Friday, October 2, 2020

We Need Connection

"It hurts to feel separate. We are wired to seek connection and belonging—to feel like we are part of something larger than ourselves. They say it takes a village to raise a child, but I believe it also takes one to sustain an adult. We were not built to live in isolation, hidden behind apartment doors, phone screens, and dead eyes. We thrive when we feel like part of a tribe, when the people we share space with become part of 'us,' not 'them.'" ~Lori Deschene

Photo by Dan Meyers on Unsplash




Yesterday, a friend of mine made an unsettling post. She had clearly been going through a rough time, and had lost her sense of self-worth. This was not a friend I knew well, but something in me felt this was a cry for help. I took some time to look through her recent posts and made a few supportive comments, hoping it would help uplift her. 

Later that evening, a mutual friend of ours (whom I had never really spoken with directly either) contacted me and expressed concern for her because her profile had been deleted. He didn't remember anyone else that was on her friend's list, and only remembered me because I had been the last to comment on her last post, which he still had up on his screen.

I spent the next several hours reaching out to people I remembered were mutual friends. I contacted the two people I knew who lived in the same area as she, and asked if they knew her. It took several hours for either to respond, during which time I was trying to find a phone number that might belong to her so that I could try calling her. It was getting late, and I began to struggle with worrying I may be bothering someone at/near/after bedtime if I called, and worrying that my friend may not be safe. I started thinking maybe I should call the suicide hotline or local police and ask for a well-check to be done on her instead, but then what if that caused CPS to get involved and remove her kids because they considered her a threat to THEIR wellbeing, and suddenly I'd have destroyed the life of the person I was trying to help?

Thankfully, one of my friends in the area responded as I was wrestling these competing worries, and told me she knew her and would reach out. I felt immense relief, and trusted that I had found the right person, and that my friend would be taken care of. My other friend local to her responded a few hours later, in the middle of the night, and reached out to her immediately as well. 

It took until morning for me to find out for sure that she was okay. I also now had several other friends worried and waiting for an update. 

Did I do the right thing by getting so many people concerned? Did I go too far in considering calling this person I called friend, though barely knew, and had never spoken with face-to face? Was it ok that I stopped when I received a response from someone who knew her? Will our friends that know her in-person be able to provide her with the support she needs?

I don't know the answer to any of these for sure. I don't even know if my friend will be ok emotionally long-term. But I know she is alive, and I know she now knows that many people care about her enough to worry about her late at night. I am a firm believer in following your intuition, and mine had been trying to tell me all day that something was wrong and she needed intervention.

If it were me, I would probably be embarrassed, but I would also feel touched to know so many people went out of their way to check on me and were worried for my safety.

She might have been ok if we had not come together to inquire for her wellbeing. Or she might not have. I would prefer to feel guilt for action rather than inaction. I would have felt far worse to have woken up a week from now to a tragic announcement and wonder if I could have done something to prevent it. Who knows? It still might happen. Emotions and mental health are unpredictable and difficult to stabilize at times. Humans are complex creatures. But I'm never going to let that stop me from trying to help a fellow hurting human.

If you see someone who is struggling, please take the time to stop and support them. Clicking "care" isn't enough. If you're close enough to support them in-person, please reach out to them. Don't wait for them to ask for help. Most people won't. Send them a message, leave a kind comment, ask them questions that help guide them to see their situation from a healthier perspective. Listen to your intuition and act when you hear warning bells going off. Don't ignore their suffering because it makes you uncomfortable. 

"Good vibes only" can lead to a lot of people losing the support they so desperately need. Yes, it is important to protect yourself from the negativity of others, especially if you feel it is taking a toll on your own mental health. But if you are someone who has the good fortune to be resilient and always look for the goodness in things, consider that maybe you have been given these gifts in order to be able to help those who cannot help themselves. Don't shut out everyone who shares their struggles, as I have seen many do. Invite them in, and share your goodness and happiness and resilience with them. 

That is how we change lives and make the world a better place.

For free resources when you need someone to talk to, you can dial 211 for the United Way (within the US), which can connect you with local free or low-cost mental health resources or even just for someone to listen to you. 

