#10 The amazing pubic symphysis during labor
Making preparations for a gentle birth and smooth delivery?
It can be helpful to understand what’s happening during labor and how you can work with your body to facilitate a smooth birth. Let’s look at the bones that make up the pelvis. You have a large fan-shaped hip bone (ilia) on each side, joined in the back to an upside down triangular-shaped bone, the sacrum. In the front, the two ilia are joined together by the pubic symphysis which is a fibrous joint that has some subtle but very important movements to it during labor. This amazing joint is the subject of my post today. To find it, place your hands on your hips and follow the bones down and in to just above the opening to your genitals. That boney prominence is your pubic symphysis. During pregnancy, baby sits in the bowl of your pelvis, then descends deeper into the pelvis for delivery. The movement of your baby down the birth canal is not a straight path. Think of it as a curved tunnel. As the baby descends, the three bones of your pelvis, the sacrum and left and right hip bone rotate and compress in a coordinated way to allow the baby to descend. Think of your pubic symphysis like a little accordion bellow; the cartilage can compress at the top of the joint or at the bottom of the joint or come apart slightly. A gap of 4-5mm is considered normal during pregnancy and may widen to 9 mm during labor and delivery. But sometimes things get too stretched out and a mom suffers a pubic symphysis separation, which is defined as more than a 9 mm separation. This makes walking extremely painful but healing is possible with some physical therapy and maybe a low-slug support belt. As far as birth preparation goes, there’s not too much to do before birth to assist your amazing pubic symphysis to get in shape. Just allow it to move as it needs to during labor by frequently changing positions; try to include standing, walking, sitting, squatting and side lying labor positions. If you experience pain at your pubic symphysis or groin during pregnancy, you should try to avoid single leg standing exercises, excessive hip abduction (sitting with legs wide apart), and consider seeking help from a physical therapist. Lasting disability from a pubic symphysis separation is rare; most moms find complete resolution within 6 months postpartum with appropriate care.
In an upcoming blog, we will look more closely at the other joints of the pelvis: the sacroiliac joints (SI joints).
