pink lines appeared in 2020, a massive wave of emotions crashed over me. Immense joy and excitement first, of course. But then, it felt like an alarm went off in my body. Those memories of the intense pelvic girdle pain that had marked my first pregnancy journey, back in 2014, came up to the surface all at once in a bout of panic.

While pregnant, Relaxin (hormone) levels rise in the body, loosening joints to accommodate the growing baby. The pubic symphysis (12) and sacroiliac (4) joints can become very painful. Case courtesy of Samir Benoudina.

Now, I'm no stranger to chronic pain and illness. I have lived with severe bilateral shoulder impingement syndrome, multiple chronic tendonitis and bursitis, and hypermobility all my life, and hypothyroidism for years. I also have idiopathic thrombocytopenia (low platelet count) and had it during my previous pregnancy, unbeknownst to me. I'm sharing my story not to frighten you, but to empower you with knowledge and resources I wish I'd had, and to remind you that you're not alone in this journey.

Pelvic Girdle Pain and Pubic Symphysis Dysfunction

Pelvic girdle pain (PGP) is more than just a pregnancy ache; it's a complex condition that can be utterly debilitating, impacting every aspect of pregnancy, and sometimes even extending beyond childbirth. Imagine pain so intense that every movement feels like a struggle.

PGP involves pain in the pelvis, hips, and lower back, often stemming from ligament laxity and muscle strain. It can include pubic symphysis dysfunction (PSD), where the cartilage connecting the pubic bones becomes overly mobile, as well as sacroiliac (SI) joint dysfunction, where the joints that connect the sacrum to the ilium bones become inflamed and unstable. While both PSD and PGP are common, the most severe cases, where pain significantly restricts daily life, tend to be less common, which may explain why these conditions are often misunderstood and dismissed by healthcare providers.

During my first pregnancy, things were uneventful and smooth sailing up to the third trimester. Relaxin, the hormone secreted during pregnancy to help prepare your body for labour, did its job a bit too well and relaxed my ligaments so much that my body felt like a crumbling tower. I couldn't sit, or stand up, for more than mere minutes at a time. Each step I took felt so painful, and tears were flowing every night as I was trying to catch some sleep. I rarely hear people talk about how debilitating this condition is. Even in the thick of it, I would read about it and couldn't find many articles truly reflecting the severity of my experience. The lack of awareness, discussion, and pain management options, combined with the fact that it never stops, even for a minute, makes it difficult to manage.

When in constant pain, there is no relaxing. Credits: vinyl album cover (1956) by Esmond Edwards, courtesy of Concorde Music via Charles Waring on udiscorvermusic.com.

The pain followed me everywhere, even into my dreams. Because no one in my family had ever experienced anything like it, I couldn't shake the feeling that I was somehow flawed, that my body was abnormal and broken for not being able to carry a baby to term without agony. I was already feeling restricted in my movements because of my shoulders, which I internalised as “feeling normal”, after so many doctors told me it was in my head. I felt trapped in a body that seemed to rebel against me at every possible opportunity, but I didn't want to let that dictate my life and stop me from having a family.

And you know what they say: that seeing your baby makes it all worth it in the end. While it was certainly true for me, I wish it didn't have to be such an agonizing process. The endless love I felt for my first born made me believe that, given enough time, my body would forget and do better next time.

A Pregnancy and a Pandemic

Before being pregnant again, I had healed my body with physical therapy and worked on my posture, alignment and strength through martial arts, especially Taekwondo. I focused on strengthening my legs, hips, and back. After preparing for what felt like a 6-year marathon, I felt ready to tackle this adventure again. After months and months of negative tests, I finally saw a positive. A few weeks into that pregnancy, the whole world went on lockdown due to the Covid Pandemic, in 2020.

Then, at the beginning of my second trimester, it showed up again (exactly as my last doctor had predicted): Earlier and with a vengeance. This time, the emotional weight was heavier, because I KNEW what was to come. My new doctor didn't seem to understand the condition and had no idea how to deal with it. I was left on my own to figure out how to get through this. I wish there would have been some support and a plan coming from my doctors other than patience, bedrest, and a pregnancy belt. The recommendation should have been to see a pelvic floor therapist and a physical therapist.

If you've ever seen the movie “Groundhog Day”, you can imagine how those 5 months felt. Waking up for approximately 150 days or so (but who's counting, really) to the same exact reality, pain and being confined to the same bed. At times, I found myself really struggling with anxiety, guilt, frustration, and shame. I had to accept that I was becoming dependent on other people's help for everything. It felt heavy, but in this exercise, I learned that I had amazing people to lean onto.

Prioritizing Moments of Connection

The flutters and kicks from within became my favourite moments of each day. Each movement was a reminder of the life growing inside me. I could notice patterns and see that my baby started each morning with a little bout of hiccups. I noticed that contrary to my first pregnancy, this tiny new person-to-be seemed to sleep while I slept. I also felt his strong feet up my ribcage, and we joked that his feet would be enormous—which turned out to be true! It was funny to imagine what was going on in there, as I felt what seemed to be popcorn kernels popping, and kickboxing sessions against my bladder. I enjoyed filming some of those powerful baby kicks, documenting the growth of my belly by making short impromptu photoshoots with my daughter.

