The pain of SPD (Symphysis Pubis Dysfunction) in late pregnancy has this reader wondering whether an elective caesarean is her best option.

Raisingkids member's problem
Should I request an early induction or elective caesarian? I am in a second pregnancy (39 weeks) and have SPD. I also have a very active three-year-old. I have no friends or family living nearby and I am really struggling with the pelvic pain.

I am really worried as to how I will cope with the final weeks of pregnancy. I understand a vaginal birth will be possible but I am really nervous about it with my SPD. I had a long pre-labour last time with very little dilation and had my waters broken in the end. That still didn't speed things up so I ended up with an epidural and a drip to move labour along. Overall the whole thing lasted three days!

As this baby is descending into my pelvis the pain is increasing significantly - enough to affect walking, I am in fact using my daughter's buggy as a zimmer frame! It is not practical for me to have crutches although I do have a support belt. Resting and sleeping are a huge problem which I know is not good for the upcoming labour as I feel I need to rest to prepare for it. Any advice for my situation would be gratefully received. I am under consultant care at the hospital but see so many different people. An early induction or elective caesarian in my mind for a few months but I have so far not asked for them. Is my situation enough grounds for either?

Midwife Genevieve Kingston's Advice
SPD is awful, you have my sympathy. Let's start with early induction. Induction is done to try and trick the body into thinking you have gone into labour, so when the false hormones wear off, your body just continues. Obviously the earlier you are, the less likely it is going to be to be able to trick your body and you may end up needing a caesarian as well as having been induced.

As for caesarian section - you have grounds for requesting one, but you need to remember that not only will you have an active toddler to care for, you will also have an abdominal wound which can take up tp 6 months to recover completely and the symphysis pain will still be there. It doesn't go away as soon as you are delivered. The weight of the baby will have been removed but it can still be debilitating.

Second labours are much less likely to be as protracted as first ones, even if the baby is bigger, and there is usually much less tearing so it's not as painful recovering after the second one.

So you do have grounds for requesting either an early induction or caesarian section but you do need to remember that neither is going to end the pain instantly and may worsen your situation.

This is a stupid question (I hope), but have you have been issued with pain killers? If not, start shouting at people as soon as their phone lines are open. To aid sleeping, it can help to put a slim pillow between your legs, so that the top leg is straight and not hanging down. This reduces the pull on the pelvis and helps to keep your pelvis stable. Pillows in front under your bump, and behind your back can help support you so your body needs to do less of the stabilising work.