The pain is unbelievable. And no, I am not talking about labor. At least during labor you know there is an end point in sight soon and that within a few hours you’ll be holding your baby. No. What I am talking about is a pain that makes you feel like you are physically tearing apart, every. single. day.

Welcome to Symphysis Pubis Dysfunction (SPD).

First an anatomy lesson! If you didn’t already know, your hips are actually comprised of a couple of bones that are joined together. At the back (posterior if you’re being fancy), your left hip and right hip are fused to your sacrum (the end section of your spine) so not much movement can occur there. At the front (anterior), the bones do not actually meet but instead have a piece of cartilage in between them, this area is called the Pubic Symphysis and is what this lovely condition is named after.

PAUSE: If you are more of a visual learner, you might want to take a moment to do some googling. “Hip anatomy” should yield some good results. If you google “pelvic inlet” the area of the bones a baby comes through should be highlighted.

Normally you have an intense set of tendons, ligaments, and various connective tissues holding everything together within your hips. None of these anatomical bits suddenly go missing during pregnancy but typically at the end of a pregnancy your ligaments go a bit loosey goosey. Your body releases a hormone called relaxin which literally relaxes ligaments and muscles (which could also lead to some heartburn). This is helpful in allowing the hips to open a bit (a centimeter or so) at the pubic symphysis in order to give that baby room to get out. However, in the case of symphysis pubis dysfunction, your body goes crazy on this aspect and it does it far too soon.

I understood that when women have a baby that their hips need to open up so when I began having the sensation that the front of my pelvic bones were being torn in half, I assumed this was a normal pregnant woman struggle. Nothing to complain about. I thought that I just needed to suck it up and deal with the searing pain that started to set in if I walked more than half a mile or that would come on sharply if I attempted anything more than a slow paced walk. As time went on the pain got worse. I don’t recall when I started having this pain but by week 25 a pregnancy app I had in my phone mentioned a common problem women have during pregnancy. It informed me that the pain I had been experiencing was not normal, and that instead of trying to tough it out, you should take steps to avoid the pain altogether. While I had been trying to walk more and more what I should have been doing was resting once the pain set in.

Because your hips are a solid chunk of your core, nearly all movements are affected by this condition. Trying to get in my car was miserable. Normally as you get in a car you put one foot in by stepping in sideways and then ducking down and setting your booty down before bringing your other leg in. However this causes your hips to take on a bit of uneven pressure and in my case that meant my hips would shift and be in pain. It became so annoying and painful that I started experimenting with alternative ways to sit down to avoid as much uneven pressure as possible. I ended up finding that the best way to get in was to sit down on the edge of the seat facing out of my car so that both hips touched down at the same time and then swiveling my legs into the car…very slowly, and very carefully. Sometimes I wasn’t able to lift my legs up off the ground that far when sitting down so I would use my hands to lift my legs up into my car.

I would also have to use my arms to lift up my legs when getting dressed. It was impossible for me to put pants on standing up, partly due to SPD, and partly due to my massive stomach being in the way. In order to get my bottoms on, I would have to sit down and bend over as I lifted one foot up and tried to quickly get my foot into the leg hole before setting it down and then doing the other side at which point I could stand up and pull them on the rest of the way. Some days I couldn’t actually manage to lift my foot off the ground without debilitating pain so I would try to lift the front of my foot, place it down once I had some fabric hooked on my foot and then lift the back of my foot. And of course as I got larger I couldn’t bend over as far and had to resort to “fishing” for my foot by flinging the leg openings towards my foot and hoping it would catch so I could then proceed with the rest of the ridiculous act of getting dressed. No wonder it took me a long time to get ready. One day I was trying to get dressed to go to church and none of my usual tactics were working. I could NOT for the life of me, put my pants on (and when I say pants I mean opaque leggings because, well, comfort). I was devastated. I am an adult, I have been dressing myself for decades, I should be able to do something so simple and to find that after all my effort I was unable to perform a basic task felt like I was useless and had lost all sense of freedom. In tears, I asked my husband for help. He was pretty used to me asking for help with things at this point because I was so restricted. I often asked for help with things like balancing, reaching, or carrying objects etc. so he asked exactly what I needed. I told him he had to dress me. I think he was a bit confused but gladly helped anyways. I will forever be grateful that he did not make fun of me in this moment as it would have been so easy to do, but instead kindly helped me in my time of desperation (men folk, take note).

