What Is Symphysis Pubis Dysfunction (SPD) During Pregnancy?

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Pelvic pain during pregnancy is common as your baby grows and moves, and your body prepares for childbirth. Symphysis pubis dysfunction (SPD), a cause of that pain, affects a little over 30% of pregnant people.

This article covers what SPD is, the symptoms, causes, treatment, and long-term outlook.

pregnant woman holding hands on her belly

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Definition

Symphysis pubis dysfunction describes a group of symptoms causing pain and discomfort in the pelvic region, the lower part of the torso between the abdomen and legs, during pregnancy. The pain is caused when ligaments in the pelvis start to soften and relax to prepare your body for labor.

Having relaxed pelvic ligaments is helpful during vaginal deliveries, but it can also lead to instability in your joints.

Signs and Symptoms of SPD

The first sign of SPD typically is a pain in and around the pelvis, especially when walking or climbing stairs. The number and severity of symptoms can vary from person to person.

Symptoms of SPD may include:

  • Shooting pain in your pelvis
  • Pain radiating to your legs, back, or abdomen
  • Increased pain during movement, especially when bending or shifting your weight

Pain is most common in your pelvis and around your pubic bone, the most forward-facing bone of the pelvis. For some people, the pain travels to their legs and back as well. You may also hear a grinding or clicking sound in your pelvis when moving.

With SPD, pain may increase while:

  • Walking
  • Climbing stairs
  • Shifting your weight to one leg
  • Turning over in bed
  • Putting on pants
  • Getting in and out of a car

Causes

SPD is caused by the hormone relaxin, which is produced during pregnancy to help the body prepare for labor and delivery. Relaxin softens the ligaments in the pelvis.

This hormone plays an important role in increasing the range of motion in your hip joints to allow space in which to deliver your baby vaginally.

Sometimes your body may begin to produce this hormone too early and leave your hips feeling imbalanced and overly mobile.

The baby’s position and weight play a role in SPD symptoms as well. As you near delivery and the baby moves lower toward the birth canal, symptoms tend to worsen.

Who Is at Risk for SPD?

There is little known about why some women experience SPD and others do not. However, a history of pelvic injury or trauma may increase the risk.

Complications

SPD doesn't pose any medical risk to your baby, and most women can deliver vaginally. The main problem with SPD is chronic pain. You will likely need to adjust how you go about your daily life to avoid activities that aggravate your pain.

If you have SPD, you may need to avoid or limit:

  • Carrying heavy objects—even laundry, grocery bags, or a small child
  • Crossing your legs
  • Vacuuming
  • Putting your weight on only one leg

Treatment

If your doctor diagnoses you with SPD, you may be referred to a physical therapist to help strengthen and stretch your pelvic floor, back, and leg muscles. The goal of physical therapy for SPD is to:

  • Reduce pain
  • Improve muscle function
  • Increase pelvic joint stability

Research shows performing exercises that target the pelvic floor muscles, like Kegel exercises, helps to reduce pain.

You may benefit from hydrotherapy (exercising while in water) as well. Being in the water helps to support your body and relieves pressure on your joints to allow for ease of movement.

Typically, physical therapy is the first step for managing SPD.

Medications for SPD

For severe pain, medications may be recommended to help relieve pain. If you’re experiencing significant pain, ask your healthcare provider which pain relievers are best during pregnancy.

Coping

Dealing with chronic pain can feel exhausting. There are some things you can do to help ease your discomfort if you are experiencing SPD, including:

  • Avoid movements that trigger pain: Wear clothing that is easier for you to put on and remove without pain. Avoid lifting and pushing heavy objects and taking the stairs.
  • Wear a pelvic support belt: Support belts can help brace the muscles and joints in the pelvis, making them more stable. These belts can also help support the weight of your baby, taking some of the pressure off your muscles.
  • Apply a heating pad or ice pack: Heating pads and ice packs can help to relieve sore muscles and reduce inflammation. Leave them on for a maximum of 10 minutes. After waiting 10 minutes, you can use them again, cycling them on and off as needed.

SPD and Postpartum

Often SPD resolves after childbirth, so the pain will likely improve postpartum. However, continuing to exercise your pelvic floor as your body recovers from delivery may help improve your pelvis’s mobility and stability.

Summary

Symphysis pubis dysfunction (SPD) is a group of symptoms that causes pain and discomfort in the pelvic region during pregnancy. SPD typically resolves postpartum, but if your pain level is extreme during pregnancy, speak with your healthcare provider about lifestyle changes and treatment options.

A Word From Verywell

Symphysis pubis dysfunction doesn’t directly affect the health of your baby, but it can impact how you feel during your pregnancy. At-home treatments, physical therapy, and being conscious of how you move can help to reduce pain. SPD often goes away after giving birth.

If you’re experiencing pelvic pain during pregnancy, talk with your healthcare provider for treatment options.

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