Relieving Pelvic Pain During And After Pregnancy Pdf

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Read about the causes and how to reduce the discomfort of pelvic, hip and back pain in pregnancy.

Metrics details. A large number of scientists from a wide range of medical and surgical disciplines have reported on the existence and characteristics of the clinical syndrome of pelvic girdle pain during or after pregnancy. The pain may radiate across the hip joint and the thigh bones.

Pregnancy-related pelvic girdle pain: an update

Pelvic girdle pain PGP is common during pregnancy and negatively affects women's lives. When PGP persists after the birth, the way it affects women's lives may change, particularly for first-time mothers as they adjust to motherhood, yet the experiences of women with persistent PGP remain largely unexplored.

The objective of this study was to explore primiparous women's experiences of persistent PGP and its impact on their lives postpartum, including caring for their infant and their parental role. Following institution ethical approval, 23 consenting primiparous women with PGP that had started during pregnancy and persisted for at least 3 months postpartum participated in individual interviews.

These interviews were recorded, transcribed, and analyzed using thematic analysis. For first-time mothers, having persistent PGP postpartum affects their daily lives in many ways. These findings provide important information for health care providers, which will improve their understanding of these women's experiences, will enhance rapport, and can be used to provide information and address concerns to optimize maternity care during pregnancy and beyond.

Pelvic girdle pain PGP is pain of musculoskeletal origin between the posterior iliac crest and the inferior gluteal fold in proximity of the sacroiliac joints, and pain also may be experienced at the pubic symphysis. Pain is a perception whereby physical, cognitive, affective, social, and behavioral aspects intertwine 12 , 13 ; hence, the meaning of pain is subjective and contextual and requires examination beyond mere quantification. Recently, 3 qualitative studies explored the impact of PPGP on women's lives during pregnancy.

Themes that emerged from these studies included feeling unprepared for PPGP, struggling to balance activities and dependency, and the importance of being understood by health care professionals.

The postpartum period is a time of great change, particularly for first-time mothers. Infant care is a demanding activity and may coexist with other challenges, including exhaustion, changes in relationships when becoming a parent, and financial burdens. Until recently, no significant studies had explored the experiences of women with persistent PGP after childbirth. Engeset et al 24 interviewed 5 women with postpartum PGP concerning their experiences of living with their persistent symptoms.

The impact of persistent PGP on the women's lives that emerged from this small-scale study warrants further exploration in a larger sample to provide more in-depth information on women's experiences with persistent PGP postpartum. The study included 3 primiparous and 2 multiparous women, whereas it may be valuable to ascertain women's experiences on the first occurrence of PGP. Thus, the objective of the present study was to explore primiparous women's experiences of persistent PGP and its impact on their lives postpartum, including caring for their infant and their parental role.

A descriptive, qualitative design was adopted, which aims to provide a rich straight description of a phenomenon. All participants provided written informed consent to take part in a recorded interview.

All primiparous women, aged 18 years or older, who attended a large maternity hospital in Dublin Ireland between February and October were asked to take part in the cohort study, which involved completing a survey concerning their health and well-being at 5 different time points: during early pregnancy and 3, 6, 9, and 12 months postpartum.

A purposive sample of 23 women, who met the inclusion criteria below, were recruited from this cohort Figure. Data saturation, the point at which no new codes emerged, 27 was reached at 20 interviews, but all 23 interviews were included in the analysis.

Inclusion criteria to take part in the interview were: 1 written consent to be contacted concerning any interview, within their MAMMI study consent form, and 2 experiencing PGP between the posterior iliac crest and the inferior gluteal fold or in the pubic symphysis area 1 indicated on a pain diagram that had started during pregnancy, had persisted for at least 3 months postpartum, and was still present at the time of the interview.

These selection criteria were assessed based on women's responses in the MAMMI study surveys and during telephone recruitment for this interview study. The telephone recruitment process was conducted by a qualified chiropractor F. This process included detailed questioning concerning their pain location and any symptoms of weakness, numbness, or paresthesia. Moreover, women were asked whether they had experienced any injuries, trauma, or recent illnesses; took any medications; or experienced any systematic or visceral symptoms, such as fever, unexplained weight loss, general malaise, or urinary or abdominal symptoms.

