Natural Birth

Has anyone had an unmedicated birth with SPD?

I had SPD last time.  It got pretty painful starting at 32 weeks and just increased in intensity from there until I went into labor at 41 weeks.  All I remember from labor was how terribly my pelvis hurt.  DS was posterior and I felt no back pain, I didn't feel pain from contractions, but I knew I was having a contraction because it felt like my pelvis was going to break it hurt so badly.  Also, my epidural didn't work BUT the complications from the epidural kept me confined to the bed and only able to labor on my left side. 

Anyway, I was really hoping not to deal with SPD this time, but for the last week or so I feel that same pain creeping in.  It's really mild right now, but I really think it's probably going to progress from here.  I talked to my MW about it for the first time today and she's SO much more helpful that the stupid practice I was with last time (whose advice was "it'll go away when you have the baby, nothing you can do about it until then") so I have a few things I'm going to try to help (support belt, and I'm also going to look into chiropractic care).

My question is has anyone had an unmedicated birth with SPD?  As I said above, the pain in my pelvis was brutal during labor last time.  Obviously I don't know for sure if I'll get SPD that bad again this time, but of course it's on my mind.  My MW did say that there are more favorable positions for laboring that they will encourage if it's a problem to help with the pain/pressure, but... ugh, I'm just so nervous about it all.  I totally believe in my ability to handle natural contractions, but the whole pelvic pain thing is kind of a wrench in the natural process! 

FWIW I'm starting a Hypnobabies course on Saturday and I'm also going to ask my instructor about this specifically.  I hope Hypnobabies will be able to give me tools to mute the pain during labor!

Anyone have thoughts or experience with this?

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Re: Has anyone had an unmedicated birth with SPD?

  • I had SPD with #3.  She was also posterior like your SPD baby.  I had an unmedicated homebirth.

    You can do it!

        
  • I had postpartum SPD with DS and now have it with this pregnancy. Some days it's okay, others days it's terrible. I am still running a bit but I seem to have a flare up after every run so probably need to stop and go to power walking instead.

    So, I don't really have advice on going unmedicated with it for labour. Hoping to have a home birth again.

    I'm going to start seeing a chriopractor and I am taking some prenatal yoga which should help with some of the pain.

    I know it's that catch-22 of working out sometimes flares it up but it can also help. Are you able to stay active now? I am weight training twice a week and hope to keep that up because I'll need that glute/hamstring/quad strength to keep my pelvis in check.

    Also hoping for a slower pushing phase this time. I think my very fast, and very painful pushing phase with DS was the start of the post-partum SPD last time around. I never felt the ring of fire but I did feel like my pubic bone was being broken in half when he crowned. Can't even blame a large head because he was average sized :(

    Have you found anything that helps ease that pain now? I'd see if counter pressure or certain stretches, maybe a hot bath, help. Then you can have those up your sleeve to use in labour.

    Good luck!

     

     

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  • image+adamwife+:

    I had SPD with #3.  She was also posterior like your SPD baby.  I had an unmedicated homebirth.

    You can do it!

    Thanks for the encouragement :)  

    Did it make for a more painful labor?  I assume so, but you got through it and that's the important part!  

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  • imagebandwife:

    I had postpartum SPD with DS and now have it with this pregnancy. Some days it's okay, others days it's terrible. I am still running a bit but I seem to have a flare up after every run so probably need to stop and go to power walking instead.

    So, I don't really have advice on going unmedicated with it for labour. Hoping to have a home birth again.

    I'm going to start seeing a chriopractor and I am taking some prenatal yoga which should help with some of the pain.

    I know it's that catch-22 of working out sometimes flares it up but it can also help. Are you able to stay active now? I am weight training twice a week and hope to keep that up because I'll need that glute/hamstring/quad strength to keep my pelvis in check.

    Also hoping for a slower pushing phase this time. I think my very fast, and very painful pushing phase with DS was the start of the post-partum SPD last time around. I never felt the ring of fire but I did feel like my pubic bone was being broken in half when he crowned. Can't even blame a large head because he was average sized :(

    Have you found anything that helps ease that pain now? I'd see if counter pressure or certain stretches, maybe a hot bath, help. Then you can have those up your sleeve to use in labour.

    Good luck!