Photo by Natalia Olivera

Early Labour Risk

Cue to week 29 of pregnancy. I started experiencing heaviness and a feeling of impending labour. My doctor dismissed my concerns, but I insisted that they check and wouldn't leave until I felt reassured. They told me that I was showing signs of early labour and gave me some forms and documents to bring with me to the hospital, should I deliver in the coming weeks. I felt scared, powerless, and frustrated that my body would do this, especially while on bedrest. I was told to go on complete pelvic and bed rest until it would be time to give birth. As for my forever increasing pelvic girdle pain, I was not given any options for relief.

In the end, we made it to 37 weeks and a few days. My water broke in the early hours of the morning, and I was admitted a few hours later. Things went well and the team did a wonderful job. This birth experience has healed me, in a way. Unfortunately, my pelvic girdle pain did not entirely disappear after delivery, this time around. I am still working on healing the aftermath of this debilitating condition, years later.

A Call for Comprehensive Care

My hope extends beyond my personal story. By speaking openly about Pelvic Girdle Pain and Pubic Symphysis Dysfunction, I'm advocating for a fundamental shift in how we understand and treat maternal health challenges. The most crushing aspect of my journey wasn't just the physical pain, but the profound emotional isolation that came with it. When doctors repeatedly oversimplified my experience, reducing it to “just” pubic symphysis pain, they missed the full-body impact of my condition. This wasn't a localized issue; it was an all consuming experience affecting every aspect of my life and I was being told (once again) that it wasn’t that bad.

The notion that “having the baby will fix everything” is not only misleading, but also dangerous. Without a comprehensive management plan, healthcare providers can inadvertently sentence patients to potential long-term physical trauma. Conditions that could be addressed through targeted physical therapy, early intervention, and holistic support often become chronic and debilitating pain that persists long after pregnancy and can impact the pregnant person’s family life, career, self-esteem and social life. The lack of mental health support exacerbated my frustration, leaving me feeling alone, dismissed, and gaslit. So please remember that your experience is valid, your pain is real, and you deserve adequate support. Whether you're reading this while navigating pain or illness, preparing for pregnancy, or supporting a loved one, know that the path ahead may be challenging, but it's navigable with the right tools, support, and knowledge.

This journey has taught me that we are stronger than we think, more capable than we believe, and deserving of better care and understanding. A little compassion and proactive care could have helped me avoid the complications that led to chronic pain, even years later. Let's continue to share our stories, support each other, and advocate for better recognition and treatment of PGP. Because both mothers and babies deserve nothing less than comprehensive, compassionate care.

Practical Strategies and Support

Navigating Pelvic Girdle Pain requires a multi-dimensional approach. I learned this not from medical textbooks, but from my own gruelling experience. I hope these tips can help. If you have some of your own, please leave a comment below to help others!

Physical Positioning and Movement Tips

Which mermaid are you feeling like today? The Buxton Museum mermaid, Magritte’s beached mermaid from “The collective invention”, or as serene as a Haenyeo from Jeju Island?

• Sleep on the slippery side of a sleeping bag to reduce friction and make turning easier

• Use a pregnancy pillow between your knees and ankles to reduce pelvic strain

• Keep your legs together when turning in bed or getting out of the car - think of your pelvis as one solid piece. You are now living like a mermaid until further notice.

• Use a shower stool to reduce standing time (and forget about shaving those legs!)

• Sit down to put on pants, socks, and shoes (and choose slip-on shoes, skirts and dresses whenever possible)

• Don’t bend to pick things up if you can avoid it.

• Use a grabber tool to pick up items from the floor and place frequently used items at waist height or higher to minimize bending

Mobility Tips

• Use a walker or crutches to distribute weight more evenly

• Use shopping and grocery delivery services

• Ask for help carrying heavy items

• Park your car as close to the entrance as possible and use designated parking if available

Pain Management & Emotional Resilience

• Apply heat or cold packs strategically (check with your doctor first)

• Invest in a good supportive pregnancy belt, a pregnancy pillow and a pelvic cushion if you can

• Take warm baths (not too hot, of course!)

• Practice gentle exercises and stretching recommended by a physiotherapist

• Create a “pain survival kit” with comfort items to help on bad days

Physical Health seen as a holistic approach

• Work with specialized physiotherapists, massage therapists and other professionals who understands pregnancy-related pain

• Learn gentle stabilization exercises that don't increase your pain

• Use supportive devices like pregnancy belts and pelvic cushions, but understand they're not a miracle cure

• Modify your daily activities and optimize your physical environment to reduce physical strain

• Recognize that healing is not linear

Mental Health support

• Find a counsellor who understands chronic pain during pregnancy

• Connect with support groups where you can share without judgment

• Practice mindfulness techniques that help stay present in the moment such as breathing exercises and journaling

• Communicate openly with your partner about your experience

• Acknowledge the emotional weight of chronic pain and adjust your expectations

Medical Advocacy

• Document every symptom meticulously

• Request comprehensive pain management plans

• Don't be afraid to seek second opinions (try to do so very early on. My pregnancy was during Covid, which made it difficult to do)

• Understand that your pain is real, even if doctors minimize it

• When speaking about your pain levels, try using a scale to describe it more accurately to your health provider (for ex: my pain is a 7/10 today)

Pelvic Pain Support Resources

• Local or online chronic pain support groups

• Specialized clinics focusing on women's health

• Pelvic Partnership (UK-based support organization)

• International Pelvic Pain Society

• Pelvic Pain Support Network

• NIH Pelvic Pain Resources for both patients and healthcare professionals

*Please note that presenting these links do not indicate endorsement, as they are a starting point for you in obtaining information and support.