Separation of the Pubic Symphysis

One person's experience's with Separation of Pubic Symphysis.

One post-partum complication of birth is separation of pubic symphysis. It can be accompanied by pain in the hips or lower back when walking or use of a waddling gait when walking. Here's one person's experience.
(Note: this information is not medical advice)


Summary: In the process of giving birth to my son in 2004 I experienced a three-centimeter separation of the pubic symphysis (the pelvis). While it is normal for the pelvis to expand during labor and delivery, mine didn’t go back into place. My husband named it the “separatoose” in the hospital since we kept forgetting what it was called.

 

Labor & Delivery: I had a very long and difficult labor - admitted to the hospital at 4:00 am with a 4 cm dilation and then got an epidural at 8am. Everything seemed to be going well and the doctors thought the baby would come by noon or 2pm. The baby arrived at 11:52pm that night by vaginal delivery. From what I understand, my pelvis was shaped in such a way that the baby had to go “over the river and through the woods” before even getting to zero station (the point at which you push). So I had a few rounds of pushing before the real pushing even happened. I was exhausted, the epidural had worn off, but I told the doctor I could go as long as it was necessary and only wanted a C-section if the baby or I was in danger. There was also a point where the OB/GYN was going to have a resident push on my stomach for the final push so that the baby’s shoulder wouldn’t get hurt coming out – but things progressed so that she didn’t have to do that. And my son was born healthy.

 

In the hospital: Immediately after giving birth my legs and pelvic area were very sore. But since I’d never done this before I thought it was normal. Once I was in my private room, I could barely sit up or lie back in the bed. I couldn’t swing my legs around or walk to the bathroom. It was more of a slow shuffle with the help of my husband or the nurse’s aide. The next morning I noticed some of the women on the hall that had delivered via C-section walking slowly up and down the hall. I couldn’t even do that. Something seemed very wrong so I requested an X-ray. The result was a three-centimeter separation of the pubic symphysis – or the pelvis. A Physician’s Assistant to an Orthopedic Surgeon saw me and the recommendation was simply rest. “Nothing you can do to make it better, and nothing you can do to make it worse”. If it had separated by four centimeters, “we would put you in a binder” – I think that’s an elastic band, girdle type thing. I ended up in the hospital for 4 days. I was not going to leave until I could walk better and climb stairs, so I met with an Occupational Therapist at the hospital to help me with that. While I didn’t plan to go in and out a lot in the coming weeks, I do live in a third floor walk up and needed to be able to get home. I also requested to speak to a Social Worker since I felt very scared and worried that I wouldn’t be able to care for my newborn.

 

At home: We hired a post-partum doula to help out in the house part time for 4 weeks. I  was able to take care of the baby for the most part but needed more rest and down time. I got shiatsu massage once and then a series of six very good post partum massages with someone skilled in this area. A friend suggested Pilates but I knew it was too soon for that. I walked bowl legged for a couple months because it minimized the pain, but another friend, who had athletic injuries in the past suggested I make a concerted effort to walk normal, “one foot in front of the other”, even if it meant doing a pronounced, funny looking lift and step. It hurt more, but it was the right thing to do and my walking improved so much. My follow up visit to the Orthopedic Surgeon 8 weeks later was a disappointment as he said, “oh, I would have put you in a binder”. I responded that his own Physician’s Assistant told me that was only necessary for 4 cm, which came from him! But I know doctors change their minds and aren’t computers – if he’d seen me in person in the hospital things may have been different. 

 

Aftermath: Six months later I was basically back to normal, with a little pain in my lower back and after a year – I was all better. Though when I feel some lower back pain I can’t help from wondering if it’s due to the “separatoose”. It is also possible that during my pregnancy I had Symphysis Pubis Dysfunction (SPD), which I heard about on Park Slope Parents, and just didn’t know it. In my next pregnancy, I plan to bring this up with my OB/GYN so if there is a way to avoid or lessen the pain of another pubic separation I can.