SPD can be addressed during pregnancy

Pubic Symphysis What You Need To Know For Pregnancy + Postpartum

March 11, 20243 min read


I recently posted a video on TikTok that had over 330,000 views hundreds of women commented and there was a VERY common and frustrating consensus. 

“I was told it’s normal pregnancy pain”

“Complained to my doctor, he said it happens and it just gets worse”
“My OB said it’s normal”
“I had this after my first and couldn’t even walk”

“Yes yes yes I have been telling my OB how bad it hurts and she told me to just get a pelvis support belt”

“I’m miserable”

“I had this for my last two pregnancies. The pain was the absolute worst I couldn’t even put my pants on. But they said it’s ‘normal’”

“I’ve been having this pain my whole pregnancy and I’m 33 weeks now”

“OMG I can’t even walk it’s so bad” 


There are HUNDREDS more and from what you can tell people are being told it’s normal and that’s about it. A few were told to get a pregnancy support belt. 

But why is it happening? 

When we get pregnant a hormone called Relaxin is released into the bloodstream and begins to loosen the joints. This is essential because a baby is bigger than our pelvis and these joints need to open to allow the baby to evacuate. But that hormone goes throughout our entire body and it happens in the first trimester so as we and the baby continue to grow that weight is then passed onto the pelvic floor and joints. 

The pubic symphysis joint is located at the center of the pelvis and this joint separates during birth. As we grow and our mobility changes we are more often than not kind of flailing our leg out to the side, to get in and out of bed, the tub, the car, and that creates friction at this joint that friction plus the added strain from the weight of baby creates pubic symphysis pain. 

So yes the easy solution would be to offset the weight with a pregnancy belt. However, the root cause of the issue is the friction and the strain on the joints. At the same time, the pelvic floor is trying to help out and tighten to hold the joints together. 

Tips to reduce the friction; 

  • When getting in and out of bed or the car you want to sit down first and then bring one leg in at a time. 

  • Avoid squatting, especially while weight-bearing. 

That’s not all you can do for relief but this can prevent it from worsening. 

The #1 thing you can do is work with a pelvic expert physical therapist who will address the pain internally and externally. 

Addressing this pain should be a priority because the pelvic floor is tightening to hold your joints together and is tightening because of the pain it can become too tight and cause you to strain or push longer during birth. 

The pelvic floor needs to relax and bulge during birth so that the contractions can assist the baby down and through the pelvic floor into the vaginal canal. If the pelvic floor is tight and you are straining and struggling to get the baby through the pelvic floor it can cause birth injuries like tearing, pelvic organ prolapse or increase the need for s c-section. Knowing these risks makes it, even more, disheartening to know that so many women are being told it’s normal and there’s nothing that can be done because it directly affects their experience during pregnancy and can affect their birthing process.


pubic symphysis painspdlightening crotch pregnancy pain

Dr. Allison Feldt, PT, DPT

Owner of Body Motion Physical Therapy + Best Selling Author

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