If you or someone you know show signs of suicidal thoughts, please contact the National Suicide Hotline at 1-800-273-TALK (8255) from within the US, or visit their website. Even if you don't feel that you are at immediate risk of suicide, they can also help connect you to local free or low-cost mental health resources. 

Monday, September 28, 2020

Let's Be Frank About Breech





Breech is when the baby is in a number of positions that are head-up. There are many different breech positions and presentations. Some babies are breech until just a few weeks, days, or even hours before labor. Others are breech until sometime during labor. And a small percentage of babies are born breech. 

Many doctors will try to tell you that breech is an indication for c-section. This is simply not true. Breech is just a variation of normal. Midwives are much more likely to have experience with facilitating the birth of breech babies than obstetricians are, because obstetricians are surgeons. Obstetricians get paid more for performing surgery than they do for vaginal births. C-sections are also more convenient for them, as they don't have to show up at the hospital at whatever random time a mom shows up in labor when they schedule the c-section in advance. They can plan their vacations and golf games easier this way. They can afford their fancy cars and private schools for their kids this way.

I recently had an extensive exchange with a mom who sounded terrified of having a c-section and all of the repercussions that came along with it. This was worsened by COVID-19 restrictions at her hospital and limited leave for her husband to be with her, leaving her to be alone for the majority of her hospital stay, and unsure of how to care for her infant and dog at home alone while her husband was forced to go back to work. However, her doctor never told her that she had any options beyond scheduling a c-section. She simply told her, at 35 weeks, that since her baby was still breech, she would schedule her for a c-section. She gave her no advice for encouraging the baby to turn, and never told her that vaginal breech birth was possible. Once I had informed her that she DOES have options, she seemed to be determined to avoid having a c-section. She went to her doctor the next day, ready to question what she had been told. Or so she thought. When I spoke with her a few hours later, she had again resigned herself to having a major surgery for no reason beyond the doctor's convenience unless the baby magically turned on its own before the scheduled time (39 weeks, not even allowing the baby the chance of going to true full-term), with no effort on her part. 

She will likely end up having that c-section, feeling defeated and powerless. She will spend multiple days in the hospital, alone for most of it, unable to keep her baby in the room with her the entire time, not knowing what is being done with or to her baby while out of her sight. She will struggle to take the dog outside, possibly pulling a stitch or worse as she tries to. She will have difficulty caring for her baby on her own while she heals from major surgery. She may have issues with her supply and getting the baby to latch. She may have difficulty bonding with her baby and develop post-partum depression. If she manages to overcome her depression through counseling, drugs, and/or any number of mindset-shifting events, she may find the strength to forgive herself . Or she may not, and wrestle with depression for the rest of her life, borne of a self-hatred for not advocating for herself and her baby. She may not even realize these feelings, or where they stem from.

This happens far too often. Moms are pressured to ignore their instincts and accept many possible risks, including infection, injury to the baby, scar tissue, lengthened recovery time, excessive blood loss, increased risk of post-partum depression, difficulty breastfeeding, difficulty bonding with their baby, and many more, up to and including death. They are not informed of their options. They are brushed aside when they learn about their options and attempt to exercise their rights to choose them. They end up with severe complications and feel angry at themselves, regretting not standing up for themselves and their babies. They have a hard time processing the trauma of what they experience, and the feeling of powerlessness that goes along with it. 

It isn't their fault. They have been groomed for this kind of mistreatment and disempowerment their entire lives. That is what our society does. Anyone who questions what they are told and seeks to educate themselves gets shamed, ridiculed, and laughed at. They are made to feel as though they know nothing, and pressured to trust that the given authority figure knows best, so they should simply accept whatever they tell them without question. The media teaches us to reinforce this, and seeks outliers to make examples of, encouraging others to judge and shame them for making choices different from those they would make for themselves.

We need to fight back. Question parents, question teachers, question doctors, question lawmakers, question the media. The United States is going through a massive upheaval right now. We are questioning the status quo. It's time to stand up and speak out. No more lying down and taking the abuse that they give. Change begins within each and every one of us.


If your doctor tells you that you are going to have a c-section because your baby is breech, tell them you know your options and you will make the choice that is right for you. Educate yourself, listen to your intuition, and make your own choice. Knowledge is the best cure for fear, and fear is the most common ingredient in a recipe for disaster.


