Unfortunately, a few women do have pain for a long time after giving birth despite receiving good manual therapy. However, they are in the minority, and the information in this website aims to improve your chances of making a speedy recovery. Even if you are told there is no further treatment available, this is rarely the case. Read on to see the options available to you. If you need additional information once you have read this, or are still not progressing despite receiving good manual therapy, please call us on 01235 820921 to talk through your options.
From time to time you may find that you have a setback in your progress to recovery: a sudden return of pain or immobility. Usually this occurs because you have simply pushed yourself a little too hard, undertaken a particularly strenuous activity or simply contorted your body into an awkward position (playing on the climbing frame in the park seems to be a common culprit!). Sometimes there is no reason for the setback – it just happens. There is no need to panic – it does not mean that you have permanently damaged your pelvis or that you are back to square one on the road to recovery. Seek further treatment from a physiotherapist, osteopath or whoever you found helpful, and expect to return to your previous level of activity.
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 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. Most women with PGP regain their mobility and function with good manual therapy; the memory of the pain and problems subsides but the joy of the baby remains.
A number of women report increased pain or a recurrence of symptoms following gynaecological interventions such as a D&C. If you have to undergo something like this, make sure that the people caring for you are aware that you have, or have had, PGP, and they take care when placing you in stirrups or moving you while you are anaesthetised. You need to take the same kind of precautions as you would for birth. 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..
When their periods restart, some women find that their PGP pain recurs. This seems to be due to the subtle hormonal element of PGP which shows up any underlying joint alignment problems. Most women find that if they take this as a signal that they still have a bit of an alignment/joint asymmetry problem, manual therapy will sort it out.
It is worth continuing with hands on treatment from whoever you have found to treat you effectively as long as you feel you are making progress. If you feel you are not progressing, discuss this with your manual therapist, review your treatment and investigate alternatives. Take a look at our 'What to do if treatment is not helping' page for more information.