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SPD — Symphysis Pubis Dysfunction | Pregnancy Power Hour
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SPD — Symphysis Pubis Dysfunction

Symphysis Pubis Dysfunction (SPD), also known as pelvic girdle pain (PGP), is a common pregnancy discomfort characterized by pain in the pubic bone and pelvic area.

3 min read

Quick answer

Symphysis Pubis Dysfunction (SPD), also known as pelvic girdle pain (PGP), is a common pregnancy discomfort characterized by pain in the pubic bone and pelvic area.

On this page
  1. What it is
  2. What it tends to feel like
  3. What the evidence says helps
  4. Working with your care team
  • Also: pelvic girdle pain
  • Also: PGP
  • Also: pelvic girdle syndrome

Symphysis Pubis Dysfunction (SPD), often referred to as pelvic girdle pain (PGP), is a specific type of discomfort centered around the pubic bone and pelvis that many individuals experience during pregnancy.

What it is

This condition, known medically as pelvic girdle pain (PGP), encompasses discomfort in the pelvic joints, including the pubic symphysis. It's quite common, affecting a significant number of pregnancies to varying degrees. The primary cause is often attributed to the hormone relaxin, which softens and loosens the ligaments in the pelvis, preparing your body for birth. When this loosening combines with uneven or asymmetric loading on the pubic symphysis joint, it can lead to the characteristic pain of SPD. Understanding this physiological shift can bring a sense of clarity to what might feel like a sudden and puzzling discomfort.

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What it tends to feel like

Individuals often describe SPD as a sharp, shooting, or grinding pain directly over the pubic bone, sometimes radiating into the groin, inner thighs, or even the lower back. This sensation can be particularly noticeable with movements that involve separating the legs, such as getting out of bed, climbing stairs, or turning over in bed. It's a discomfort that can make everyday activities feel challenging, and it's completely valid to seek support for it. This isn't something you simply have to endure; there are practical strategies to help manage the sensations. Just as Pregnancy Back Pain can impact daily comfort, SPD is another area where gentle, informed approaches can make a difference.

What the evidence says helps

When it comes to managing SPD, evidence-based approaches focus on supporting your body and minimizing strain. Pelvic floor physiotherapy, specifically with a therapist trained in pregnancy and postpartum care, is widely considered the first-line treatment. These specialists can offer individualized assessments and exercises to help stabilize the pelvis.

Many people also find significant symptomatic relief from using pelvic support belts. These inexpensive tools can provide external compression and support to the pelvic joints, which can be a welcome comfort. Another widely recommended option is water therapy, such as pool walking or hydrotherapy. The buoyancy of water reduces the load on your joints, offering a gentle way to move and find relief.

To minimize discomfort, it's often helpful to adjust how you move. This means avoiding asymmetric movements where possible. For example, try to keep your knees together when getting in and out of a car, or climb stairs slowly, one step at a time. Sleeping with a pillow between your knees can also help keep your pelvis in a more aligned and comfortable position. While general exercise interventions have mixed evidence, individualized physiotherapy is often more effective than generic exercise programs. It's about finding what specifically supports your body.

It's reassuring to know that SPD typically resolves over the weeks to months following birth. However, for some, the discomfort might persist, and continued physiotherapy support can be very beneficial. This period of change can bring various physical sensations, and just as you might experience Pregnancy Headaches or Pregnancy Dizziness and Lightheadedness at different points, understanding the specific nature of SPD helps in navigating it with more calm and confidence.

Working with your care team

Navigating pelvic pain during pregnancy involves collaborating closely with your care team. Your obstetrician or midwife is your best resource for an initial assessment and to rule out any other concerns. They can also provide referrals to a specialized pelvic floor physiotherapist, which is a key step in developing a personalized management plan. As a trained full spectrum doula, I often see how empowering it is for clients to understand their options and feel heard. You get to decide what feels right for your body and your comfort. Open communication with your provider ensures you receive the most appropriate, evidence-based support for your unique situation. Remember, this guidance is for practical wellness and education, not medical care, and your provider is your best resource for your specific situation.

Common questions

What causes SPD in pregnancy?+

SPD, or pelvic girdle pain, is primarily caused by the hormone relaxin loosening the ligaments in your pelvis, combined with uneven pressure or load on the pubic symphysis joint. This combination can lead to discomfort and pain in the pelvic area.

What can help relieve SPD pain?+

Evidence suggests several approaches. Pelvic floor physiotherapy with a pregnancy-trained specialist is a first-line treatment. Many also find relief from pelvic support belts and water therapy like pool walking. Adjusting movements, such as keeping legs together when getting in/out of a car, can also help.

Does SPD go away after birth?+

For most individuals, SPD symptoms typically resolve over the weeks to months following childbirth. However, for some, the pain might persist, and in those cases, continuing with physiotherapy can be beneficial for ongoing relief and recovery.

Brittany Nance

“Pregnancy is under-supported at every week. This is the kind of clear, calm guidance I give my one-on-one clients — and the questions worth taking back to your provider.”

Brittany Nance · Pregnancy Wellness Consultant · full-spectrum doula

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Written by Brittany Nance, Pregnancy Wellness Consultant· BADT Full Spectrum Doula · Founder, Pregnancy Power Hour
Last reviewed July 15, 2026

This is evidence-informed education from a birth-doula perspective, not medical advice. Always discuss your individual situation with your prenatal care provider.

On this page

  1. What it is
  2. What it tends to feel like
  3. What the evidence says helps
  4. Working with your care team

Keep reading

  • RelatedPubic Bone Pain in PregnancyPubic bone pain, or pelvic girdle pain (SPD), affects many pregnant individuals due to ligament loosening, but evidence-based strategies can offer comfort.
  • RelatedPubic Bone Pain at 20 Weeks PregnantAt 20 weeks, pubic bone pain, or pelvic girdle pain at the pubic symphysis, can emerge as relaxin begins to loosen pelvic ligaments.
  • RelatedPubic Bone Pain at 19 Weeks PregnantAt 19 weeks, pubic bone pain, often called pelvic girdle pain (PGP) at the pubic symphysis (SPD), can emerge due to relaxin-driven joint laxity.
  • RelatedPubic Bone Pain at 21 Weeks PregnantAt 21 weeks, pubic bone pain, often called pelvic girdle pain, can arise as your body adapts to pregnancy, driven by relaxin-induced joint laxity.
  • RelatedPubic Bone Pain at 25 Weeks PregnantAt 25 weeks, pubic bone pain, often called pelvic girdle pain, can arise as relaxin loosens your pelvic ligaments, leading to discomfort.
  • RelatedPubic Bone Pain at 24 Weeks PregnantAt 24 weeks, pubic bone pain, or pelvic girdle pain (PGP), is common due to relaxin and your growing baby, affecting many pregnancies.