Here is a list of resources to learn more about breech presentations and your options if your baby is breech:

Home4Birth

Birth Without Fear

Informed Pregnancy

AIMS

BellyBelly

Spinning Babies

Evidence Based Birth


As always, do your own research and listen to your intuition, and do not allow anyone, regardless of the letters after their name, to pressure you into making a choice that you do not feel comfortable with.

Friday, July 24, 2020

What is Self-Care?

Happy International Self Care Day! Everyone seems to be under so much more stress these days, or at least they believe they are. This has brought the concept of self-care out into the spotlight and made it a major buzzword. There are entire communities built around it. It is a booming market for many retailers, with whole stores built upon the idea of self-care. There are many voices extolling the virtues of self-care, and a quick scroll through any social media can show you many examples of people doing various things in the name of self-care. But what is it, really? Read on to learn more about it!

Why is Self-Care Important?

Self-care is the concept of taking care of yourself, in order to have the strength, energy, and motivation to take care of others. Any flight attendant could tell you that it's important to take care of yourself first before taking care of those that depend on you. If you burn out, how will you be able to take care of anyone else? As a Mother, it's easy to overlook your own needs while attending to those of your family, but when you have tiny lives depending on you, you have to be sure you keep enough fuel in your tank to keep going. 


What is Self-Care NOT?

It is not finding excuses to avoid responsibility. It is not drinking a bottle of wine for breakfast because you're overwhelmed by constantly being needed in today's shut-in lifestyle world. It is not sleeping halfway through the day because you stayed up all night playing video games or binge-watching a new show. It is not spending everything in your savings account on bath and beauty products. These things are called excuses, rationalizations, laziness, and in some cases even addiction. Indulging yourself a little once in a while is fine. Finding a "reason" to do it every day is not. Engaging in unhealthy, unwise, and at times unsafe behavior is NOT taking care of yourself, and it does NOT fill up your tank.


How Can You Practice REAL Self-Care?

Keep yourself healthy -- inside and out. Eat well. Participate in healthy activities that keep your brain and body moving. Set up a routine that fits your needs and schedule. Take regular, short breaks from anything you do that takes a long time. Have someone to talk to when you need to vent. Don't hold it all in.

Be kind to yourself. Forgive yourself for mistakes while also learning from them and using them to make better plans in the future. Don't wallow in sadness or guilt for things that haven't gone the way you had hoped. 

Hold yourself accountable. If you make a commitment, don't allow yourself to make excuses for skipping out on them. Make plans with friends, family, and/or coworkers and keep them. Set goals for yourself and keep yourself on the path to achieving them. 

Set healthy boundaries. If there is someone in your life that is asking too much of you, it's okay to tell them no. That includes your Partner and your Children. You can't pour from an empty cup, so make sure not to pour all of yours out into someone else's.

Ask for help. If something is too much for you, or you've otherwise found yourself with a heavier metaphorical load than you can safely carry on your own, stop. Set it all down. Take a moment and think about the many things you are carrying. Do YOU need to be the one carrying all of them? Is there something that you can relinquish a little bit of control over in order to allow someone else to help you with it? Find ways that you can stop doing everything yourself and get help from others.

Seek professional advice. If you feel that you are struggling and nothing you've tried seems to be helping, don't hesitate to hire a professional to help you. This could be a life coach, therapist, fitness guru, doctor, yoga instructor, naturopath, or even just a professional cuddler (yes, it's a real thing!). You may even be lucky enough to know someone who could be your mentor without requiring payment. My first mentor was my school librarian in elementary school, whom I lived next door to for a time and spent many afternoons with. My second one was the leader of my local birth network; she took me under her wing and shared all kinds of life wisdom with me until she, sadly, moved across the country and we stopped connecting as often. My third, I hired; she runs a business empire on helping people get motivated to get doing. All of them have had a profound impact on my life and helped to shape who I am today as a person. I would not be where I am today without any of them. There is no shame in admitting you don't know how to help yourself and asking someone else to guide you to find your own answers.


Where Can You Get More Inspiration on Ways to Practice Self-care?

You can search #selfcare on your favorite social media platform or just search the internet for self care ideas. Lately, I've been enjoying posts from Hamilton CASPower of Positivity, The Holistic Psychologist, and The Unruly Woman


For free resources when you need someone to talk to, you can dial 211 for the United Way (within the US), which can connect you with local free or low-cost mental health resources or even just for someone to listen to you. 