These recruitment questions were constructed by the first author F. Table 1 shows the participants' characteristics regarding their pain and sociodemographic data. Face-to-face interviews were conducted between June and October , at a time and in a place convenient for the women; 17 women were interviewed at their home, 4 interviews took place in a private room at the university, and 2 interviews were conducted in a public location.

Prior to the interview, the women completed a short questionnaire that included a pain diagram to confirm the pain location and questions concerning pain pattern and pain severity. Other sociodemographic data, including age, highest qualification, and the number of days postpartum when taking part in the interview, were obtained from the MAMMI study surveys. Interviews were transcribed verbatim, checked twice for transcription errors, and imported into NVivo 8 software QSR International Pty Ltd, Doncaster, Victoria, Australia 29 for data management and analysis.

Thematic analysis was used in which, after familiarization with the data, all interviews were coded. This coding followed by axial coding to identify emerging categories and broader themes. The first author F. For quality control, the last author C. As analysis of the 3 transcripts demonstrated congruence between the 2 researchers' findings, no further reviews were necessary.

Other strategies to enhance methodological rigor included negative case analysis and member checking. These quotes are identified by a number for confidentiality purposes and the number of days since the birth. All but one woman said that theme 1 was true to life or significant.

This woman no longer had pain at the time of the member checking, which may explain the difference between her interview transcript and her response to member checks. Theme 4 resonated with all but 4 participants. Table 3 gives an overview of all categories and themes that emerged from the data. In that context, they also told how they often had no choice in avoiding pain-provoking activities if nobody was around to help. This ambiguity reflects the challenging balancing act that women had to deal with daily: on the one hand, continuing as normal, and on the other hand, trying to avoid worsening of their symptoms.

Women's partners played a crucial role in providing support to manage daily activities with the additional burden of having persistent PGP. Other family members also were a great support for the women, in various ways eg, minding the baby sometimes, helping with housework.

They've all been very good. One woman also employed someone to assist with housework, such as cleaning, because of her PGP. The women said their persistent postpartum PGP affects their ability to do everyday activities. All women described how their PGP affected activities related to taking care of their child, such as lifting and carrying their baby and getting down on the floor to play with him or her.

Four women said they were afraid of dropping their baby if they had a sudden pain: When I get that sharp type of pain, that worries me that, you know, you might get weakness or something when you're carrying him baby , like that the pain would come if you'd move a certain way carrying the car seat or whatever.

Although they generally still could continue such activities despite the pain, they expressed frustration that it made these everyday tasks more difficult. Moreover, 10 women said that household activities were challenging and provoked pain, although this factor was regarded as less important than taking care of their baby.

The women did not feel their PGP affected their general health, with the exception of one woman who said she thought that taking painkillers would not be good for her health and 2 women who referred to the possible negative impact on their health of not being able to exercise much. Women described their pain in a variety of ways, depending on its pattern and severity.

Eight women mentioned it was a more constant or dull pain, whereas 5 women described experiencing more severe or sharp pain. Women who had more constant pain felt that they were coping less well than those who said their pain was intermittent.

Five women described their PGP, not only in terms of the pain but also how it made their body feel weaker and more restricted: I started to exercise more because I was able to with her baby , and then I felt the pain was getting worse again.

It felt like my pelvis was about to fall apart. That's the only way to describe it; it feels like it is kind of hanging and about to fall. Moreover, 9 women said that their PGP slows them down. Four women said that it felt as if they were still pregnant. All 23 women questioned why the pain was still there and tried to think of possible reasons. Someone else read it could be hormonal, as she was still breastfeeding, and another woman noticed it was worse mid-menstrual cycle.

Some thoughts also provoked worry. Seven women were worried about being able to keep up when their child is older and starts walking. Three women also questioned whether they are damaging their pelvis more over time by just putting up with the pain: It just makes simple enough things harder, and then you have always a bit of worry. Am I damaging something? Am I doing permanent damage by all the lifting or whatever way you're moving?

The women felt frustrated and annoyed by the pain, especially because they could not do the activities they wanted to do.

