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Pubic Symphysis Diastasis

Timika HopkinsComment
Separation is caused by the presence of the hormone "Relaxin", and the weight of the uterus and baby

Separation is caused by the presence of the hormone "Relaxin", and the weight of the uterus and baby

This one was rough…

During my first pregnancy, somewhere in the 3rd trimester, I remember feeling occasional twinges of pelvic pain.  I was active, I was happy, I was glowing and I had final exams to study for.  A little bit of pubic/pelvic pain didn’t stop me!

The next time I was pregnant…bloody hell!  I recall numerous times when I would go to stand up from a seated position, and I would get stuck midway up.  Through the tears of pain I would imagine myself as the Tin Man, and I experienced the temptation to yell out “Oil can, oil can”.  After 3-4 deep breaths, I would force my hips up into a straight stand, and watch as onlookers cringed at the “POP!” sound that followed.  My Pubic Symphysis Pain had evolved in to full blown Diastasis Symphysis Pubis.  

Sigh...the things we do for our children.

Pubic Symphysis Diastasis (PSD)

There are many names for this condition, but whether you refer to it as Pubic Shear, Pubic symphysis, Diastasis Symphysis Pubis (DSP), or Symphysis Pubis Dysfunction (SPD), the common element is that there is moderate pelvic discomfort, or even severe searing pelvic pain right above the top of the vagina in the area called the Mons Pubis.  This pain can range from frustrating to debilitating, and you should monitor and report this condition to your medical provider as soon as it begins.

Why Does This Happen?

PSD is caused when the pregnancy hormone “Relaxin” is a little too effective (overachiever!) as it works to relax and loosen the joints in the body. This hormone is so important during pregnancy.  Relaxin allows the hips to expand at the joints and ligaments in order for the baby to pass through at delivery.  While some separation in the pubic symphysis area is desirable, too much separation causes instability and shearing pain for mom.  The pain generally begins later in pregnancy as the weight of the baby and uterus increase and put more pressure on the unstable pubic symphysis area.  Some women experience pain earlier on with subsequent pregnancies.

Symptoms and Treatment:

When does the pain happen? How about when doesn’t it happen?  I only had relief from this pain when I was absolutely still, propped up on the couch, with both legs up and parallel. The pain occurred while walking, transitioning from sitting to standing (POP!), rolling over in bed or stepping up onto things like sidewalks or steps or into cars.  Keeping your legs/knees in line and parallel, helps minimize the pain tremendously.

Treatment options are temporary, but do offer some relief, which is better than nothing. Options include:

·         Applying moist warm packs to the Mons Pubis area

·         Wearing a maternity belt to keep the hips stabilized and reduce the pressure

·         Keeping legs and knees in line-no squatting, pushing, splits or crossing legs

·        Move the legs in unison when getting out of the car (yes, like a robot), and keep your knees together when you step over things or walk    (yes, like Charlie Brown)     

·         Put a pillow or wedge between your legs when you lay on your side in order to keep the hips parallel and stable

·         Wade in the water (pool class), which relieves pressure/weight on the pubic area

·         Physical Therapy with a certified provider that is knowledgeable about the issue

·         Prenatal Yoga with a certified yoga instructor (communicate about your hip issues to prior to class)


My experience with this condition was severe.  At the time I had such difficulty moving that my provider placed me on medical leave from my more physically demanding job, and also offered me prescription pain medication (which I chose to refuse during pregnancy).  This condition can be so debilitating, but if you take care, you can avoid doing permanent damage and return to having a pain free pelvis after delivery!