The pain was always worse in the morning right after waking up. I sleep on my side so as I was sleeping massive pressure was being placed on my hips (thanks pregnancy weight) and the normal pregnant-lady-side-changing-shuffle in the middle of the night was always that much more dreadful because I knew it was going to hurt but I had to do it anyways.

PAUSE: When I say “I had to do it”, I mean that there were a few times I tried to sleep on one side the entire night and the next morning I found bruises on my hip due to the weight and my anemia. If a pregnant woman says she “has” to do something, she probably means it.

As I lifted my weight off one side, it hurt. It hurt as I turned over, hoping not to bump my hip on the way. It hurt as I set myself down on the other side. After hours of beating up my hips simply by sleeping, I would awake dreading having to sit up and take my first steps. If you’ve ever had a stiff neck in the morning you might be able to imagine how this feels. Except that the joint that hurt me had to support the weight of my body, my baby carrying body… I supported myself on the walls as I walked, barely being able to lift my feet off the ground. I would sit down to eat, but had to do so slowly. I found that hard surfaces hurt more but if a surface was too soft then I would be stuck so my best bet was to fold up a blanket, set it on top of a hard chair, and then sit on that. I even took my own “sitting blanket” to a friend’s house for Thanksgiving while I was pregnant. The mornings differed with it taking anywhere between 10 minutes to two hours for my hips to be warmed up enough to walk normally. Throughout the day I could only walk, never run. I once tried to do a quick walk to move out of the way of a car in a busy Costco parking lot…bad idea, instant agony, not recommended. It got to the point where I actually looked up my state’s requirements to get a temporary handicap parking permit because walking the extra 20 feet to a non-handicapped spot sounded REALLY appealing. Unfortunately I didn’t qualify but if you are in the same boat as me, it might be worth checking out the requirements for your particular area.

Sometimes I could hear a crunching sound emanating from my hips because there was so much movement. This was entertaining to me but I can see how it could be a worrying noise to some (especially my poor husband who was simultaneously impressed by the magic of pregnancy and a bit scared I was falling to bits). I could handle all of this pain and annoyance but there were a couple of things that worried me. on could easily result in

In the last couple of weeks of my pregnancy, the shifting in my hips and the extra weight caused me to develop sciatica.

PAUSE: Sciatica is a condition resulting from a pinched nerve (the sciatic nerve, hence the name) which typically results in pain on one side in the buttock and sometimes spreading down into the leg of the affected side. The reason that the nerve is pinched varies, some people were born with the nerve placed in an unusual location causing them to be more prone to the condition whereas others may just have a muscle that needs stretching.

The way my particular sciatica chose to show up was a sharp and intense stabbing pain on my right buttock/leg combined with a temporary loss of control of my leg. Normally this was only another painful inconvenience, as were many things that late in my pregnancy, however it presented a problem. The random nature of these leg spasms meant that it would be unwise and unsafe for me to drive a car because a sudden kick of the accelerator or the few moments of lost function could easily result in an accident. Opting to not tempt fate, I relied upon others to drive me wherever I needed. The other worry of mine was concerning delivery because not only will SPD cause your hips to compress and widen easily (and painfully) but it can also cause unnecessary rotation. If your hips do rotate, this might make it impossible for your baby to come through your hips and an emergency C-section would have to be performed fairly late on, which is not ideal. There is no absolute guarantee that this will not happen to you but in order to help prevent it, or perhaps just to put my mind more at ease, I started seeing a chiropractor while I was pregnant. I went to someone who had experience with pregnant women and who knew how to work with my changing body. It seemed to work for me seeing as I didn’t end up needing a C-section, and had a relatively short labor (8.5 hours) with no complications.

PAUSE: If you are pregnant and do see a chiropractor or are thinking about it for your pregnancy, going to someone who is experienced and knowledgeable about working with pregnant women is absolutely vital because so many things can go wrong when you are manipulating the spine and adaptations need to be made.

In the future I would probably get a belt that is specifically for people with SPD (they are usually in the $20-$45 range) to help alleviate the pain but the first time around I was just too stubborn. Please learn from me, the pain does not magically get better and it isn’t until after that baby greets the world that your joints will start to stabilize. And on that note I have to mention that there is a small percentage of women who will continue to have SPD after their baby is born. The good news is that the chance of that happening is quite small indeed. Your body will get the hormones flushed out of its system eventually, you will become more stable, walking will be normal, you will be able to sit wherever you like without fear, and of course you will be able to dress yourself! Whoop whoop!