SPD and natural vs caesarean childbirth

[freedomfighter]

ive got spd and am due in a couple of weeks. how severe does the SPD have to be for them to advise a caesarean? and are there any difficulties and longer term effects associated with vaginal birth with SPD? have read that sometimes caesarean is better as vaginal birth can mean SPD continues and gets worse. All experiences welcome please! The babys head's not engaged at the moment and when it does does this mean SPD will be more painful????

[CatherineEarnshaw]

the spd was not an issue in my delivery -i just forgot it!

[MerryChristmasPANDAGHappyNewYe]

I was hospitalised with SPD for a month before I had DD. I had a vaginal delivery, and was a lot better (ie walking not bedbound) within a few days. I know this is not the experience of everyone on here though.

[freedomfighter]

Thanks, both reassuring. Its just good to hear as many different experiences as possible. The midwife doesn't seem bothered at the moment and the SPD although hurts and limits my walking its not so horrendous as I imagine it can be if you have to be hospitalised. did it hurt more for the both of you when the head engaged or did it make no difference?

[Harry2007]

I have sever SPD and have been hospitalised 3 times in the last 4 weeks. Literally can't move though - am confined to the sofa/hospital bed all day.

I'm seeing my Consultant on Monday to book in for a CS as I can only part my knees 9cm. My Consultant has advised that if I was to have a vaginal birth, I would probably have to have an epidural which could have future consequences. The reasoning behind this is that due to the severity of my SPD, should a midwife part my legs further thab what is normally comfortable when not under anaesthetic, it could cause considerable effects after the birth.

I have to stress though that it is the severity of the SPD that seems to make the difference. I am also having a very large baby!

[snugglebumnappies]

Hi Freedom, I think a c/s for SPD would have to be a last resourt, I had very severe SPD in my last pregnancy from 30 weeks I was housebound and using ctrutches to get around the house. No analgesia worked and I was offered (but declined) pethedine for it. I could not sleep as it was much worse at night, prob due to the rise in hormone levels at nght, I could only lie on one side for 20 mins before it got so uncomfortable that I had to tr and roll over, in doing this I could feel my whole pelivs "cracking" through the roll and I was literally screaming in agonny. If I got out of bed my feet would be pointing inwards (I kid you not!) and my pelvis conrtinued to "click" and "clunk" untill it aligned itself. Intrestingly I had no problems abducting my legs (although the physio still told me to avaoid this) but it was the scissor walking movement that caused so much pain. I didn't consider a cs but decided to have a waterbirth, found the pool wonderful, infact hired one and used it pre labour in the evening, this was truly the only time I was pain free and would spend hours in the pool watching Tv and just relaxing! Used the pool during labour but unfortunatly ended up with a cs as DD turned to oblique breech. Have to say that I don't think thatc/s or vaginal birth would have made the slightest difference as it took over 6 months before the symptoms of SPD subsided after my c/s.
As it was my second baby and she was breech I have no personal experience about an enhaged head making SPD more painful, however professionally I have looked after women who found that an engaged head actua;lly made the SPD les painful (maybe having the head in the pelvis actually stabalized it?)
Hope this helps a little.

[lulumama]

good articles about positions for birth & SPD

[freedomfighter]

Snuggle - thanks for comments, i was looking at birthing pool pre-labour (if its available!) - your experience sounds horrendous, at least now you're symptom free cos that was one of my main worries that the symptoms are then permanent due to damage caused to pelvis in childbirth cos I've already got joint problems for last 10 years and I don't want any more!!

Lulu - when first started link was thinking "oh my god" but by end was more reassured about birth positions and in particular the couple of comments about SPD meaning pelvis more flexible so might make birth shorter!

[lulumama]

you do have to trawl through some of the articles as they can sound a bit 'medical' , but they are really excellent and reassuring on the whole, for lots of birth queries..!

[taylormama]

i had bad SPD - was told to go on crutches which i refused. I had a natural delivery and tbh was fine - kept mobile as much as poss and on hands and knees - used the bath when i could and ended up giving birth on my back but that was my choice and how i felt most comfortable ...

[thehairybabysmum]

Hello FF...just for the other side of the coin..I had SPD, not as severe as some on here but was grim (as you know).

I discussed with my MW in labour room about it and the need to avoid having legs v. wide apart as apparently it is this that can lead to longer term probs. However DS went into distress and the docs when examing me didnt really take any notice of this.

I ended up with an emergency CS and have to say that even with the CS pain I felt so much better even the next day...went from being barely able to walk because of SPD to it being much more comfortable even with scar. I think having the SPD pain made the CS scar seem like no trouble at all.

I would say from everything i read pre-birth that if you are able to get a water birth then that would be an excellent option...apart from the support of the water itself you are less likely to be examined as often if you are sat in a pool.

If you do have a natural birth then i think the main thing is to avoid legs being in stirrups or midwives holding legs apart but i think this is easier said than done when time comes as its not exactly uppermost in your mind during a contraction!!

Maybe you could discuss with your midwife and say that if it looked like you may end up needing instruments (where stirrups used), then could you just have a CS in that eventuality instead?

Overall i would say that obviously a natural birth is the preferable option but if things seem to be heading towards a medically managed natural birth then maybe a CS would be better than that. If you do end up having a CS then I think the pain of SPD stands you in good stead for dealing with your recovery.

[freedomfighter]

Brilliant, thanks for all the posts - really really useful...got birthing pool on birth plan so hopefully it will be free when i go in!