November 14, 2021

Everything to know about SPD in pregnancy

Pubic bone pain can happen during pregnancy and feels like sharp or shooting pubic bone or groin pain when you roll over in bed, take a step, stand on one leg getting dressed or get out of the car.

pregnant woman

What is SPD in pregnancy?

If you’ve had it, then you know what I am talking about. SPD in pregnancy feels like sharp or shooting pubic bone or groin pain when you roll over in bed, take a step, stand on one leg while getting dressed or get out of the car. Pubic symphysis pain, also known as SPD in pregnancy is due to an increase in hormones causing your joints to get loosey-goosey. This allows your pelvis to expand to accommodate a growing fetus but can also lead to instability and pain. Below are some tips to help with SPD in pregnancy.

What are the symptoms of SPD in pregnancy?

The main symptom will be a sharp, stabbing pain in your pubic bone or groin area.

How to go about your day with SPD? 

  • Drink plenty of water to stay hydrated. 
  • Sit down to put on your socks and shoes or shave your legs. Avoid standing when putting on socks, shoes, underwear, or pants/shorts which can make the pain worse. 
  • Get a compression or maternity support to keep your joints supported. My faves are the Serola belt and MomEZ maternity support.  You will want to wear this throughout the day and with activity, and it’s not typically necessary to wear at nighttime. Do wear a compression belt with exercise.
  • Stay symmetrical. When you sleep put a pillow between your knees and keep your legs together when getting out of the car.
  • Work with a pelvic floor physical therapist to learn to strengthen the muscles that keep this joint strong and to help prepare for birth. (Psst – we can help in an online session.)
  • Put frozen peas over your vagina to help ease pain. Place over your pants or undies for 20 minutes several times a day as needed. 

Can you avoid SPD in pregnancy? 

There are certain things you can avoid doing to help with SPD in pregnancy as mentioned above. In severe cases you can even use a rolling walker (I know, not the coolest!). You can also lean into a stroller or grocery cart to offload your pelvis a little when out and about. Standing on one leg during pregnancy can shift and shear the pubic bone joint and compromise balance. Sitting down will help minimize and prevent pain. 

What are the best sleeping positions for SPD?

To sleep with SPD, sleep on your side with a pillow between your knees and your knees and ankles in alignment. When you roll over in bed, gently squeeze the pillow between your knees to roll. You can wear the Serola belt at nighttime if you have pain. To get into bed, sit where you want your booty to land in the bed. Lie down on your side and keep your knees together or squeeze a pillow between them as you bring both legs onto the bed. Same for getting out of bed. Remember to stay symmetrical when you have SPD in pregnancy. Activities that separate the knees widely may pull on the muscles and ligaments that attach to the pubic bone and cause pain.

What exercises help with SPD in pregnancy?

You’ll want to activate your core stabilizers like your pelvic floor and deep transverse abdominal muscles with movement. Perform this contraction when you stand up, take that first step after getting up from sitting, lift your kids, etc. Below are some other tips. 

  • Avoid activities that cause your SPD in pregnancy to be worse. This may include certain yoga poses, running, lunges or activities that cause you to widely separate your knees and thus, stress the pubic bone (like a deep squat).
  • Other exercises to avoid include lunges, child’s pose, pigeon pose, a butterfly inner thigh stretch, that thigh machine at the gym, or Pilates reformer work.
  • When walking, take shorter steps.
  • When going up or down stairs try going up sideways one foot at a time. Avoid them if you can.
  • If you have SPD, remember deep squats are NOT recommended. These deep squat alternatives are great options to lengthen and relax your pelvic floor muscles and stretch the perineum for childbirth preparation.
    • Modified downward dog
    • Modified cat cow

How can you manage SPD in pregnancy?

You should work with a pelvic floor physical therapist to learn how to strengthen the muscles that keep this joint strong and to help prepare for birth if you have SPD in pregnancy. We can help in an online or in person session! Here at The Vagina Whisperer, we encourage all women to know her options (pelvic PT is one of them), make informed decisions and build her team to have the birth and after-birth experience she wants. It’s never too soon OR too late to get pelvic floor PT. If you want more stretches, or stretches tailored to you and your body, schedule an in-person or online session with our pelvic floor PT team.

Hope this helps keep your lady bits from lighting up!

P.S. Have back pain in pregnancy? Check out these physical therapist recommended exercises. 

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Are you currently pregnant or planning to conceive? If so, make sure to download my FREE resource — 5 Myths We’ve Been Told About Pregnant Bodies!  I correct common pregnancy myths and give you tons of tips to help you feel strong and healthy for 40 weeks and beyond.
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Sara Reardon PT, DPT, WCS is the owner of NOLA Pelvic Health and founder of The Vagina Whisperer, a resource for online pelvic health education and therapy to help women worldwide with pelvic health conditions. She is a board certified women’s health physical therapist with a special interest in treating pelvic pain and pregnancy and postpartum conditions. She is a mom, wife, Saints fan and wanna be yogi.

Some links may be affiliates. This means we may make a small commission if you make a purchase. The products we recommend on this website and in blog posts are always products we use ourselves or recommend to clients. Thank you for supporting us in our mission to revolutionize women’s healthcare.

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