If you or someone you know show signs of suicidal thoughts, please contact the National Suicide Hotline at 1-800-273-TALK (8255) from within the US, or visit their website. Even if you don't feel that you are at immediate risk of suicide, they can also help connect you to local free or low-cost mental health resources. 

Tuesday, May 30, 2017

Loss Never Leaves Us

Trigger warning: Loss


I recently suffered something that a large number of childbearing-age women do every year. Something that is not talked about enough. Something that happens and then is swept under the rug. Something everyone tries to avoid talking about and pretend it never happened. Miscarriage. The loss of my unborn Child. It wasn't my first, and it may not be my last, but it was a unique event all of its own, similar in generality, and yet entirely unique from any other experience. This particular one was what is known as a missed Miscarriage, where Baby has passed, but the body continues the Pregnancy for a few weeks, or longer, without the Mother realizing that Baby is no longer developing.

    At 11 weeks, I started bleeding, which is not unusual during pregnancy, but it lasted longer and was heavier than I had experienced in previous Pregnancies. I tried to remain optimistic, simply waiting for confirmation one way or the other. But 6 days after it began, it reached a point where I knew it was definitely over. Instead of cramps, I began having contractions. I was in a training class for a promotion at work, and we were not permitted to miss any time of training under threat of losing the promotion and possibly the job entirely, and I knew that losing my job in addition to losing my Baby would just make things so much worse. So, for the last 2 hours of class that terrible Tuesday afternoon, I lied on a blanket on the floor in front of my computer (I work from home), listening to my trainer without really even hearing a word he said, and vocalizing through my contractions. I went to the hospital after my class ended, to confirm and ensure that nothing had been left behind, and that is where I delivered my tiny Baby into my own hand. The sac was still intact, and much, much bigger than Baby was. This was because Baby had not developed past 6 weeks, meaning that my body only thought it was still pregnant for half of my Pregnancy. My Husband was not permitted to be in the room while I had the ultrasound, so he was not with me when Baby came out in the bathroom in between tests. By this point, I had accepted that my Baby was gone, and shock had made me mostly numb. I had to endure another 10 minutes of testing before my Husband could come back in the room with me. I managed to hold it together until he had returned and the sonographer left the room, but just barely.
     The next few days, I spoke very little and I could not really focus at work. I made it through training, but not at the standards I normally hold myself to. During the week before, I told myself and those that knew what I was going through that I'd never be able to go through another pregnancy again if I lost this Baby; it was just too painful. But right after I opened the sac, held the baby on the tip of my finger, and said goodbye, I felt this immense emptiness inside. I'd spent the past 8 weeks believing that I had a life growing inside of me, and now, I did not, and yet I had no new Life to hold in my arms either. It felt like a cruel joke, and it just made me want to have another Baby even more. I told my Husband that I wanted to try to get pregnant again right away because I couldn't wait. This was the spacing between children we wanted, and this was the time we had originally planned to try to have our next, and final Baby. But it was not a good time to have a Baby. Pregnancy is very hard on me, and due to a deformity caused by a childhood injury, I break my tailbone in labor. Right after a promotion, in the middle of trying to buy a house and move, was most definitely not a good time to have a Baby, especially for me. And so now we wait. We will wait until next year. When things have settled, when I have healed, when our life is stable. Hopefully. And I'm okay with that.
     Mostly.
     I have accepted that this is not the time to bring a new Life into our Family. I have acknowledged that it is merely selfish desires that drive me to want to try to have a Baby again right away. And I need to think of the Children I already have first. They need me right now, more than ever. It would not be right to take my time and energy away from them. But it doesn't stop my yearning to fill my womb to replace the Baby that is no longer there.
      I miss my Baby every day. Just as I miss the Baby that I was not given the chance to grow 11 years ago. One month has passed since the day I said goodbye to my little tadpole. No one asks about my Baby anymore. No one asks about me anymore. Life is moving on without my Baby. But I feel sometimes as though it is moving on without me, as well. I feel a tiny bit of my heart died along with my Baby. I have so many friends that are pregnant or have recently had Babies, and it hurts me so to see and hear about them. But, just as I did after losing my first Pregnancy in 2006, I will survive. I will be the best Mother I can be to the Children I have with me right now, and someday I may have more.
      I will survive, even though it doesn't really feel like it right now.


