What is Symphysis Pubis Dysfunction?

pregnant woman
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Pregnancy is a special and exciting time, but that doesn’t mean it doesn’t come without discomforts, especially for the person who is pregnant! Most expectant parents experience their fair share of discomforts—nausea, morning sickness, back pain, constipation, heartburn, round ligament pain, sciatica… and the list goes on.

But there is one pregnancy ailment you may have never heard of, and yet is actually more common than most of us realize: symphysis pubis dysfunction, otherwise known as pelvic girdle pain.

The condition can cause a lot of discomfort and pain, but there are many ways to effectively manage it, and the good news is that once you deliver your baby, your pain will usually diminish significantly, or disappear altogether.

What is Symphysis Pubis Dysfunction?

Ranging from moderate to severe, symphysis pubis dysfunction is generally defined as pelvic pain, or pain involving your pelvis and its surrounding joints. It is most common in pregnancy. The pain is usually felt on or near your pubic bone, back, lower back, perineum (the area between the vagina and anus), and thighs.

Symphysis pubis dysfunction is usually quite painful, but the extent that you feel disabled by your symptoms varies.

Most people are able to function on a day-to-day basis, with modifications (and lots of rest!). Others find the pain too debilitating to perform normal tasks, and may need modifications such as crutches or even wheelchair support.

How Common is Symphysis Pubis Dysfunction? 

According to The Journal of the Canadian Chiropractic Association, general pelvic pain in pregnancy is quite common, with between 48-71% of parents reporting symptoms. Reports of symphysis pubis dysfunction specifically are somewhat less common, but more common than you might imagine, with 31.7% reporting this diagnosis.

What Are the Symptoms of Symphysis Pubis Dysfunction?

Symphysis pubis dysfunction is experienced a little differently for each pregnant parent, and with different levels of severity. But there are a couple of signs that might indicate you are dealing with the condition, including:

  • Pelvic pain in the symphysis pubis area (located in your midline), often described as “shooting pain”
  • Pain that can also be felt as radiating to your back, lower back, abdomen, perineum, thigh, or legs
  • Pain that may be accompanied by a clicking or grinding sound
  • This pain may be aggravated by certain activities, such as walking, bending forward, bearing weight on one leg, standing up, using stairs, or getting in and out of bed, or spreading your legs

What Causes Symphysis Pubis Dysfunction?

Experts aren’t sure precisely what causes symphysis pubis dysfunction. It is thought to be caused in part by the hormones of pregnancy, such as relaxin, that make the muscles, joints, and ligaments softer and more flexible. During pregnancy, your pelvis and its joints are shifting and changing in order to accommodate your baby, and this is also a primary cause of symphysis pubis dysfunction.

While experts aren’t sure why some pregnant people seem to be more prone to symphysis pubis dysfunction than others, there are some risk factors that might make you more likely to develop the condition, including:

  • Previous pelvic injury or damage
  • Pelvic joints that tend to move unevenly
  • Previous history of pelvic or lower back pain
  • Having had symphysis pubis dysfunction in a previous pregnancy
  • Overweight individuals
  • An occupation that puts increased demand on your pelvic muscles and joints
  • Carrying twins or multiples
  • Your baby’s position may increase your risk of symphysis public dysfunction pain

Is Symphysis Pubis Dysfunction Harmful to Your Baby?

No, symphysis pubis dysfunction is not harmful to your baby. However, if you have symptoms, you should get a proper diagnosis from your doctor or midwife to ensure that nothing more serious is happening with you or your pregnancy. 

Symphysis pubis dysfunction usually is just a painful and uncomfortable situation for you, but thankfully should not affect your growing baby.

What To Do If You Have Symptoms of Symphysis Pubis Dysfunction

If you are experiencing any of the symptoms of symphysis pubis dysfunction, the first person you should contact is your doctor or midwife. They can consult with you and possibly examine you to rule anything more serious.

After receiving a symphysis pubis dysfunction diagnosis, depending on your situation, your healthcare provider may simply discuss pain management techniques with you. However, if your condition warrants it, they may refer you to a physical therapist who specializes in obstetric pelvic joint issues to help you treat and manage the condition.

Treatment Options for Symphysis Pubis Dysfunction

The good news is that there are actually many ways that you can tackle and treat your symphysis pubis dysfunction pain and discomfort.

