Many pregnant women are familiar with this: pulling and twinging in the pelvic area, a fairly typical side effect of pregnancy. Often the pelvis even hurts very noticeably. Then the diagnosis is often Symphysis loosening.
What is a symphysis?
This refers to a connection between two bones using fibrous cartilage. In our case, the two pelvic bones are connected in this way. You can imagine this symphysis as a kind of upright intervertebral disc, i.e. a cartilaginous connecting piece. It holds the two halves of the pelvis together at the bottom of the pubic bone in co-operation with the opposing sacroiliac joints at the sacrum and ilium.
Instead of the term "symphysis", you have probably heard the word Pubic symphysis more common. It should and must loosen as planned during pregnancy. However, if it becomes too loose, it can become painful. Let's take a closer look at the whole thing.
What is a symphysis loosening?
Various hormonal changes prepare a pregnant woman's body for the birth of the baby. The release of the hormone relaxin not only ensures that the cervix becomes softer, but also causes the ligaments, tendons, joint connections and the connection between the pelvic bones in the female pelvis to become looser and more elastic. This allows the pelvis and also the Pelvic floor and in this way make it easier for the baby to be born.
When the symphysis (pubic symphysis) widens as the pregnancy progresses, the gap between the two pelvic bones increases by three to four millimetres. Within around six months after the birth, this gap will shrink again - often unnoticed.
However, if the pubic symphysis loosens beyond the usual extent, this can affect the stability of the pelvis during pregnancy and in turn irritate the joints and the symphysis. This then leads to more or less severe pain, which usually intensifies with movement. Around half of pregnant women suffer from this condition from the second and third trimester onwards. An estimated five per cent of pregnant women have such severe pain that their everyday life is considerably impaired. This applies, for example, when walking, climbing stairs or lying on their side.
In some cases, the loosened symphysis can only cause pain after the birth - for example, if the child is born with a very high Birth weight is born and the pubic symphysis had to stretch extremely during birth.
How can you recognise symphysis pain?
I still remember well a pregnant woman I looked after who had great difficulty getting into her panties or trousers because lifting one leg caused her intense pain. Another woman sighed in the last trimester of pregnancy that she felt like a stranded whale and a waddling penguin at the same time. Such a "waddling gait" is also typical of a painful symphysis loosening. The pain can even radiate into the groin, thighs or lower back. In contrast, the pubic symphysis is relieved when walking backwards. This means that if you, as a pregnant woman, can walk a few steps backwards better than forwards, this also indicates a symphysis loosening.
In any case, you should always Midwife or talk to your gynaecologist about pelvic pain. They can feel for a loosening of the symphysis. An ultrasound examination will also provide information.
How does excessive symphysis loosening affect the birth?
In principle, a pregnant woman with excessive symphysis loosening can also give birth to her child by vaginal delivery. Excessive symphysis loosening is not a compelling reason for a vaginal birth. Caesarean section. If it is foreseeable that the child will be exceptionally large and heavy, the situation may be different, as there is then a possible risk of the symphysis tearing off during birth. However, this really only happens very rarely. The pregnant woman should discuss with her midwife or doctor in advance what is best for her individually.
For pregnant women with excessive symphysis loosening, positions that relieve the pubic symphysis, such as the quadrupedal position, are particularly recommended for labour. The supine position with bent legs, on the other hand, is not recommended.
What favours painful symphysis loosening?
Let's get straight to the point: The risk factors that favour painful symphysis loosening cannot be clearly identified. Many studies have not provided clear results on this either. Certain metabolic disorders are discussed as a cause. Smoking, heavy physical labour, obesity and rapid and high weight gain during pregnancy may also play a role.
Proven risk factors include arthritic joint inflammation, hip injuries and previous back problems. In addition, if painful symphysis loosening occurred during pregnancy, there is a high probability that it will occur again during the next pregnancy.
What helps with severe symphysis loosening?
Excessive symphysis loosening cannot be reversed. There is no corresponding medical treatment. However, you can do a few things yourself to relieve the pain, take the pressure off your symphysis pubis and strengthen the muscles. These include
- moderate protection: It is very important to avoid heavy lifting if you have excessive symphysis loosening. So someone other than you should carry your weekend shopping or your sibling. Climbing stairs frequently also puts strain on the symphysis. Therefore, "treat" yourself to a ride on the escalator or lift where possible. Also avoid long walks or even hikes and long strides. Positions that involve straddling or heavy movements, such as sitting cross-legged, cause pain, so they are now a no-go.
However, taking it easy does not mean that you do virtually nothing from now on! If you don't move, you will only increase your pain. This leads to a vicious circle: The pain causes you to do even less - but doing even less causes even more pain. And you don't want to get into this unfortunate cycle in the first place.
- gentle sport: Moderate exercise is good for you. Due to the weightlessness in the water, aqua gymnastics and swimming are very suitable for relieving the pelvis and at the same time gently strengthening the muscles. Specialised gymnastics exercises can also be used to specifically train the muscles of the pelvic floor, buttocks and torso. Targeted physiotherapy is also a good way to strengthen them.
relieving aids: To provide relief when lying on your side, a Nursing or positioning pillowthat you simply place between your legs. Your gynaecologist can also give you a so-called Symphysis belt prescribe. This is an elastic pelvic belt that is applied and stabilises and relieves pressure on the hips. An adhesive kinesiotape can also relieve the pubic symphysis. Ask your midwife if she can tape you. A gentle massage with a natural analgesic oilcan reduce the discomfort. Apply this to the lower back and the painful area around the symphysis.
- tolerable pain relief: If, despite all measures, the pain becomes or remains so severe that it becomes unbearable for the woman, painkillers can also be used. Paracetamol is considered a safe medication during pregnancy. However, the expectant mother should always seek advice from her doctor before taking any medication and should never "self-prescribe"!