     

    In researching SPD I saw some talk of it happening with birth/postpartum, that's crazy!  It did take me a while to heal from it completely postpartum.  It slowly got better though.  I'm just remembering the pain now and even though what I'm experiencing is totally mild it just bring it all back :(

    Staying active IS a catch-22.  It definitely seems to make it worse.  I've been trying to get out for regular walks, but anything more high-impact definitely has a negative effect.  Pretty much anything but laying down tends to have a negative impact, but obviously that's not helpful or realistic. 

    I have been doing pelvic rocks, which is supposed to be helpful with pelvic pain as well as with sciatic nerve pain, which I get too.  I think I mentioned in my OP that I'm going to try to get in with a chiropractor.  My MW actually recommended one that works with a lot of pregnant women and is trained in Webster so maybe she'll have some suggestions on stretches or something along those lines that might help in addition to adjustments.  I'll definitely ask and do some looking around on my own to see if I can find some recommendations.  

    I'm so annoyed that this is all starting up again.  I'm trying to remain positive because I KNOW I might have a different experience than last time, but I'm just getting nervous/scared since the pain is starting up again and it just got so bad last time.

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  • Like you, I had SPD starting around 32wks with DS2.  It was rough.  I managed to stay active and still do light exercise routinely...all in all, it was probably a mild case (someone on my BMB was in a wheelchair for months).  It didn't bother me at all during labor, weirdly enough.  I was unmedicated, and the ctx felt much like I remember them feeling with DS1 (no SPD with him).  Take it one ctx at a time, and see how it goes.  Good luck!
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  • imagesbevmc09:
    image+adamwife+:

    I had SPD with #3.  She was also posterior like your SPD baby.  I had an unmedicated homebirth.

    You can do it!

    Thanks for the encouragement :)  

    Did it make for a more painful labor?  I assume so, but you got through it and that's the important part!  

    #3 was definitely my most painful labor.  It was also my longest.  I've had two posterior babies, but something about the positioning of #3 was really rough.  I still had the bad back labor and oddly enough, the SPD symptoms got better as the labor progressed.  I'm not sure if it's because the pain was all blending together or if as she moved down it changed the position of my pelvis and things felt different.

    But my SPD symptoms went away very shortly after the birth, which was wonderful.

    I'm fortunate to be married to a physical therapist/massage therapist.  He gave me exercises to do to help during the pregnancy.  I highly recommend doing some physical therapy if it flares up again on you this time!

        
  • There are several schools of thought on this. One is bedrest and a c-section. There is no evidence that this is helpful. It just is all part of the medicalized/OB-controlled/use intervention as a preventative strategy school of thought. The other is the opposite--stay active and have a NB (an epi is contraindicated because the pain can guide a woman from over-spreading her legs during delivery). 

    With DS1, I made it through 55 out of 63 hours of labor with no meds. He was OP and then OT in labor. Near the end, I elected an epidural--I think my pelvis misalignment was preventing him from coming down and the epi helped. I was in a hospital and though I had a doula, we just hit a wall with knowing how to deal and I was no longer allowed in the tub, my strength was giving out, and the OB on call was not supportive and was pushing a c/s and an epi was a worthwhile compromise in that setting.

    In contrast, I had a CPM for DS2 and we focused on my pelvis through the whole PG. I had regular chiro care which kept it manageable. I had DS2 in a natural birth center with no meds. He was 3 pushes from being a water birth (last-minute complication and I had to get out during pushing). WB is GREAT for SPD!  It was an awesome birth and great recovery. I go days without pain now and am only 7 weeks PP.

    Below is a C&P all I've learned through my extreme journey with this. I wrote it at different times, hence the different POVs...

    I went diastatic as 24 weeks pregnant with DS1 (meaning my that bottom part of my pelvis actuall seperated, a diagnosis beyond SPD) and then had all sorts of rare related craziness post-partum that landed me in pelvic PT until he was 9 months old. I won't get into the gory details since they won't apply to 93% of people who do have SP loosening during PG and heal quickly and easily after delivery, but here are some thoughts that might help you...

    Your pain will very much depend on how much your ligaments loosen and what your pain tolerance is. I was able to walk and work until baby was born at 40+ weeks. I was in pain, but stitting or laying for too long also caused pain. So, it was mentally healthier for me to keep moving around and stay busy. Plus, being active is good for your overall body, healthy, weight, etc. It is tough to find the balance of gentle activity vs. pain, but every woman's body will give her different cues on where the line falls. I have learned that though the pain is intense with activity, it doesn't cause damage to the body (unless you over-spread your legs). In that PG, I was afraid of hurting my body through too much movement. With PG2, I felt empowered knowing that movement was only good for me.