At-Home Treatment Options

  • Pelvic support belts are a simple way to keep your ligaments, joints, and muscles stable and supported
  • Resting periodically and taking pressure off your joints is important when you are dealing with symphysis pubis dysfunction
  • As much as rest is important, you want to continue to engage in as much physical activity as you feel comfortable with
  • Wearing flat and supportive shoes can be helpful
  • Consider sleeping on your side and using a pregnancy support pillow
  • Be mindful of keeping your legs together, especially when performing activities such as getting in and out of the car
  • During sex, try alternative positions, like kneeling on all fours
  • Avoid standing on one leg when possible, such as when you are getting dressed
  • Ask for help around the house, especially with physically taxing chores like vacuuming and gardening
  • Icing the painful area can be relieving
  • Avoid sitting or standing for long periods of time; vary your activates and body positioning as much as possible
  • You can speak to your doctor about pregnancy-friendly pain relief medicine

Other Treatment Options

  • Chiropractic treatment, acupuncture, and massage have been known to be helpful for symphysis pubis dysfunction; make sure to clear these treatments with your doctor or midwife.
  • A physical therapist with a background in pregnancy-related conditions may be able to show you or lead you in exercises that will help stabilize your pubis joints and offer comfort.
  • In severe cases, crutches or the use of a wheelchair might be needed if the condition makes it difficult to walk or move.

When Does Symphysis Pubis Dysfunction Resolve? 

For most expectant parents, symphysis pubis dysfunction resolves after the birth of your baby. For example, most symphysis pubis dysfunction pain resolves in the first 1-6 months postpartum, and 25% of people are still experiencing it at 4 months postpartum. However, only a small number are experiencing it at one year postpartum.

In general, pregnant people who experience long-term problems with symphysis pubis dysfunction are rare, and most of these cases involve people who experienced traumatic births along with symphysis pubis dysfunction.

Recurrence of the condition in future pregnancies is common, with 85% experiencing this.

Giving Birth After a Symphysis Pubis Dysfunction Diagnosis

If you have been diagnosed with symphysis pubis dysfunction or suspect that you might have it, you are probably wondering if it is safe or possible to give birth, especially if you are hoping for a vaginal delivery.

Thankfully, childbirth is usually not an issue, especially with a little planning ahead. Discuss your feelings and concerns with your doctor or midwife. If you have a birth plan, you can add these concerns into this birth plan, and if you have a labor support person or doula, you can discuss these concerns with them before the birth.

Often, discussing different laboring conditions, and asking for the option to try positions that feel most comfortable to you, are great places to start. You might want to consider the option of water birthing, or laboring in a water birth pool, as water immersion can take the stress off your joints.

You may also choose to consider alternate pushing positions—positions that don’t require the full spreading of your legs, such as giving birth on your side or on all fours. Your range of motion and comfort levels are important to discuss, even if you are planning on using epidural pain relief during childbirth.

A Word from Verywell

Most of us don’t have symphysis pubis dysfunction on our list of “What To Expect During Pregnancy.” Yet it’s a condition that affects many pregnant people, to varying extents. The pain can be quite debilitating at times, but it can be helpful to know that you are not alone, that treatment options are out there, that it is not harmful to your baby—and most importantly, that the pain will most likely resolve after your baby is born. 

If you are experiencing something like symphysis pubis dysfunction, now is the time to be an advocate for yourself. Don’t be afraid to share your experience of pain with your healthcare team—this is not something you should hide from others, or just “grin and bear.” Once you have a diagnosis, make sure you get the help you need to feel more comfortable. And yes, that will mean getting your partner or friends and family involved in helping you.

Pregnant parents most definitely deserve breaks—and even more so if they are dealing with something like symphysis pubis dysfunction. So take a load off, accept that household help from your family, say yes to that pregnancy massage, and remember that this too shall pass.

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Article Sources
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  1. Howell ER. Pregnancy-related symphysis pubis dysfunction management and postpartum rehabilitation: two case reports. J Can Chiropr Assoc. 2012;56(2):102-11.

Additional Reading
  • Howell ER. Pregnancy-related symphysis pubis dysfunction management and postpartum rehabilitation: two case reports. J Can Chiropr Assoc. 2012;56(2):102-111.

  • Pelvic pain in pregnancy: your pregnancy and baby guide. National Health Service website. Updated August 1, 2019.