Reviewed By: Pramod Kerkar, MD, FFARCSI

There are various problems or ill health issues women may suffer during pregnancy. One of the conditions most commonly associated with pregnancy and childbirth is Symphysis Pubis Dysfunction. It is a problem with the pelvis. In this current article of ours we will discuss on the causes, symptoms, diagnosis and the treatment procedures for symphysis pubis dysfunction during pregnancy.

What is Symphysis Pubis Dysfunction During Pregnancy?

Overview: What is Symphysis Pubis Dysfunction During Pregnancy?

Symphysis Pubis Dysfunction or SPD is a condition that is linked to the pelvis. This condition causes excessive movement of the Pubic symphysis, possibly because of a misalignment of the pelvis and may cause symptoms of pain and swelling. Symphysis Pubis Dysfunction is commonly associated with pregnancy and childbirth in women. It is known that approximately about 1 in 300 pregnancies, though sometimes the estimates also go as high as 1 in 50 pregnant women suffer from Symphysis Pubis Dysfunction. This condition is also associated with pelvic girdle pain at times.

Our pelvis mainly is formed of two pubic bones that curve round to make a cradle shape. Symphysis pubis is the firm joint, at the front of your pelvis where the pubic bones meet. The joint’s connection is made strong by ligaments or a dense network of tough tissues. However, during pregnancy swelling and pain can make this symphysis pubis joint, less stable and lead to symphysis pubis dysfunction.

We will know about the symptoms, causes, diagnosis and treatments for the symphysis pubis dysfunction during pregnancy in the following array of our article.

Symptoms of Symphysis Pubis Dysfunction During Pregnancy:

Let us list down the symptoms of symphysis pubis dysfunction experienced during pregnancy.

  • Pain and discomfort in the pelvic area.
  • Some patients also hear their lower back and hip joints in the sacroiliac, clicking or popping in and out as they walk, move or change their position.
  • There may be pain in the lower back, groin, hips, lower abdomen and legs. Pain may be mild or extreme and prolonged suffering.
  • Some patients with symphysis pubis dysfunction during pregnancy may walk with a characteristic waddling gait and may have issues while climbing stairs, problems with leg abduction and adduction, pain may be present while carrying out weight bearing activities, and also may be difficulties while standing.
  • Any untreated condition of symphysis pubis dysfunction during pregnancy may also lead to disabilities or certain physical damage in the person.

Causes of Symphysis Pubis Dysfunction During Pregnancy:

The hormone “Relaxin” is the prime cause of Symphysis pubis dysfunction most commonly experienced during pregnancy in women. This is the hormone that makes your ligaments stretchy so that the baby can ease his or her way in to the world. Sometimes relaxin performs greatly by making the ligaments around the pelvic bone during pregnancy loose way before baby is ready to come out to the world. This causes instability and the pain in the pelvic joint. However, most times this instability or flexibility does not necessarily cause pain or other symptoms of symphysis pubis dysfunction. This problem or condition occur usually when the body doesn’t adapt well to the stretchier or looser ligaments caused by relaxin hormone.

One is more likely to develop Symphysis pubis dysfunction during pregnancy if:

  • She had pelvic girdle pain or pelvic joint pain before getting pregnant.
  • The woman had a previous injury to her pelvis
  • If she is overweight before pregnancy or if had high BMI before becoming pregnant
  • If there is hypermobility in all joints.

Things You Need to Know About Symphysis Pubis Dysfunction During Pregnancy:

Below are some things you need to know and be careful about in symphysis pubis dysfunction during pregnancy.

  • In very rare cases of symphysis pubis dysfunction during pregnancy, the joint may gape apart and cause a condition known as disastis symphsis pubis or symphyseal separation which can cause more severe pain in the pelvis, hips, groin and buttocks portion.
  • Rarely Symphysis pubis dysfunction during pregnancy can make a vaginal delivery impossible and your doctor may go for a C-section instead. In even rarer cases, SPD or symphysis pubis dysfunction can turn worse after childbirth and may require medical intervention. However in most women the ligament returns back to normal.

Diagnosis of Symphysis Pubis Dysfunction During Pregnancy:

Symphysis pubis dysfunction during pregnancy is first diagnosed from the symptoms after pregnancy. A thorough physical examination is done by the health professional to rule out other lumbar spine issues like prolapsed disc, or conditions like urinary tract infection etc. and then after the patient is referred to a women’s health physiotherapist for testing the stability, movement and pain in the pelvic joints and muscles. The suspected women may require undergoing some diagnosis procedures like MRI Scans, X-rays, Ultrasound scanning etc.

Treatments and Management of Symphysis Pubis Dysfunction During Pregnancy:

Various types of treatment and management of symphysis pubis dysfunction include the following.