    One thing I wish I had done was seen a chiropractor who specializes in pregant women (optimally one who knows the Webster Technique) and focused on optimal fetal positioning even more than I did. SPD (which actually is called Pelvic Girdle Pain these days-- a name that ecompasses a variety of pelvic instability issues) is associated with non-optimal fetal positioning which can mean tranverse or breech baby and a c/s or OP which is a difficult way to labor.  Plus, a chiro can actually put things back in place. Even if the ligaments don't hold, it provides some relief. I saw a chiro though all of PG2 and it made a HUGE difference. I would feel some relief right after the adjustment, then increased sorenes, and then 1.5 days after the adjustment I would feel amazing. Not all adjustments took. Sometimes my body was just too loose. But, it did work most visits. I did 1x per month early in the PG moving to 1x per week at the end.

    With PG2 my separation started at 20 weeks. When my pelvis falls out of alignment, a quick, gentle adjustment gets it back into place. Exercise also comes into play here, as strong muscles in the thighs, stomach, and pelvis all help to hold the ligaments in place. Walking is nature's perfect exercise. Hold your abs in (like a string in pulling your belly button in) as much as possible when walking to support the lower back, also, practice kegels while walking. This will help keep things strong down there.

    Here is the go-to book on this: https://www.amazon.com/Relieving-Pelvic-During-After-Pregnancy/dp/0897934806

    Other thoughts...

    -Last PG I slept with a pillow between my knees. This PG, I just use a thick blanket. I think the pillow was too wide. Knees should be mo more than hip-width apart. Not all practioners agree that back sleeping is out. My MW is fine with it. If it hurting my body or baby, my body will protect itself and wake me up.

    -The Prenatal Cradle Plus V2 belt was helpful-ish in my last PG, though I did not wear it every day. On desk-work days I skipped it because it is uncomfortable to sit in.  Also, our floors at home are wood and springy and gentle on my body?especially when I wear shoes. Oh, that is a big thing I learned?shoes really help cushion things and keep the pain away for longer. On active days at work when I was on my feet a lot (and on the unyielding floor, which is carpet over concrete slab), the belt makes it MUCH better.  This PG, I sometimes bind my hips with a woven wrap for babywearing over the prenatal cradle because the wrap gets so much snugger and gives a custom fit. But, optimally I do not bind at all. I have the chiro get me back into place and then I let my body use its naturral strength to cope. I did pelvic PT after DS was born and the PT also encouraged not relying on a belt. My chiro sees no harm in doing an SI belt sometimes, namely at night, So, obviously opinions vary.


     -This website is one of the first things I found that was helpful. While this is a lay-person?s site, her tips on keeping legs together when getting in and out of the ca and bed, sitting when putting on pants, etc. are little things that make a big difference: https://www.plus-size-pregnancy.org/pubicpain.htm

    -Swimming and soaking in the tub also feel great. Swimming  and water walking is not advisable for all people with this. The resistance of the water can be too much for some people. In that case, tread water using the arms and not the legs for exercise. The flip side is that swimming is incredible for strengething the body. So, do what your body is comfortable with. This PG, swimming is like magic. I stick to flutter kicks versus froggy legs and water-walking and it makes a huge difference.

    -In my 1st PG, I personally had a terrible time with OBs taking even my extreme case seriously and getting any advice other than "it happens, there is nothing you can do, take some pain meds". I am seeing a midwife this PG and the mindset is so, so  different. Do not be afraid to get as many opinions as needed to feel supported. When looking at care for this birth, I met with yet another OB and asked how he would approach this and he said bedrest and a c-section, which is the absolute opposite of everything I have learned. Needless to say, we didn't go with him. The midwife we ended up picking has has SPD herself, so finally feel believed, validated, and given resources and support.

  • imagepixieprincss:

    There are several schools of thought on this. One is bedrest and a c-section. There is no evidence that this is helpful. It just is all part of the medicalized/OB-controlled/use intervention as a preventative strategy school of thought. The other is the opposite--stay active and have a NB (an epi is contraindicated because the pain can guide a woman from over-spreading her legs during delivery). 

    With DS1, I made it through 55 out of 63 hours of labor with no meds. He was OP and then OT in labor. Near the end, I elected an epidural--I think my pelvis misalignment was preventing him from coming down and the epi helped. I was in a hospital and though I had a doula, we just hit a wall with knowing how to deal and I was no longer allowed in the tub, my strength was giving out, and the OB on call was not supportive and was pushing a c/s and an epi was a worthwhile compromise in that setting.