Please, if you have been a Presence in the life of someone that has experienced this tragedy (and chances are that you have been), ask them how they are doing. Acknowledge the life of their Baby. Let them know that you have not forgotten about that tiny Being's brief life. Show them that they are loved and that their Baby still has a presence in this world through the love of others. Not constantly. Just once in a while, to let them know that they are not alone, and not forgotten.


For free resources when you need someone to talk to, you can dial 211 for the United Way (within the US), which can connect you with local free or low-cost mental health resources or even just for someone to listen to you. 

If you or someone you know show signs of suicidal thoughts, please contact the National Suicide Hotline at 1-800-273-TALK (8255) from within the US, or visit their website. Even if you don't feel that you are at immediate risk of suicide, they can also help connect you to local free or low-cost mental health resources. 

Sunday, May 3, 2015

Pregnancy is Sacred




I'll say it again -- Pregnancy is sacred.

It occurs to me that, even in the community of Birth geeks that I inhabit, we all too often focus solely on the Birth and not enough on the Pregnancy. We focus on the Pregnancy sometimes, sure; we focus on how to get through it. We focus on how to attain it. We focus on how to get it over with. We focus on how big our bellies get. We focus on how many weeks we are. We focus on how much pain we're in. We focus on how hard it is to make our clothes fit.

We should focus on how amazing it is that we are creating an actual life. A tiny Person that someday will be grown. Someone with a future, hopes, and dreams of their own. A new generation that will shape the future of the entire world. And WE are doing that! WE are creating it! Our bodies are so immensely POWERFUL! These human beings we are growing inside of us are the future. And the kind of Mothers we are determine what kind of future that will be. Not entirely, of course. Everything else in their lives will help to shape the kind of People they become, but we are laying the foundation for that!

We should be celebrated! We should be treated as the incredible beings we are. We are in the process of an immensely difficult task. It drains our energy, our nutrients, our bones, even our brains at times. We are strong, capable, independent, fierce! But we also deserve to not have to be all the time. We deserve to be able to lie back and let our walls down and let someone else take care of us for a moment. Because, in the grand scheme of things, Pregnancy is but a moment. We deserve to enjoy it. We deserve to feel loved and valued and even occasionally pampered. Yes, seeing our beautiful Babies' faces at the end is all the reward we could ask for. But just because we don't ask for it doesn't mean we don't deserve it.

Do me a favor. The next time you see a Pregnant Woman, thank her. Just tell her "thank you for giving your body to create another". Thank her for creating the future. Let her know that she is appreciated, and she is gorgeous. And there is nothing more valuable than that.

Sunday, March 15, 2015

It's Okay to Not Always Be Happy

I've always felt born to be a Mom. I mothered all my friends. I mothered my Mother from the age of 3. I mothered my Husband from the moment we moved in together. But becoming an actual Mother, a tiny Life depending on you for every single thing,  24/7, after two and a half decades of only being a Mother to my friends when they needed guidance, not wiping their butts or putting food in their mouths... that was a huge change!

I watched my Husband go to work every day, come home and play video games, eat all the unhealthy crap he wanted, snore his head off and sleep without waking. I watched my friends go about their daily lives, as if nothing had changed. Because for all of them, it hadn't. But for me?

My entire life was completely upside down. I had this tiny thing attached to me. I was responsible for every aspect of its life. I had to focus all of my time and attention on it. I had to respond to its every noise and movement. I couldn't play video games all day. I couldn't go anywhere I wanted anytime I wanted. I couldn't just slip on my shoes and go for a run. I couldn't roll over and go back to sleep until 4 in the afternoon if I still felt tired when I woke up. I couldn't binge on brownies and cake all day if I wanted to. My life was all about this little being that was and always will be a part of me. She was now my entire world. I couldn't do anything without thinking about how it would affect her.

I was happy to do it, it was what I had wanted, longed for, ached for, for so many years. But there were definitely times when I questioned if had made a mistake. If I was crazy for wanting this. If I was good enough. If I could handle it.

