Pelvic pain in pregnancy

一些妇女可能会在怀孕中出现骨盆疼痛。这有时称为妊娠相关的骨盆腰痛（PGP）或耻骨功能障碍（SPD）。

PGP is a collection of uncomfortable symptoms caused by a stiffness of your pelvic joints or the joints moving unevenly at either the back or front of your pelvis.

PGP的症状

PGP is not harmful to your baby, but it can be painful and make it hard to get around.

Women with PGP may feel pain:

• over the pubic bone at the front in the centre, roughly level with your hips
• across 1 or both sides of your lower back
• in the area between your vagina and anus (perineum)
• 蔓延到你的大腿

有些妇女可能会感觉到或听到骨盆区域的点击或打磨。

The pain can be worse when you're:

• 步行
• 上下楼梯
• 站在一条腿上（例如，穿衣服时）
• 躺在床上
• moving your legs apart (for example, when you get out of a car)

Most women with PGP can have a vaginal birth.

Treatments for PGP

尽早诊断出可以帮助保持疼痛至少并避免长期不适。

You can ask your midwife for a referral to a physiotherapist who specialises in obstetric pelvic joint problems.

物理疗法旨在缓解或缓解疼痛，改善肌肉功能并改善骨盆关节位置和稳定性。

这可能包括：

• 手动疗法以确保正常移动骨盆，髋关节和脊柱的关节
• exercises to strengthen your pelvic floor, stomach, back and hip muscles
• exercises in water
• advice and suggestions, including positions for labour and birth, looking after your baby and positions for sex
• pain relief, such as十
• equipment, if necessary, such as crutches or pelvic support belts

These problems tend not to get completely better until the baby is born, but treatment from an experienced practitioner can improve the symptoms during pregnancy.

You can contact thePelvic Partnership以获取信息和支持。

应对怀孕的骨盆疼痛

Your physiotherapist may recommend a pelvic support belt to help ease your pain, or crutches to help you get around.

它可以帮助计划您的一天，以免导致您疼痛的活动。例如，不要比您更频繁地上下楼梯。

The骨盆，产科和妇科理疗（POGP）network also offers this advice:

• 在疼痛限制中尽可能活跃，避免使疼痛恶化的活动
• rest when you can
• 询问您的家人，朋友或伴侣（如果您有）来帮助日常活动
• wear flat, supportive shoes
• 坐下来穿好衣服 - 例如，穿牛仔裤时不要站在一条腿上
• 进出车时，保持膝盖在一起 - 座椅上的塑料袋可以帮助您旋转
• sleep in a comfortable position – for example, on your side with a pillow between your legs
• try different ways of turning over in bed – for example, turning over with your knees together and squeezing your buttocks
• take the stairs 1 at a time, or go upstairs backwards or on your bottom
• if you're using crutches, have a small backpack to carry things in
• 如果您想做爱，请考虑不同的职位，例如跪在四个方面

POGP建议您避免：

• standing on 1 leg
• bending and twisting to lift, or carrying a baby on 1 hip
• 交叉双腿
• 坐在地板上或坐在地板上
• 长时间坐着或站立
• 举重，例如购物袋，湿洗或蹒跚学步
• vacuuming
• pushing heavy objects, such as a supermarket trolley
• carrying anything in only 1 hand (try using a small backpack)

The physiotherapist should be able to provide advice on coping with the emotional impact of living with chronic pain, such as using relaxation techniques. If your pain is causing you considerable distress, then you should let your GP or midwife know. You may require additional treatment.

Download the POGP leaflet与妊娠有关的骨盆腰带疼痛.

您可以从The的PGP中获得有关使用PGP管理日常活动的更多信息Pelvic Partnership.

Labour and birth with pelvic pain

Many women with pelvic pain in pregnancy can have a normal vaginal birth.

提前计划并谈论您出生计划with your birth partner and midwife.

Write in your birth plan that you have PGP, so the people supporting you during labour and birth will be aware of your condition.

考虑最适合您的出生职位，并在您的出生计划中写下它们。

Being in water can take the weight off your joints and allow you to move more easily, so you might want to think about having a water birth. You can discuss this with your midwife.

Your 'pain-free range of movement'

如果您张开双腿时会感到疼痛，请找出无痛的运动范围。

为此，请躺在您的背上或坐在椅子的边缘，并尽可能地打开双腿。

您的伴侣或助产士可以通过胶带尺寸测量膝盖之间的距离。这是您的无痛范围。

To protect your joints, try not to open your legs wider than this during labour and birth.

This is particularly important if you have an硬膜外for pain relief in labour, as you won't be feeling the pain that warns you that you're separating your legs too far.

如果您患有硬膜外麻醉，请确保您的助产士和出生伴侣知道您的腿部无痛运动。

When pushing in the second stage of labour, you may find it beneficial to lie on one side.

This prevents your legs from being separated too much. You can stay in this position for the birth of your baby, if you wish.

Sometimes it might be necessary to open your legs wider than your pain-free range to deliver your baby safely, particularly if you have an assisted delivery (for example, with the vacuum orventouse).

即使在这种情况下，也可以限制腿部的分离。确保您的助产士和医生知道您患有PGP。

If you go beyond your pain-free range, your physiotherapist should assess you after the birth.

Take extra care until they have assessed and advised you.

Who gets pelvic pain in pregnancy?

It's estimated that PGP affects up to 1 in 5 pregnant women to some degree.

尚不清楚为什么骨盆疼痛会影响某些女性，但人们认为这与许多问题有关，包括先前对骨盆的损坏，骨盆关节不均匀地移动以及婴儿的重量或位置。

可能使女性更可能发展PGP的因素包括：

• 下背部或骨盆腰部疼痛的病史
• 骨盆以前受伤（例如，秋季或事故）
• having PGP in a previous pregnancy
• a physically demanding job
• being overweight
• having a multiple birth pregnancy

healthtalk.org接受了女性谈论她们的采访experiences of pelvic pain in pregnancy.

Read more about coping withcommon pregnancy problems，包括恶心，胃灼热，疲倦和便秘。

寻找maternity services或者理疗服务near you.