My story: I found a ‘support team’ to help me to manage my second pregnancy with PGP
For Aman, difficulties with PGP in her first pregnancy enabled her to find out more about the symptoms and treatment of PGP so that she felt much more aware of what she needed during her pregnancy and birth with her second daughter.
In my last pregnancy, which was four years ago, I was mobile and enjoying it until I had a serious car accident at six and a half months. Thankfully, both the baby and I were fine. At the time I was lucky because I just suffered some whiplash. However, a few weeks later, I developed pain over my pubic bone. The midwife and GP said, “Deal with it – it’s one of those pregnancy things”. After it persisted, I was referred to a physio. The NHS physio suggested a support belt (which helped take the weight off my pelvis) and gave me a few tips for managing the pain, like keeping knees together at all times and symmetrical weight carrying rather than favouring one side. I wasn’t offered any treatment by the physio such as manual therapy to help increase my mobility and reduce the pain. No-one mentioned putting anything about having PGP in my birth plan, or things to do and to avoid doing during labour which (I know now) can help to avoid the PGP becoming a long term issue. I kept being told it would disappear after birth.
Two days before the due date, I was induced because of suspected pre-eclampsia. Being a first time mum, I put all my faith in the medical team. I mentioned I had PGP, but did not realise this would be ignored, or the implications. I was totally ignorant of how bad my pelvis could become if I didn’t protect it. The epidural masked all the pain but it also made me unaware of the damage that was being done to my pelvis during the birth. In fact, I now realise that lying on my back was the worst position for my PGP. My legs were then put up in stirrups, to do the episiotomy, ventouse delivery and stitches, which I subsequently learned had further damage to my pelvis.
Once the epidural wore off, the pain near my pubic bone had reduced dramatically. I guess the buzz of a new-born was enough to reduce any pain! Apparently, a reduction in PGP symptoms does occur sometimes following the birth but it’s rare. Over the coming weeks, I was left with general aches and pains all over, but an extremely sore back. I now know this pain was misaligned SI joints but none of the nursing team recognised this possibility at the time. The front pelvic joint pain had disappeared but I still had pain at the back. This is why I assumed my PGP had gone, because I thought PGP resulted only in pubic bone pain.
In the months that followed, I had further NHS physio and was told that I was going to suffer back pain because I was breastfeeding (and therefore spending a lot of time sitting) and carrying a heavy baby. No one mentioned that the back pain may be because of stiff SI joints in particular or PGP in general. So I just coped the best I could. When my daughter was two and I was hardly ever carrying or lifting her, I was still experiencing the pain so I started to doubt what the physio had told me. The reduced mobility and pain were really making me miser-able. I was getting through day-to-day life by using pain-killers. I was feeling quite sorry for myself and generally not feeling like a happy young mum.
I then saw a private physio in the hope of further help. She gave me yet more exercises to improve my core strength and bring relief to the pain in my back. In hindsight, I now realise that she barely touched me so she couldn’t have discovered by touch that the problems were not due to my back but because of my pelvis.
After a few months, I felt marginally better due to the various exercises and decided that I might be up to trying for another baby. At five weeks pregnant that all too familiar pubic pain came back with a vengeance and my lower back was in agony. That’s when it hit me. That back pain that I had now experienced for two years, had in fact been underlying PGP. The symptoms were pregnancy-related and I hadn’t overcome the problems experienced during my first pregnancy. With some ‘googling’ on the web, I came across the Pelvic Partnership and a local Chiropractor, Verity Wills. The Pelvic Partnership website helped me understand what PGP is, and how it could become a long term problem without appropriate treatment. I called the Pelvic Partnership a few times for guidance and support. Feeling enlightened and determined to get to the bottom of this, I went to see an orthopaedic surgeon, who, after an MRI scan, said there was nothing wrong with me! My GP referred me to a pain clinic, where they would have injected my pubis with steroid injections had I not been educated about this treatable condition.
By the time I got round to seeing Verity, I had miscarried. Within a few months of seeing Verity and understanding the underlying issues related to pelvic instability, I felt better and more like my natural state before I had my daughter. Verity treated me by realigning my pelvis, releasing my joints, triggering various muscles to keep my pelvis stable. She also dealt with some of the extra issues that had been caused by not being treated properly at an earlier stage, such as upper back tension. I continued seeing Verity and joined a Pilates class to strengthen my core muscles.