I still have those thoughts sometimes, nearly 4 years later and pregnant with our second. They're normal. It doesn't matter what it is, when you make a drastic change in your life, you're going to have moments of doubt, of regret, of despair, especially when it gets hard. And even when it's easy, you can still miss the way things were before at times. But when it comes down to it, I absolutely would not go back and not become a Mother if I had the chance. That doesn't mean I don't have moments I question whether that's true. We all fantasize about things being different than they are at times. And that's okay. It doesn't make you any less of a Mother. It doesn't make you wrong or crazy. It makes you Human.

So go ahead, cry. Cry and scream and make plans to run away. Think out the details, think about the greasy diner you'll work double shifts in, in some tiny,  backwater little town where no one knows you. Think about how you'll go to night school and get a law degree and become a rich, successful lawyer, all on your own. Think about all of that and more.

Then, after you've had your fill of fantasy,  come back to reality. Think about getting through the day without having to change your spit-up covered shirt more than three times. Think about how, tomorrow, Baby might take her first step. Think about next weekend, when your Husband surprises you by changing a diaper without being asked. Think about 10 years from now, when your Child surprises you by doing something you didn't think a 10 year old could do. Think about seeing your Child driving for the first time, getting married, having her own Children. Think about her calling you in the middle of the night, crying because she is having all of the same thoughts that you are having right now. Think about telling her that she's okay. Think about telling her that it's normal.  Think about how you will tell her that you thought and felt it all yourself, and you got through it. Think about how you will tell her how much you love her,  and how you wouldn't change any of it for the world.

Being a Mom is hard, even when it's easy. There is no job in this world that is more difficult or rewarding. So be happy when you can. And let yourself be miserable without feeling guilty about it when you need to. It's okay. I promise.



For free resources when you need someone to talk to, you can dial 211 for the United Way (within the US), which can connect you with local free or low-cost mental health resources or even just for someone to listen to you. 

If you or someone you know show signs of suicidal thoughts, please contact the National Suicide Hotline at 1-800-273-TALK (8255) from within the US, or visit their website. Even if you don't feel that you are at immediate risk of suicide, they can also help connect you to local free or low-cost mental health resources. 

Saturday, May 7, 2011

SPD -- Symphysis Pubis Dysfunction

This is something important for all women to know about. It is a lot more common than you might think, despite the fact that most doctors in the US don't know about it, or don't believe it exists.. Don't ever let your doctor tell you that excruciating pain is "normal" or tell you to "just deal with it". If you are experiencing a large amount of pain, you have every right to adequate treatment of the cause, not just of the pain! If you suspect you may have SPD, and your doctor refuses to refer you to a specialist, find another doctor. SPD can cause permanent, sometimes debilitatingly severe damage if not handled properly. Please see the warning about labor and delivery near the end of this post for more information on this.


What is SPD?

SPD stands for Symphysis Pubis Dysfunction. It is also sometimes referred to as pelvic girdle pain, or PGP. It affects pregnant women, but can persist beyond pregnancy in a rare few very unlucky ladies. In the simple terms, SPD is a misalignment of your pelvic bones, caused by your body producing too much of a hormone called relaxin during pregnancy. Relaxin is what helps your spine realign to make room for Baby, your hips to expand, and your pelvic bones to separate to allow Baby to be born. It's a good thing -- in proper amounts. When your body produces too much of it, the joints in your body become extra flexible, and much more prone to misalignment. In some women, this doesn't become a problem unless they have some kind of trauma occur, such as a car accident or a fall. We don't exactly have the best of balance when we're carrying an extra 20+ pounds in front of us and our joints are soft, do we? When we fall, especially if we land on our hands and knees, which of course is much better than our bellies, the pelvis can easily become misaligned. In my case, my right hip became tilted backward. The body does not naturally realign itself without proper guidance, so the misalignment, if not corrected, can cause excruciating pain that lasts for a very long time, and only gets worse. In some women, however, SPD can occur without any kind of trauma. The hypermobility in the joints caused by the excess hormone can make it easy for the symphysis pubis to work itself into misalignment over time.


How is it Diagnosed?

It cannot be 100% diagnosed "officially" until pregnancy is over, by doing an x-ray to see if the symphysis pubis is misaligned. It's not that difficult for a chiropractor to recognize it, though. For one thing, most women with SPD have one leg slightly longer than the other, due to the misalignment of the pelvis. 


