Pregnancy-related Pelvic Girdle Pain: In the News

Pregnancy-related pelvic girdle pain (PPGP) has received increased interest in the news and in the research community in the past few years. PPGP can cause significant movement dysfunction both during and after pregnancy, and therapists can play a valuable role in prevention, intervention and rehabilitation. In the news lately are several recent studies that I will summarize and for which I have provided abstract links below.

Is pelvic girdle pain predictable?

The International Association for the Study of Pain reports on predictors of pelvic girdle pain in the working mom. In the study, 548 pregnant Dutch working women were recruited, and at 12 weeks postpartum nearly half of the women reported pain in the pelvic girdle. The pregnancy-related predictors for pelvic girdle pain at 12 weeks were low back pain history, increased somatisation, 8 hours or more sleep or rest/day, and uncomfortable postures at work. Pregnancy and postpartum-related predictors included increased disability and having pelvic girdle pain at 6 weeks, higher somatisation, higher baby birth weight, uncomfortable postures at work, and number of days of bed rest. The authors concluded that when a woman has pelvic girdle pain during pregnancy, increased attention should be given to the woman to prevent serious pelvic girdle pain in the postpartum period and beyond.

Research addressing mode of delivery and pelvic girdle painin 10,400 women who had singleton pregnancies found an association between cesarean section and persistent pelvic girdle pain following birth. A planned c-section was associated with 2-3 times higher rates of pelvic girdle pain at 6 months postpartum. The authors conclude that for women who have pelvic girdle pain in pregnancy, unless there is a compelling medical reason for c-section birth, a vaginal birth is recommended. In a study by the same lead author,Dr. Bjelland of Norway, women were found overall to have high rates of recovery from pelvic girdle pain in the postpartum period, yet women who experienced significant emotional distress during 2 times points in pregnancy had an independent association with persistent pelvic girdle pain.

Another Norwegian study asked if women were following exercise guidelines in pregnancy and how that was related to pelvic girdle and low back pain. The authors conclude that most pregnant women in Norway do not follow the current exercise guidelines in mid-pregnancy. For women who exercised at or more than 3x/week, they had a lower rate of pelvic girdle pain. In the women who exercised 1-2x/week, rates of low back pain and depression were lessened. The study findings suggest that exercising during pregnancy may lower the risk of pelvic and low back pain.

The more we understand about the relationship between pregnancy-related pelvic girdle pain and postpartum persistent pelvic girdle pain, the better prepared we are as pelvic rehab providers to offer support and healing. The research addressing best rehabilitation approaches for pelvic girdle pain continues, with reviews of the literature often concluding that we need more and better research.