  1. Medication for Symphysis Pubis Dysfunction During Pregnancy:

    It is not advisable to take anti-inflammatory medications during pregnancy. So, most women are prescribed with 30 mg or 60 mg of Codeine phosphate to be taken along with 1000 mg paracetamol for 4 times in a day. However Codeine phosphate carries risk of depressed respiration in the newborn if it is taken near to the baby birth. So, this is also avoided 2-4 weeks before the estimated due date. Some other medications for Symphysis pubis dysfunction during pregnancy include oral morphine.

  2. TENS or Transutaneous Electronic Nerve Stimulation:

    Physiotherapists may suggest using TENS or Transutaneous Electronic Nerve Stimulation so as to relieve pain in Symphysis pubis dysfunction during pregnancy. Apart from this, there may be use of support belts, crutches etc. for reducing pain.

  3. Other Treatments for Symphysis Pubis Dysfunction:

    Among other treatments for symphysis pubis dysfunction; the most known ones are aromatherapy, reflexology, acupuncture, hypnotherapy, and specific herbal therapies.

  4. Exercises and Exercising Tips to Manage Symphysis Pubis Dysfunction During Pregnancy:

    Here, let us know about some of the exercises which can help you manage the symptoms of Symphysis pubis dysfunction during pregnancy.

Exercises to do for Symphysis Pubis Dysfunction:

  • Pelvic tilts can be done regularly which helps in strengthening the pelvic muscles. They are also known as cat stretch. This is a yoga pose which can be used to reduce pain in symphysis pubis dysfunction. This actually aids in strengthening the core muscles and enhances stability.
  • Doing Kegels on daily basis during pregnancy can also be helpful in strengthening the muscles of the pelvis and reduce pain in symphysis pubis dysfunction. These exercises involve contracting the pelvic floor muscles. This helps balance the pelvic bones and reduce their movement which would help in reducing pain and inflammation.

Exercises to Avoid for Symphysis Pubis Dysfunction:

  • If you are pregnant and suffering from Symphysis pubis dysfunction during your pregnancy, you should minimize large pelvic movements. Avoid swimming breaststrokes and look for other strokes if you are a swimmer. Go for the exercises but be sure that the exercise you do will not aggravate the symptoms of symphysis pubis dysfunction. Apart from this, avoid the exercises which involve spreading the legs more that your hips width.
  • Avoid exercises which include lifting heavy weights.

Various Tips to Manage Symptoms in Symphysis Pubis Dysfunction During Pregnancy:

Here let us take a look on some of the tips to manage symptoms in symphysis pubis dysfunction during pregnancy.

  • Avoid strenuous exercises or prolonged standing
  • Avoid stepping over things
  • Rest your pelvis
  • Brace the pelvic floor muscles before doing any activity that might cause pain. Wear pelvic support belts
  • Sit down for works where possible; like ironing, preparing food etc.
  • Avoid straddle movements; especially while weight bearing
  • Keep away from twisting movements of the body
  • Place a pillow between the legs while resting
  • Try not to do heavy lifting or pushing.

FAQs Related to Symphysis Pubis Dysfunction:

Q: When Does Separation of Symphysis Pubis Occur?

For few women the pain begins during the first trimester of pregnancy, while some other women may experience this separation during the childbirth or even a few days postpartum. However most women with previous experience on symphysis pubis dysfunction with their earlier pregnancies will not necessarily have the issue with subsequent pregnancy.

Q: How Common is Symphysis Pubis Dysfunction in Pregnancy?

About 1 in 300 pregnant women suffer from symphysis pubis dysfunction; though experts say that more than 2% of all pregnant women will experience symphysis pubis dysfunction.

Q: Should a Woman Worry About the Delivery if She has Symphysis Pubis Dysfunction?

Birthing vaginally is not an issue even with the symphysis pubis dysfunction. However, spreading of legs should not be extreme. Squatting may be painful; however be sure you explain everything to the caregivers, nurses etc. while delivering your baby.

Q: What Would be the Recovery Time from Symphysis Pubis Dysfunction after Childbirth?

Usually women will recover within few weeks to a few months after the baby birth. If possible, carry on with exercises even after the birth and consult your doctor for best treatments of SPD.

Final Words on Symphysis Pubis Dysfunction:

Be known that SPD or Symphysis Pubis Dysfunction is a temporary medical condition affecting pregnancy or postpartum women and can resolve within few week of the delivery. However, seek experts help to minimize the symptoms like pain and prevent self from worsening the situation.

Pramod Kerkar

Written, Edited or Reviewed By:


Pain Assist Inc.

Last Modified On: April 6, 2018

This article does not provide medical advice. See disclaimer

Sign Up for Our Newsletter

We'll help you live each day to the healthiest