A year after I miscarried, I fell pregnant again. I understood it would be a tough pregnancy and I prepared myself for the possibility of crutches or a wheelchair. However, I told myself it was a temporary hurdle which I could overcome. I felt much more confident now that I had a greater awareness of the mechanical nature of PGP, the help of the Pelvic Partnership, regular treatment from Verity Wills, assistance from an NHS physio and a reflexologist (Pauline Green of Green Mobile Therapies who had also had PGP and knew exactly which areas to treat). This time I felt it was a journey I could make and more smoothly now that I had my “support team” and knowing I would have my baby at the end of it.
Once pregnant, I swapped the Pilates for pregnancy yoga. I saw various people in my “support team” regularly. I took it carefully, week by week, each week a major milestone. My husband helped to keep me positive on down days where I was scared of pushing the baby out, or of the PGP becoming a long-term or permanent issue as every twinge felt as though my pelvis was coming apart. As four years had passed since my last pregnancy, I did find that more of the medical world was becoming aware of PGP. The subject started to appear in the maternity literature I was given where it has been missing in my first pregnancy. My midwife took PGP seriously and because I was now armed with the various leaflets and booklets from the Pelvic Partnership, those healthcare professionals who didn’t know what PGP was, were soon educated by me!
As the weeks went by it got harder to get showered, get dressed and look after my daughter. I was riddled with guilt at not taking my daughter out and merely putting the TV on for her. I kept telling myself it was temporary. We raised the bed, to make it easier to get in and out. I bought a grabber, to enable me to pick things off the floor.
I never thought I would make it beyond 30 weeks at work. I managed 34 weeks in the end because of my support team and could have done more, but I wanted some time at home with my four-year-old before her world changed forever. At 35 weeks, the NHS physio offered me crutches to take some weight off my pelvis and reassured me it would just be for occasional use, such as to get to the car, etc, as I wasn’t walking more than about 50 metres a time anyway. I turned them down because I was still shocked that I had made it so far and wanted to do the last bit on my own. Looking back, I really should have taken them, though, as it would have prevented me from over doing things! Now I know that every little bit of help is useful and my tip to other women in a similar position is: don’t be a hero and take any offer of help you are given!
I called the Pelvic Partnership who helped me put together a birth plan by giving me many positive things to think about. With their support, I realised that I could have the water birth I had dreamed of. I also found out that giving birth on all fours was better than being on my back. I measured my pain ‘free gap’ and put that at the top of my birth plan. I went to see the birth centre at 38 weeks, and tried to get in and out of the pool to see if I could manage it.
At 38+3 days I went into natural labour. I stayed home most of the day using the breathing techniques I had learnt in yoga (I had been sceptical of some of the practices learnt at yoga, but they really do work)! I was able to walk around slowly and leaned over a chair or a work surface during the contractions. I went to the hospital at 4pm and as late as I could manage so I was over the moon to be told that I was already 8cm dilated! I hobbled over to the birthing pool. I found being in the water helped immensely by taking the weight off my pelvis. Three hours later I started to push. I had a moment of fear when my baby’s head dropped. The “clunk” had me thinking my pelvis had finally given up and fallen apart – then I realised the head had dropped and we were almost there. Three pushes later and she was out.
The following day, I asked for an NHS physio to come to the ward to see me and I must thank the Pelvic Partnership for recommending this. The physio examined me confirmed that my SI joints were intact and moving well which was music to my ears! It made me realise that I’d gotten through the hardest bit without any further damage to my pelvis.
My daughter is now eight months old. I am still seeing Verity regularly for re-alignment and regular checks to make sure my pelvic joints are moving freely and that my pelvis is staying symmetrical. I am doing mummy and baby yoga to work on the core muscles. Most importantly, I can enjoy my girls. No more fear of being unable to do nor-mal things and no more painkillers. The invincible feeling that I did what I once thought was impossible, makes me smile every morning. It’s a really good feel-ing and I want other mums with PGP to experience this.
Thank you, Aman for sharing your story. It is great to hear that with your second daughter, there was more awareness of PGP amongst healthcare professionals. It is also reassuring to know that once you had more information about PGP, how to manage PGP in labour and what to do to keep your joints and pelvis moving freely, that you could have the kind of water birth you wanted and that you didn’t experience the extreme levels of pain that you had to face with your first baby.