If you had PGP during one pregnancy, it is common, although not inevitable, that it will recur in subsequent pregnancies, but the PGP may start earlier and be more painful if left untreated. However, if you actively treat your PGP with manual therapy from the start, you may find that your symptoms respond well and are less troublesome than in your previous pregnancy.
If you had severe problems last time and think this may happen again, you can proactively plan what assistance you are likely to need and arrange it in advance rather than reacting to emergencies. It is also worth considering how old your existing child/children will be when the new baby arrives and how independent they will be for nappies, walking etc, and how you will manage this during a pregnancy if you are not very mobile.
There are no hard and fast rules on the time you should leave between pregnancies but, generally speaking, it is helpful to recover as best you can from one pregnancy before embarking on another. Good general fitness and being pain-free and back to your previous level of mobility/activity will give you the best possible chance of managing PGP well in a subsequent pregnancy. It is worth seeking treatment and advice as soon as you become pregnant again or even while you are planning your pregnancy – actively keep your PGP at bay as long as possible rather than passively waiting to see if it recurs. This can also help you to feel in control of your PGP rather than the other way around.
If you have had PGP it can seem that everyone has an opinion on whether or not you should have another baby. Whilst this concern is often well meaning, it is misplaced. Ultimately, the decision whether or not to have another baby is yours and your partner’s only – nobody else counts. Remember that having a baby is not just about pregnancy, birth and the early months.
If you have or have had PGP you may need to take extra care when undergoing gynaecological treatments or interventions, including D&C, smear tests, internal examinations or termination of pregnancy, or anything where you are asked to open your legs wide apart. You will know your own body and its limitations or when you feel particular pain or a flare-up in symptoms, so it is important to explain this to healthcare professionals so they can take extra care.
If you have to undergo a gynaecological treatment or intervention, make sure that the people caring for you are aware that you have, or have had, PGP. Make sure they take care if placing your legs in stirrups or moving you while you are anaesthetised. You need to take the same kind of precautions as you would for birth, such as avoiding moving your legs apart if this causes you pain, to reduce the chances of irritating your pelvic joints. Make sure everyone is aware of your previous PGP, how badly affected you were, and how concerned you are about the possible consequences if this is not taken seriously. It is another situation where good communication beforehand can save a lot of pain afterwards.
Some women report increased pain during their periods/ovulation. It might mean that one or more of your pelvic joints are still slightly stiff, which is likely to improve with further manual therapy treatment. Some women find that they still have increased pain at this time despite good treatment and this may be due to hormones. Whilst PGP is not caused by hormones, the link between hormones and the perception of pain is interesting and is the focus of many research studies.
If you consistently experience severe pain around the time of your periods it is important to discuss this with your GP who is likely to refer you to a gynaecologist or pain clinic to explore this further. It is important to remember that PGP is not the only cause of chronic pain; you may find it helpful to read our ‘If it’s not PGP, then what could it be?’ page.
Content added in 2017.
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