How Can You Tell if You Have It?

A tearing feeling in the middle of your pubic bone and/or perineum is a pretty strong clue. I'm not talking about the odd twinge here and there caused by stretching during pregnancy. This tearing feeling is different. It feels like you are being ripped in half. While the pain may subside quickly in the beginning, over time (if left untreated), it becomes more constant, and spikes with every movement, rather than just walking. It may hurt when rolling over in bed, or when sitting in a bad position. The pain usually subsides for the most part when sitting or laying down, at least until the condition progresses very far. Taking long strides when walking, going up and down stairs, and standing or walking for very long also causes great pain. This pain can also be felt in the hips, usually one side more than the other, or only on one side. The pain can be in different areas for different women, and may feel a bit different because everyone perceives pain differently, and the misalignment can go in various directions and affect different places. 

Clicking, cracking, and popping noises and feelings in the pelvic region and hips are also very common with SPD. Sometimes they can be so loud that others hear them, and sometimes they just feel like they are. Sometimes these pops can bring relief, other times they can make the pain worse. It just depends on whether or not your body is adjusting itself in the right direction.


How is it Treated?

There is no one-size-fits-all treatment. A combination of stabilization exercises, ice, positioning, and manual therapy is the most effective. Stabilization exercises reduce stress on the joint and improve stability. Stabilization exercises include strengthening the abdominals, pelvic floor, gluteals, latissimus dorsi and hip adductors. Chiropractic care is the most highly recommended component of treatment by those that have tried it. It is certainly what I recommend over anything else. Physical therapy is common in the UK, and sometimes attempted in the US, as well. Swimming is a good option, especially in conjunction with specialized physical therapy (in the water) if you can find a therapist trained in treating SPD. 

Many doctors will simply tell women to take acetaminophen (paracetamol), and if the pain gets bad enough, give them crutches, or in rare cases, a wheelchair. This isn't really treating the problem, however, only the symptoms. There are also a couple of different types of surgery that can be performed to try to repair it if it persists after delivery, but they have very low success rates, and sometimes can actually make the pain worse. One type involves fusing the pubis together with a metal plate. Another involves binding it with something else, like thread or ligaments from a donor (like a pig) or another part of your body. These surgeries also make future pregnancies highly inadvisable, since they immobilize the pubis, and make future vaginal delivery impossible. They can also come undone if you do become pregnant again because it will try to separate anyway to make room for Baby. I do not personally recommend these procedures at all, based on their outcomes, unless everything else has failed and you are desperate enough to risk it.




What Can You do to Minimize the Pain?

⬨When getting in and out of a car or getting up from a chair or bed, keep your knees together. Do NOT do extreme stretches, especially one-sided ones. DON'T do lunges or squats. These kinds of stretches have the ability to cause irreparable damage to the symphysis pubis that simple chiropractic care cannot fix, and then your only hope left would be the dismal chance of successful surgery. It is important that any stretching you do be symmetrical, to avoid exacerbating the misalignment, and that it be done while sitting or lying down, to avoid pressure on the pubis. 
Sleeping with a pillow between your knees also helps to stabilize the pubis at night. If you are the type that likes to sleep with one knee drawn upward and the other leg straight like I am, I'm sorry to inform you that this can worsen the misalignment and cause you much more pain, despite being comfier for sleeping. It might take some getting used to and a lot of training yourself to be able to sleep in a different position, but it is well worth it. 
Sit down to put on socks, shoes, underwear, and pants. 
Take stairs one step at a time if you cannot avoid them altogether. A good phrase to remember is "up with the good foot, down with the bad foot," meaning that you lead with your least painful side when going up steps, and your most painful when going down. 
Take small strides when walking, trying to keep your knees as close together as possible, and don't walk for too long at a time. 
Rest frequently. 
Do not cross your legs while sitting.
Limping actually makes the pain worse, so try to avoid it if at all possible. 
Keep your knees together when rolling over in bed, or with the pillow still between them. 
Try sitting in a tall chair if you do the dishes or cook. 
Anything you can do to take pressure off of your pelvis will help. 
Change positions and shift your weight frequently when standing. Try not to favor one side when doing this, as this helps further the misalignment.