    In contrast, I had a CPM for DS2 and we focused on my pelvis through the whole PG. I had regular chiro care which kept it manageable. I had DS2 in a natural birth center with no meds. He was 3 pushes from being a water birth (last-minute complication and I had to get out during pushing). WB is GREAT for SPD!  It was an awesome birth and great recovery. I go days without pain now and am only 7 weeks PP.

    Below is a C&P all I've learned through my extreme journey with this. I wrote it at different times, hence the different POVs...

    I went diastatic as 24 weeks pregnant with DS1 (meaning my that bottom part of my pelvis actuall seperated, a diagnosis beyond SPD) and then had all sorts of rare related craziness post-partum that landed me in pelvic PT until he was 9 months old. I won't get into the gory details since they won't apply to 93% of people who do have SP loosening during PG and heal quickly and easily after delivery, but here are some thoughts that might help you...

    Your pain will very much depend on how much your ligaments loosen and what your pain tolerance is. I was able to walk and work until baby was born at 40+ weeks. I was in pain, but stitting or laying for too long also caused pain. So, it was mentally healthier for me to keep moving around and stay busy. Plus, being active is good for your overall body, healthy, weight, etc. It is tough to find the balance of gentle activity vs. pain, but every woman's body will give her different cues on where the line falls. I have learned that though the pain is intense with activity, it doesn't cause damage to the body (unless you over-spread your legs). In that PG, I was afraid of hurting my body through too much movement. With PG2, I felt empowered knowing that movement was only good for me.

    One thing I wish I had done was seen a chiropractor who specializes in pregant women (optimally one who knows the Webster Technique) and focused on optimal fetal positioning even more than I did. SPD (which actually is called Pelvic Girdle Pain these days-- a name that ecompasses a variety of pelvic instability issues) is associated with non-optimal fetal positioning which can mean tranverse or breech baby and a c/s or OP which is a difficult way to labor.  Plus, a chiro can actually put things back in place. Even if the ligaments don't hold, it provides some relief. I saw a chiro though all of PG2 and it made a HUGE difference. I would feel some relief right after the adjustment, then increased sorenes, and then 1.5 days after the adjustment I would feel amazing. Not all adjustments took. Sometimes my body was just too loose. But, it did work most visits. I did 1x per month early in the PG moving to 1x per week at the end.

    With PG2 my separation started at 20 weeks. When my pelvis falls out of alignment, a quick, gentle adjustment gets it back into place. Exercise also comes into play here, as strong muscles in the thighs, stomach, and pelvis all help to hold the ligaments in place. Walking is nature's perfect exercise. Hold your abs in (like a string in pulling your belly button in) as much as possible when walking to support the lower back, also, practice kegels while walking. This will help keep things strong down there.

    Here is the go-to book on this: https://www.amazon.com/Relieving-Pelvic-During-After-Pregnancy/dp/0897934806

    Other thoughts...

    -Last PG I slept with a pillow between my knees. This PG, I just use a thick blanket. I think the pillow was too wide. Knees should be mo more than hip-width apart. Not all practioners agree that back sleeping is out. My MW is fine with it. If it hurting my body or baby, my body will protect itself and wake me up.

    -The Prenatal Cradle Plus V2 belt was helpful-ish in my last PG, though I did not wear it every day. On desk-work days I skipped it because it is uncomfortable to sit in.  Also, our floors at home are wood and springy and gentle on my body?especially when I wear shoes. Oh, that is a big thing I learned?shoes really help cushion things and keep the pain away for longer. On active days at work when I was on my feet a lot (and on the unyielding floor, which is carpet over concrete slab), the belt makes it MUCH better.  This PG, I sometimes bind my hips with a woven wrap for babywearing over the prenatal cradle because the wrap gets so much snugger and gives a custom fit. But, optimally I do not bind at all. I have the chiro get me back into place and then I let my body use its naturral strength to cope. I did pelvic PT after DS was born and the PT also encouraged not relying on a belt. My chiro sees no harm in doing an SI belt sometimes, namely at night, So, obviously opinions vary.