However, they expressed joy because of having a baby, and 11 women said that the PGP did not—and they would not let it—have an impact on being a good mother. On the other hand, 7 women did felt that sometimes they were not able to do as many things with their child as they would like: It affects things, certain things I can't do with her baby …that would be the one that really bugs me; the fact that I can't get down on the floor with her and kind of have a play with her; that really bothers me.

Nine women also described how they felt the pain was having a negative impact on their mood and made them less patient: The pain just makes me cross and grumpy and out of sorts, and just niggly, that you'd love to go to bed, but you can't go to bed.

It's just, yeah, if you didn't have a baby, I would have been in bed a long time, but you just have to get on with it. The 5 women whose pain was improving also expressed feelings of happiness and relief that it was getting better. I didn't really know; I guess, I didn't think anything different. As a result, for 2 women, it took some time to acknowledge that they continued to have problems: You kind of have to admit to yourself: yes, there is still stuff left over from pregnancy, and it has to be dealt with.

Four women said they had not expected the pain to go away immediately after the birth; however, despite the fact that they had expected some PGP postpartum, they had not thought that it would persist for so long. Also, 4 women said they were somewhat surprised the pain persisted, as they were fit before their pregnancy. We got leaflets on the pelvic floor; it was all about the pelvic floor and doing the pelvic-floor exercises, but that isn't really what's been impacted in me; it's more the joints and the skeleton, kind of the hips and the back of the pelvis, the tailbone, that sort of thing.

Although all women stated their PGP had started during pregnancy and persisted postpartum, for many, symptoms had changed over time. This change, however, varied across participants. Ten women said their symptoms were somewhat different at the time of the interview compared with during pregnancy. For some women, the pain had become less severe; for others, the pain had increased since the birth, or sometimes the type of pain had changed.

Three women also mentioned that the pain location had changed eg, from side to side or from the front to the back of the pelvis.

I had a C-section, so initially when I came home from hospital, my focus was on the section pain. And I was trying to reduce the painkillers and get used to being more mobile. I first noticed the issues with my pelvis were still there when I was going up and down the stairs.

All women strongly hoped their symptoms would go away soon. However, they were doubtful whether they would. And I can try and get a bit stronger, like I said. It is less than it was, so I feel if I keep working on it, it will go away, but I don't know. Six women expressed worries about going back to work, and one was on sick leave. Twelve women also felt they would have to do something actively about it to improve, either by doing more exercise or by seeking advice from health care professionals.

One woman was an exception in that she thought she would just have to give it more time to resolve itself. Other people's stories about persisting symptoms after the birth added to the uncertainty and created worry about the progression of their PGP: I'd love to be just back to normal, prepregnancy.

What to know about symphysis pubis dysfunction

Metrics details. Pelvic alignment changes during pregnancy and post-childbirth. Pelvic belts exert external forces that compress and stabilize the joints, and therefore, could influence pelvic alignment. However, limited information is available regarding this potential effect. Therefore, the purpose of this study is to investigate the influence of pelvic belt use on pelvic alignment during and after pregnancy. Data of pregnant women in late pregnancy and 1 month after childbirth were used.

Figuring out what's causing your chronic pelvic pain often involves a process of elimination because many different disorders can cause pelvic pain. In addition to a detailed interview about your pain, your personal health history and your family history, your doctor may ask you to keep a journal of your pain and other symptoms. Finding the underlying cause of chronic pelvic pain can be a long process, and in some cases, a clear explanation may never be found. With patience and open communication, however, you and your doctor can develop a treatment plan that helps you live a full life with minimal discomfort.

Volume 8, Number 2, June , pages A Literature Review. The effectiveness of exercises to prevent or relieve postpartum pelvic girdle pain PGP has been investigated for decades.

Problem statement: Pelvic girdle pain PGP is a common condition during or after pregnancy with pain and disability as most important symptoms.

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2 Comments

  1. Octave B. 13.05.2021 at 05:09

    Symphysis pubis dysfunction SPD involves discomfort at the front or back of the pelvic joints.

  2. Vitalia P. 17.05.2021 at 01:51

    Pelvic girdle pain PGP is common during pregnancy and negatively affects women's lives.