What Should You Do if You Think you Might Have SPD?



If your insurance will cover it, or you can afford it, don't wait for the pain to become unbearable. Get an adjustment from a knowledgeable chiropractor at the first sign of trouble and see a physical therapist to instruct you in stabilization if at all possible. This makes it much easier to treat, and increases your chances of a full recovery. The longer you wait, the worse the damage becomes. Many chiropractors have a self-pay option for $25-50 per visit, and some give discounts for those on Medicaid or who are uninsured or have no or low income. Reach out in your local community and ask for help. If you are in the US, call 211 to ask for referrals to resources that may be able to help. Start a GoFundMe. Do whatever you can to take care of yourself. Don't let yourself suffer.



What is Good to Keep in Mind During Delivery With SPD?

The best position for delivery with SPD (and one of the best for all women in general) is on all fours. It is the most natural, and allows more room for the pelvis to expand, while actually taking pressure off of the pubis. In this position, the tailbone has room to move to make more space in the birth canal. It is much more comfortable during contractions for most women, as well.

Squatting has been recommended by some providers. I have not heard any accounts from women with SPD that have delivered in this position, though, and since it still puts so much pressure on the pelvis, and stretches it so much, I am personally a bit hesitant to try it, but I would definitely try it before the lithotomy position if I needed an alternative to being on all fours. 

Waterbirth is also a really good choice. This is when you actually deliver Baby in a pool or tub of water. It helps to decrease tearing of the perineum, and decreases the pain of contractions, as well. This is not always possible, but is becoming increasingly more available of an option across the world. It is most common in birthing centers, but some hospitals do offer it. Homebirth with a midwife or freebirth (without any medical professional in attendance) also makes this possible. 



What is the Most Important Thing to Know About SPD?

You have to be careful during delivery when you have SPD. If Baby is in a funny position, such as with their arm up by their head, during delivery, most doctors/nurses will forcefully grab your legs and push them up to your shoulders. This is one of the absolute worst things that can be done to a woman with SPD, and almost always results in irreparable damage to the symphysis pubis, which can cause her extreme pain for the rest of her life. Like with the stretching I warned against, this can actually cause severe tearing of the ligaments and in some cases, the muscles around the pubis. 

The lithotomy position (lying on your back on a bed or table during delivery) is the worst possible position for a woman to give birth in. Not just women with SPD, but all women. The World Health Organization cautions against this position. Despite the fact that the US uses this position almost exclusively, it has been banned in many countries. It compresses the birth canal and slows labor. It also increases the chances and degree of tearing that may occur during birth. It may even increase the chances of needing an emergency C-section and the use of other interventions, such as forceps or venthouse. The common use of stirrups in this position is one of the dangers to women with SPD, as it can also cause tearing of the ligaments in the pubis.

Having an epidural or spinal block also increases your chances of permanent damage due to SPD. Because it numbs you, your body can't tell you when you are in a position that is putting too much stress on the pubis. You won't be able to feel it if your ligaments or muscles do begin to tear. 

It is very important that you make sure the doctor/nurses/midwife present at your delivery know that you have SPD, and know not to force your legs apart or to put you in stirrups. Some doctors will try to tell you that you cannot have a vaginal delivery if you have SPD. This is simply untrue. While there may be more risks to the pubis with a vaginal delivery than with a C-section, there are still more risks in general with a C-section, so it is still no more advisable over a vaginal delivery for a woman with SPD than a woman without it, unless there are other issues present that make a C-section a safer option.

Again, don't ever let a doctor blow you off if you are having extreme pain. Trust your body. If something doesn't feel right, then it probably isn't. You know your body better than anyone else. Doctors may have lots of knowledge about lots of things, but they are not omniscient. They do not know everything. The best doctor can admit that sometimes the patient does know better than they do. If your doctor is unwilling to listen to your complaints, or is refusing to investigate your symptoms, please don't hesitate to find another doctor that will listen to you and CARE. Many doctors think of patients as just numbers -- money in their pocketbook. A truly good doctor will actually care about you as a person.


Where Can You Find More Information on SPD?

You can find further information on Wikipedia, Physio-Pedia, Healthline, and the NHS, but the best information by far that I have come across in my research came from Plus Size Pregnancy.