     -This website is one of the first things I found that was helpful. While this is a lay-person?s site, her tips on keeping legs together when getting in and out of the ca and bed, sitting when putting on pants, etc. are little things that make a big difference: https://www.plus-size-pregnancy.org/pubicpain.htm

    -Swimming and soaking in the tub also feel great. Swimming  and water walking is not advisable for all people with this. The resistance of the water can be too much for some people. In that case, tread water using the arms and not the legs for exercise. The flip side is that swimming is incredible for strengething the body. So, do what your body is comfortable with. This PG, swimming is like magic. I stick to flutter kicks versus froggy legs and water-walking and it makes a huge difference.

    -In my 1st PG, I personally had a terrible time with OBs taking even my extreme case seriously and getting any advice other than "it happens, there is nothing you can do, take some pain meds". I am seeing a midwife this PG and the mindset is so, so  different. Do not be afraid to get as many opinions as needed to feel supported. When looking at care for this birth, I met with yet another OB and asked how he would approach this and he said bedrest and a c-section, which is the absolute opposite of everything I have learned. Needless to say, we didn't go with him. The midwife we ended up picking has has SPD herself, so finally feel believed, validated, and given resources and support.

    This is awesome!  Thank you so much for sharing and all the info!  I'm going to read through it all more carefully tomorrow when I have more energy to digest everything :)

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  • I also had postpartum SPD with my first. It was by far the worst part of my recovery. I found that seeing my chiropractor helped the most. I was concerned that it would reappear with my second pregnancy, and it did, at about 20 weeks. I continued to see my chiropractor and did prenatal yoga, which helped. I used ice on it almost every night. I was determined to do everything possible to minimize doing further damage during labor this time, but my plans flew out the window when I had a precipitous labors that lasted just over an hour. I pushed on my back again, which I swore I wouldn't do, but baby was out with just a few pushes. I went completely med-free again. I'm happy to say that my SPD has barely been an issue during recovery this time. I'm definitely going to the chiropractor soon just to get checked out, but I am up and moving around so much better than last time. I certainly think that alternative medicine/therapies are the way to go with SPD. Even my OB said that the chiropractor would be able to do more for me than he could.
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  • I had SPD with DD and I had a great med-free birth.  I remember being worried about SPD being a problem during labor, but I have no recollection of any SPD pain at all during labor and didn't experience any SPD pain post-partum.

    I have it again this time (currently 34 weeks and its been here since around 24 weeks). 

    I definitely find that modifying movement to keep weight balanced between both legs (as mentioned by another poster) such as sitting down to put pants on, getting in/out of cars a different way (e.g. sit first and then keep legs together to swivel front / swivel to the side and then step out with both feet) really make a difference.

  • I had/have SPD and had a natural birth. It wasn't planned TBH, but I had a precipitous labor and there was no time for an epi. And the pain was severe, I won't lie. It was like one long nonstop contraction that lasted 3 hrs. I wasn't able to distinguish between contraction pain and pelvic pain. End result was hypoxia me and bradycardia DS which led to episiotomy and vacuum extraction.

    Before birth, I read Ina May's guide and took an autogenesis birthing class with the intention of trying to go natural for as long as possible. But in reality I was in so much pain that I couldn't even begin thinking about any of the techniques.

    I think that had my labor been more drawn out, with the chance to gather my wits about me between contractions, I probably could have dealt with the pain easier and perhaps been ok with going natural. I actually frantically asked for an epi but there was no time and frankly I found labor rather traumatic. I know I can deal with contractions though as I went into labor with DD 1/2012 ended in ECS and I had SPD with her as well. The pain was nowhere near like what it was with DS and with her I likely would have been ok mentally I mean with a med free birth.
  • I had SPD starting really early last time. Like, early second tri. It was awful. I wanted so badly to keep up with yoga and I just couldn't. My labor was really intense from the start and I don't recall even thinking about pelvic pain. I had an OP baby and was transferred to the hospital after 5 hours of pushing. I ended up getting an epi so I could rest so his actual birth wasn't med free but no labor position bothered me prior to that, even squatting. I don't know if hormones and adrenaline took over but I hadn't been able to squat my entire pregnancy. Hope that helps some...

    I found this article helpful. Someone else posted it a while back. Ignore the website name. It really has nothing to do with plus sized pregnancy. I'd suggest seeing a chiropractor. I wonder now if my pelvic issues actually caused DS to be malpositioned. Some are certified to do something called the Webster Technique and there is a way to locate those chiros through the main chiropractor organization website. I can't remember the name of the organization.

    https://www.plussizepregnancy.org/pubicpain.htm
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