Posted by Madeleine Speed, the Pelvic Partnership, February 2016
Exploring techniques and approaches that could help
On 23rd February 2016, NHS England announced the outcome of the Maternity Review which has been taking place over the past year. We contributed by attending the Birth Tank event as well as one of the listening events, and raised the profile of Pelvic Girdle Pain (PGP) with the review team. We are really pleased to see the focus on choice in the final report, and hope that this will improve things for women with PGP. A pilot project will start later this year ahead of a full roll-out in 2017. The aim is to improve safety and enable women to exercise real choice about their pregnancy and birth, particularly about where to have their babies. Although current maternity services are already underpinned by a policy of encouraging choice, evidence suggests that women are not routinely offered the range of options available and this certainly seems to be reflected by the statistics where a large percentage of women are giving birth within hospitals. In 2014, of 664,543 births in England, 87% were in hospitals, 11% in midwife-led units and 2% at home, although almost half would have preferred to give birth in a midwifery-led unit and 10% would have preferred to be at home .
Do you feel you are getting what you want?
This news item about encouraging choice prompted the topic of this month's blog. The NHS has a policy of women-centred care and this should be apparent to us as women with PGP both in terms of seeking treatment for it but also in the support we receive to exercise choice in where and how we give birth to our babies. Do you feel you are getting what you want?
Sometimes it's easy to get what you want: a GP appointment is offered at exactly the date and time you requested, the book you'd like suddenly becomes available at a sale price, or the plumber responds immediately to your call to fix a leak. Sadly, it isn't always that simple and it can feel that, on balance, the disappointments outweigh the successes. This is where taking a step back can help and a new focus on factors that might influence the successes over the setbacks. If you compare the occasions when there's a successful outcome concerning your PGP, with times of failure, you might see a useful pattern. There may be ways for you then to exert an influence over events so that the successes outnumber the failures. You might find that all it takes is a slight shift in technique, approach or perspective to get you what you want more often. So read on, compare notes and see if this tactic can work for you in your quest to get what you want with your PGP.
There are some wonderful healthcare professionals out there. Sometimes it is hard to find them and many of us may have encountered one or two who haven't been well informed about PGP and how to treat it. We may not be responsible for how professionals respond to us but we can take responsibility for acknowledging that something isn’t right with our health and that we need to be directly responsible for taking action individually to get help.
With PGP, what we say and do can often reveal whether or not we are really taking responsibility for our health. Are we prone to just grumble with frustration or to use that dissatisfaction to drive us on to finding a way forward? For example, we could be proactive in sending off for information, finding out about the condition, talking with friends, family or healthcare professionals we meet about it in case they know anything that would help. It can be time-consuming and difficult at times but this can also be a source of great satisfaction when you know your efforts have delivered a little progress. The fact that you have got this far in reading the blog suggests that you are motivated to push for more help (and we hope that exploring the Pelvic Partnership website, as a further step to demonstrate your persistence, will find you both support and up-to-date information about PGP).
Getting what you want and need from your care
What experience do you have of approaching a healthcare professional for help in combating PGP? GPs and midwives can make referrals to an NHS physiotherapist for an assessment and diagnosis of PGP. When PGP is diagnosed, the physio should then outline a proposed treatment plan to you which ideally includes the use of 'hands on' manual therapy. Within the Pelvic Partnership team, some of us found relief from PGP symptoms with our first contact with a physio (or an osteopath or chiropractor) while for others it took a while to find one who seemed to be 'right for us'. You will want to find someone who knows their facts and also has a good 'bedside manner'. However, even if this person seems well-informed, if they don't appear to be listening to you or responding to what you ask or say, then they may not be the best person to help you get what you want.
Click here for the next part of 'Are you getting what you want?' we will explore the kinds of questions you could ask your GP, midwife or physio.