Woohoo.. 30 weeks pregnant with Dot and I’ve started feeling different symptoms of the third trimester.

I constantly catch myself waddling like a little ducky, despite my conscious efforts NOT to do so. Honestly it’s difficult to walk properly, so i figured I might as well just let go and walk whichever way is most comfortable for me. I have the best excuse ever. I’m pregnant.

Morning sickness is back, although it’s not as severe as during the first few months. It’ll come about once a week and I’d be back fighting nausea and headaches. The only thing that’ll help is a nap and a good rest, so there have been times when I took myself off work as I couldn’t hold my head up. Sigh. I hope the bosses don’t think I’m just skipping work for fun or anything like that.

However, that is NOTHING compared to the sharp back pain that I have been facing over the past few days. Sometimes it gets so bad that I walk with a limp. At first I thought it was sciatica. After reading up more on pregnancy issues and syndromes, I realize that I am actually enduring Pelvic Girdle Pain or PGP for short.

So I thought I’d share this little bit of info I found on PGP with all of you Doodlers. For the expecting mommies, may this info be useful for you if you ever experience the pelvic pain that I am experiencing and for the non preggo Doodlers, mayb this help you understand a little better when you see a waddling big bellied lady walking with a limp and her face contorted in all efforts to try and bear the pain.

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What happens to the pelvis during pregnancy?

During pregnancy your body produces a hormone called relaxin, which softens the ligaments (the tough, flexible tissues that connect your bones) in your pelvis and other joints. This helps your baby to pass through your pelvis during birth. As a result, these joints move more during and just after pregnancy (Kristiansson 1997; Bjorkland et al 1999; 2000).

What causes pelvic pain ?

It’s thought that this softening combines with changes in your body to put too much stress on the joints, ligaments and muscles of your pelvis (Buyruk et al 1999; Damen et al 2001). These changes are in your posture, muscle strength and in the way the left and right joints in your pelvis work.

Normally, when you lie down, stand up or walk, your pelvis is in a locked, or stable, position. Women who suffer from pelvic pain are thought to do these activities with a less stable, or unlocked, pelvis (Hungerford et al 2004).

The result is swelling or pain. About half all pregnant women and about a quarter of women who have already had a baby are thought to have some sort of back or pelvic pain in pregnancy (Wu et al 2004).

What is pelvic girdle pain (PGP)?

Pain at the back of the pelvis is known as pelvic girdle pain (PGP). It is sometimes also called sacro-iliac joint (SIJ) pain, because that is the name of the joint where problems arise. PGP is often misdiagnosed as sciatica. Only a few women, just one per cent, have sciatica during pregnancy. We now know that most lower back or leg pain in pregnancy is PGP (Ostgaard et al 1994).

If you feel pain on or around your pubic bone at the front, you may have symphysis pubis dysfunction (SPD), a condition to do with ligaments in another part of your pelvis.

What are the symptoms of PGP?

The pain is often one-sided and may be concentrated in your buttocks (Sturesson et al 1997). It may appear to jump from side to side or be accompanied by a general back pain or pain at the front of your pelvis.

It can send shooting pains into your buttocks or down the back of your legs. You may also have pain in your hips. One or both of your legs may feel very weak and you may not be able to lift your legs, particularly when lying down (Mens et al 1999).

I’m definitely having the pain at the back of the pelvis

What makes the pain worse?

The pain is usually made worse by lying on your back, turning over in bed, walking and standing from a sitting position. It is often worse at night and the amount of night pain you feel will probably be related to how active you are during the day. Moving your legs apart, especially when sitting in a slumped position or lying down, can be painful.

This is spot on, I was wincing in bed the whole night whenever I wanted to change positions. I guess the school session on Thursday triggered it as I was standing and walking about most of the time. Also, my enthusiastic shopping session around Midvalley Megamall with mom and sis earlier during the day would explain why the pain intensified yesterday night.

At what stage in pregnancy does it happen?

PGP can begin as early as the first trimester or as late as the last few days before giving birth. If the pain comes on at the very end of your pregnancy, it may be because your baby’s head is engaging, or moving down into the pelvis. If this is the case, it is unusual to have pain after giving birth.

