Delivery Advice: Sciatica/Sep Pubic Bone

[carolinamama]

I am trying to figure out how to best manage the next few days. I am 40+ weeks pregnant and ds2 seems entirely too comfortable to come out!

The problem is that I can hardly walk because I separated my pubic symphasis a few weeks ago in a slip/fall (obviously suspected based on clinical exam since no one will x-ray a pregnant woman) and now as of this last week I think baby is sitting on my sciatic nerve and my hips feel stuck. It is difficult for me to walk at all. My ob suggested a chiropractor after I deliver to help heal the pubic separation but I am trying to figure out how all this will affect delivery. I am an epidural girl, so I think I can handle the pain with that hopefully.

Anyone btdt? Or advice if you have had a separation after delivery? I would love to have an adjustment at this point before delivery, but it's Friday and I will be induced Tuesday if baby hasn't made an appearance by then. OB feels confident that induction can be accomplished by just rupturing my membranes as I am atleast 4 cm dilated and thinned out.

Also, how do I find a chiropractor or PT for this issue? Anyone have recommendations in the Raleigh/Durham, NC area?

Thanks for any help or experience you can share. I feel like an old woman way before my time.

[CAM7]

Ouch! Sorry to hear that you are dealing with this...

I've never had to deal with the 'separation' issue... but when I used to have sciatic nerve problems ice really helped. I know it's doesn't sound appealing to put ice on your lower back but if you have inflamation it will help control that pain.

HTH!

[SnuggleBuggles]

I haven't bdtd but when I used to host a labor board I had this question come up and I set out to find the most helpful info I could. The very best I found is the plus-sized pregnancy one. And plus sized or not this website is fantastic! This is the intro to their section on birthing with SPD as a complicating factor. Follow the link to read in detail about each suggestion (I don't know if I could post the whole thing b/c of copyright but I really hope you will take the time to follow the link):
Planning for Birth
Certain common obstetric interventions tend to make Symphysis Pubic Dysfunction pain worse, and may even lead to ligament damage or severe separation of the joint, causing true Diastasis Symphysis Pubis. Therefore, it is vitally important that your doctor or midwife understand and believe in the existence of SPD and realize its implications for birth. The following ideas (taken from a number of sources) are supposed to help maximize your comfort and help the normal birth process, while also minimizing the risk for pubic symphysis-related trauma.

Be extremely careful of birth positioning. Certain positions are better than others. Avoid stirrups!
Be sure your labor assistants and providers know all about SPD, what movements can hurt or damage you, and what your comfortable range of motion is
Avoid most common labor interventions, as these often cause pubic symphysis strain/damage
Avoid an epidural if at all possible, as this often is associated with more severe damage
Use a 'narrow gap' between the legs for any routine procedures that can't be avoided
Hire a birth attendant that is familiar with and can help resolve baby malpositionhttp://www.plus-size-pregnancy.org/pubicpain.htm#Planning%20for%20Birth

There is postpartum info on that site as well as relief tips for now. Hope that helps.



Just me unsolicited advice of the day...always have a back up plan for dealing with labor pain. You never know if you will be able to get that perfect epidural when you need it. Unmedicated labors are much tougher if you never plan to have one but end up with one. :)


Beth

[brittone2]

nak-

call around and try to find a PT that specializes in pregnancy/post partum issues. They can help suggest labor positions, etc and possible rehab post partum.

eta: you are in my area. Try calling the birth center in CH and see if they know what PTs are good for prenatal/postpartum. They recommended Balanced Movement studio in Carrboro to me for my diastasis recti (separated ab muscles). If Balanced Movement doesn't do prenatal/postpartum, they'll know who does in the area most likely.

back to add this:
http://www.womenshealthapta.org/plp/index.cfm
It looks like Duke has some options available.

[carolinamama]

THANKS to everyone who responded. Ack, why do all the specialists in this area have to be on the wrong side of town? It would take at least an hour to get to Durham (from far side of Cary) and with a newborn and preschooler, I'm going to have to figure this all out. At least I know where to start.

As for a natural birth, I'd love to think that's a possibility. I just don't have a doula set up at this point and dh is very supportive, but so not prepared to support that. Up until a few weeks ago, I had a very comfortable pregnancy.

Thanks again. And if anyone else has any great info or experience, please let me know.

[shilo]

hugs, i ended up with a small separation after delivering sam and have had SPD since about 14 weeks with this one. even tho i am a PT and know what to do for myself exercise wise, there are many hands on techniques that i just can't do for myself, and PT has been invaluable in keeping me functional this pregnancy. i'd highly recommend getting in to see a PT who has women's health training, if you can.

you mentioned you're on the cary side of town, so here's a few listings i could hunt up thru my PT/OB friends in the triangle area. i don't know any of them personally, but hope one of them might be able to help!


jennifer maddocks, Dunn PT, Cary nc 919.388.0111
laura sutter, Dunn PT, Cary nc 919.388.0111
jamie tjalma, Avante PT, Cary nc 919.463.9443

hth, lori

[Momof3Labs]

I had a separated pelvis after DS2 was born and the chiro would provide temporary relief but did NOT help me heal properly. I ended up in a LOT of pain for almost a year before I found a PT who could help me (the first PT did not, which is why I didn't pursue PT more actively). My PT was a pelvic specialist and I drove 45 mins each way to see her, but it was worth it.

There's no way I could bring two kids to one of my PT appointments (they were an hour long and I was on a table most of the time); you'll probably need to have a sitter or go when your DH can be home with the kids. I had a series of exercises to do daily at home, and did them at night when the kids were in bed.