My Birth Stories and experience of SPD
When I first had SPD (Symphysis Pubis Dysfunction) 7 years ago, it was mild during my pregnancy. There was very little information available, and it was not taken very seriously. As a result, I tried not to make a fuss, and ended up, after a traumatic forceps delivery (both physically and emotionally) with severe SPD and extreme difficulty walking.
It took me ages to find treatment – I kept being told to do exercises, lose weight, just get on with it etc., and when I finally found my current physio, who works in private practice, 16 months had passed. It did take some time to get on top of all the extra problems that had been generated by the original injury. She treated me initially by realigning my joints as they were not moving symmetrically, and then as this improved used a combination of gentle joint realignment and pelvic stability exercises, often using a gymball (the kids love having it at home!).
During my second pregnancy, I found that although I knew much more about SPD than before, not everyone else did, and I found antenatal appointments with well-meaning but ill-informed midwives and doctors very frustrating. I was also very concerned about my ability to give birth after my first experience. I chose to have the baby at a different hospital, where there was a supportive consultant who was able to give me choices about how I gave birth, and after lots of indecision, including discussions about elective caesareans, had a water birth, with a very supportive midwife, which was a lovely experience.
When I got pregnant with my third baby (yes, I did it 3 times!) I decided I would plan the birth that would be best for me and my baby. I now knew that I could actually give birth. However, I didn’t feel that the hospital environment had actually added anything to my experience or to the care I had received; in fact the staff were so stretched that I had not had the bed-rest that had been planned, and I had gone home the day after the birth, and had been much more effectively looked after at home by my husband. Having learned lots over the past few years, and met and talked to lots of women with SPD, I decided to have a home water birth.
My midwife was supportive from the outset, as were my hospital consultant and my GP, and I felt that I knew all I needed to about my pelvis. I saw my physio regularly throughout the pregnancy and she kept me on my feet (though using crutches from about halfway through), and kept the pain manageable. I couldn’t have even considered either my second or third pregnancies without her.
I was very limited in how far I could walk – I could just make it up and downstairs a couple of times a day, and could get to my car (automatic – I couldn’t change gear) to go out, so long as I could park directly outside my destination. I did manage to get a disabled parking badge for a year, which transformed my life! School was a nightmare, as there is no designated disabled space, so if there was not a gap in the staff car park, it was a long trek on crutches to get to the door (looking at the distance now, it seems amazing that I couldn’t manage it, but at the time it felt like a marathon).
My antenatal care was ideal for me this time. I had met my midwife, Liz, just in passing prior to my pregnancy, and thought that if I did get pregnant, she was the person I would like to care for me. When I tried to make an early appointment, the “system” made it impossible for me to book to see her, but when I bumped into her in the car park as she was on her way to an aquanatal class, and tried to explain that I was pregnant, had SPD and wanted a home birth, she calmly suggested that she ring me later to talk about it. Sure enough, she managed to find my number and did ring me that day – I was both relieved and impressed!
She made all the difference to my pregnancy, and understood enough about SPD to make me feel very confident in her ability to care for me. We didn’t have any of those conversations which went “so apart from your SPD everything is fine...?” As before, because of the SPD, everything was pretty hard work, but not as bad as the last time.
Liz started to visit me at home once I was on crutches, which made a huge difference, and in fact I didn’t get nearly as much pain as I had done with my second pregnancy, because I knew that I had to ask for help, and my friends and family now understood that I really needed it. I had been really concerned that they would not understand why I had chosen to have another baby, but if they did think it, they kept it to themselves, which also helped.
In my own home, I had everything I needed to keep me mobile – a monkey pole so I could turn over in bed, a shower seat so I could sit down in the shower and wash my feet (I couldn’t get into the bath), and a perching stool so I could do a bit in the kitchen. I knew that in hospital things were just not set up as I needed them, and I would have to constantly ask for help, whereas at home, my husband was available and knew what I could and couldn’t do, so home birth was definitely the best option.
I hired a birthing pool, as I had used one for both my previous labours and knew how much pain relief and freedom of movement it had given me. When the pool arrived, I had ordered an extra liner so I could use it for relaxation and pain relief in the days before I went into labour, and the children thought it was great having their own pool in the playroom/dining room – it was really at the centre of the house - so we had a wonderful time in it.
The midwives were all very supportive of the home birth, and started popping round to check that everything was ok and have a peek at the pool, which made it feel like it really was going to happen, and it would all be fine.
My first 2 babies were 14 days overdue (I declined induction both times as I felt my pelvis was not up to it, and wasn’t convinced it was the best thing for the babies either), so I was fairly confident this would be another long wait. However, only 10 days overdue (early by my standards) I went into labour. I had had a few twinges in the morning, and had some last minute thing to get for the baby, so hobbled round a couple of shops on my crutches, keen to keep as upright as possible just in case it got things going. Liz was due to visit that day to do a stretch and sweep, so I rang to check she wasn’t planning to come around lunchtime so we could go out for a last quiet lunch together before the baby arrived.
We went out, and I started having contractions about 5 minutes apart, but as they had just started, I wasn’t too concerned, so carried on with the meal. (I did decline to drive home though). When I got home I thought I would give Liz a ring at about 2pm. She wasn’t able to come out straight away as she was doing a clinic (working for the NHS at this time), and probably thought we had plenty of time, but after another hour, I rang and said I really did think I was in labour, so she came out at about 3.30. By the time she examined me at 4pm I was 4 cm dilated, and so it was time to get in the pool. Liz mentioned at this point that I should warn her when I wanted gas and air as it would take half an hour to arrive – I was slightly concerned by this as “about now” was the answer – I thought things were moving quite fast! Fortunately, it got there a bit quicker than expected, so it was all fine.
We were by now well practised at filling the pool, so I pottered around and made cups of tea while Paul filled it up, and then I perched on my kitchen stool while they helped my legs in over the edge – what bliss! Instead of a hobbling whale, I could roll and move about, and the pain relief was great, along with a bit of gas and air.
By 5.30 I felt ready to push. As I had torn the previous time and had an episiotomy the first time, Liz and I had discussed this in advance, and she suggested not pushing, but letting my body do the work. So I took another big swig of gas and air and tried to relax everything as the contraction got stronger. I suddenly felt something gushing through a huge space inside me, and suddenly Liz was passing me my new baby, Heather! The waters broke as she was born. I had a tiny graze, and by the next day really felt like I had not given birth - those of you reading this who have ever given birth vaginally will not believe this, I know – I thought it was a myth perpetuated by pregnancy magazines until it happened to me.
I was then able to potter upstairs to my own bed and all my mobility equipment (and my husband) were available. We were able to snuggle up in bed together with our new baby this time, which felt absolutely perfect. I made a very quick recovery – after only 2 weeks I was able to push the pram a few hundred yards without pain (this took over a year after my first and 6 weeks with my second), and a year on, I am able to carry her up and downstairs, and walk quite a long way, again, in total contrast to my previous experience. I still see my physio every so often to progress my exercises or to realign things if I have overdone it. I have just started to push light shopping trolleys, and do Pilates classes to help my pelvic stability.
The information I had and the support from both friends and the professionals caring for me (and I really felt they did care) made all this possible, and the feeling of achievement and empowerment is really wonderful.
If you would like information about SPD, please contact the Pelvic Partnership: phone 01235 820921 or visit their website.