If you experience PGP in one pregnancy, it is more likely to recur earlier in your next pregnancy, and without treatment, may be more severe. Health professionals advise letting the symptoms from one pregnancy settle before trying for another baby.

How is it diagnosed?

PGP is not widely understood. You may have been told by your doctor, midwife or physiotherapist that you have sciatica. If possible, ask to see a physiotherapist with a qualification from the Association of Chartered Physiotherapists in Women’s Health who is experienced in treating joint complaints. If you see a chiropractor or osteopath, make sure that they are experienced in treating pregnant women.

Your health professional should assess the stability and any irritation of your pelvic joints (Kristiansson and Svardsudd 1996; Vleeming et al 2002; De Groot et al 2006), examine your back and hips to make sure the problem is not coming from these joints, and take a detailed look at how the muscles of your tummy, back, pelvis and hip are working.

How is it treated?

A number of tactics can be used:

Be careful during every-day activities. Your physiotherapist can show you how to lock out your pelvis during painful movements such as walking or standing up.

You may be given a pelvic support belt. For about eight out of 10 women, these give immediate relief and can be worn safely during pregnancy (Mens et al 2006; Ostgaard et al, 1994; Vleeming 1992).

Exercises, especially for the tummy and pelvic floor, improve the stability of your pelvis and back.

Your physiotherapist can gently manipulate your hip, back or pelvis to loosen stiff areas.

Acupuncture may help, but your practitioner must be trained and experienced in treating pregnant women (Bourne 2007; Elden et al 2007; Kvorning et al 2004; Lund et al 2006; Ternov et al 2001).

Will it affect my labour?

With the right advice, it is rare for PGP to cause problems in labour. If possible, avoid lying on your back to give birth, upright or kneeling positions protect your pelvic joints and are generally more comfortable. If you have to sit on the bed during labour, sitting as upright as possible makes parting your legs easier.

If your symptoms make it difficult for you to open your legs, it may be worth discussing with your midwife or doctor which positions would be best for an assisted birth, if you need one. Read our expert question on SPD in labour for more information.

Avoid lying down when giving birth? Highly doubtful that hospitals in our country allow that. I don’t know why they insist that we defy gravity when everywhere it is said that it is easier to give birth if you’re NOT LYING FLAT ON YOUR BACK. Sheesh.

How soon will it go away?

In a few cases, PGP can linger after birth. If it does, it’s important to carry on with your treatment (Ostgaard et al 1994). A few will have pain that persists, but this is rare. It is not unusual to have a mild recurrence of the discomfort just before your period, as hormones released at this time can have a similar effect to relaxin.

What can I do to help myself?

If you find turning over in bed very painful, try sitting up directly from lying on your back, after pulling up your knees as far towards your chest as your bump will allow. This moves your pelvis from an unstable to a locked position. Tighten your pelvic floor and lower tummy muscles before moving.

Avoid lying on your back or sitting slumped, particularly with your legs straight. Lying on the sofa or in the bath are particular temptations to sink into this position. If you do have to lie on your back, place a rolled towel under your back, at waist level to support your back and bend your knees.

Avoid pushing through any pain. If something hurts, if possible, don’t do it. If this type of pain is allowed to flare up, it can take a long time to settle down again.

When you are walking, arch your back and swing your arms as though you are marching. This locks your pelvis in a stable position and activates the muscles that stiffen your joints.

Doing regular pelvic floor exercises may help to strengthen your pelvic joints (Richardson et al 2002; Van Wingerden et al 2004).

Avoid heavy lifting or pushing. Supermarket trolleys can be particularly painful. Shop online or ask a friend to shop for you.

Rest regularly, preferably by sitting on a large exercise or birthing ball or by resting on your hands and knees.

Move little and often. You may not feel the effects of what you are doing until later in the day.

Sometimes sleeping on a softer surface can help. Try placing a duvet under your sheet.

When dressing, sit down to pull on your knickers or trousers.

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So what am I doing to help myself? Well I’m just going to rest today and try not to move around so much. Apart from that, I’m just praying that it goes away soon. Work has put me out into the field again (as I mentioned in previous post), so standing and moving around a lot is unavoidable. Although I just wish they didn’t have to take me along *sigh* It really drains all the energy out of me.

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