Severe Pubic Pain in Late Pregnancy: Impact on Natural Birth Options

Pelvic pain in late pregnancy to the point of being unable to walk?

Hello, I am currently 38 weeks pregnant.
Around 37 weeks, I experienced pubic symphysis pain, which I initially thought was within the normal range.
However, it has since worsened to the point where I cannot turn over in bed, get up, or walk without significant pain.
Going up and down stairs is particularly difficult, and any movement of my legs to certain angles causes sharp pain in the pubic area, severely affecting my daily life.
I have researched and it seems to be symptoms of pubic symphysis dysfunction, but I am not entirely sure.
My obstetrician has advised me to see an orthopedic specialist for evaluation, as it may affect my ability to have a vaginal delivery.
Therefore, I would like to ask the doctor for any additional opinions for reference: 1.
Will the severity of my condition affect my ability to have a vaginal delivery? 2.
After a cesarean section, will the inability to walk improve?

quter, 20~29 year old female. Ask Date: 2009/07/14

Dr. Chen Changfu reply Obstetrics and Gynecology

In the late stages of pregnancy, due to the relaxation of the ligaments and joints, pubic symphysis separation can occur, leading to pain during movement.
Pregnant women should move cautiously and slowly to reduce discomfort, which is also safer for those with a larger belly.
This condition is not related to the ability to deliver vaginally; however, some may opt for an early cesarean section due to the inability to tolerate pain and the inconvenience during labor.
Symptoms of pubic symphysis separation caused by pregnancy typically resolve quickly after delivery, with symptoms disappearing.

Reply Date: 2009/07/14

More Info

Severe pubic pain during late pregnancy, particularly around the 38-week mark, can be a concerning symptom for many expectant mothers. The pain you are experiencing may indeed be related to a condition known as pubic symphysis dysfunction or separation, which occurs when the ligaments that hold the pubic bones together become lax and the bones move apart. This can lead to significant discomfort and mobility issues, as you have described.

1. Impact on Natural Birth Options: The severity of your pubic pain can indeed influence your ability to have a natural birth. If the pain is severe enough to limit your mobility and daily activities, it may pose challenges during labor. Natural childbirth often requires a range of movements and positions to facilitate the process, and if you are unable to move comfortably, it could complicate labor. Additionally, if your obstetrician has recommended a consultation with an orthopedic specialist, it suggests that they are concerned about the extent of your condition and how it may affect your delivery options. In some cases, if the pain is too severe or if there is significant instability in the pelvic region, a cesarean section may be recommended to ensure the safety of both you and your baby.

2. Postpartum Recovery: If you do end up having a cesarean section, it is important to understand that while the surgical delivery may alleviate the immediate concerns related to labor, it does not guarantee that your pubic pain will resolve immediately after delivery. Recovery from a cesarean section involves its own set of challenges, including pain management and mobility restrictions due to the surgical incision. However, many women find that their pelvic pain improves postpartum, especially if the pain was primarily related to the stresses of pregnancy and labor. Physical therapy may also be beneficial in addressing any lingering discomfort and helping you regain strength and mobility in the pelvic region.

In summary, the severity of your pubic pain is a significant factor to consider when discussing your birth options. It is crucial to maintain open communication with your healthcare providers, including both your obstetrician and any specialists they refer you to. They can provide personalized recommendations based on your specific situation, including pain management strategies and potential delivery methods. If you are considering a natural birth, discussing pain relief options, such as epidurals or other analgesics, may also be beneficial to help manage discomfort during labor. Ultimately, the goal is to ensure a safe delivery for both you and your baby while addressing your pain management needs.

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