Symphysis Pubis Dysfunction (SPD), often referred to as Pelvic Girdle Pain (PGP), is characterized by severe pain and instability in the pelvic joints during pregnancy. This discomfort naturally leads many to worry about the potential consequences for the developing baby and the pregnancy itself. Early labor is defined as a preterm birth occurring before 37 completed weeks of gestation. Given the intensity of the pelvic pain associated with SPD, expectant parents often feel anxious about a potential connection to early labor. This article provides an evidence-based answer to whether this common musculoskeletal condition affects the timeline of the pregnancy.
What Is Symphysis Pubis Dysfunction?
Symphysis Pubis Dysfunction involves the pubic symphysis, the joint located at the front of the pelvis where the two pubic bones meet. This joint is normally held together by strong ligaments, allowing only minimal movement for stability. During pregnancy, hormonal changes, primarily driven by the hormone relaxin, cause these ligaments to soften and stretch.
This necessary relaxation prepares the pelvis for childbirth but can lead to excessive mobility or misalignment in the joint, causing pain and instability. The mechanical stress from the growing uterus and the shifting center of gravity further strain the loosened pelvic structure. Symptoms commonly include sharp, stabbing pain directly over the pubic bone, which may radiate to the inner thighs, back, or perineum.
The pain is typically aggravated by weight-bearing activities that involve asymmetrical movement, such as walking, climbing stairs, or standing on one leg. Because SPD is a mechanical and hormonal issue affecting the joints and ligaments, it is structurally distinct from complications arising from the uterus or cervix. The condition is painful for the mother, but it is not harmful to the unborn baby.
Does SPD Increase the Risk of Early Labor?
The medical consensus is that Symphysis Pubis Dysfunction does not increase the risk of spontaneous preterm labor. SPD is classified as a musculoskeletal disorder, involving the bones, joints, and soft tissues of the pelvis. Spontaneous early labor, in contrast, is driven by factors affecting the uterus and cervix, such as infection, inflammation, or premature rupture of membranes.
The anxiety about a connection often arises because the severe, constant pain experienced with SPD can be mistaken for uterine contractions or other signs of labor. However, the origin of the pain is the unstable pelvic joint, not the rhythmic tightening of the uterine muscle that characterizes true labor.
In extremely rare cases where maternal pain is debilitating and cannot be managed, a healthcare provider might consider an earlier scheduled delivery. This decision would be made solely for the mother’s quality of life and pain control, not because SPD is causing the baby to come early. For the vast majority of women, effective management allows the pregnancy to safely continue to term.
Treatment and Management of SPD During Pregnancy
Management of SPD focuses on reducing pain and preserving function to ensure the pregnancy progresses safely to full term. The first line of treatment involves non-pharmacological interventions, with physical therapy being highly recommended. A specialized pelvic physical therapist can prescribe specific exercises to strengthen the core muscles, glutes, and pelvic floor, which help stabilize the entire pelvic girdle.
Supportive devices, such as a pelvic support belt or band, provide external compression and stability to the joint, often offering immediate pain relief. Lifestyle modifications are equally important to prevent exacerbating the pain. This includes avoiding activities that require standing on one leg, keeping the knees together when getting in or out of a car, and moving the body as a single unit when changing positions.
Applying heat or ice to the painful pubic area can help manage local discomfort, and safe pregnancy analgesics may be used if approved by an obstetrician. The goal of these strategies is to control the physical symptoms, allowing the mother to remain mobile and comfortable. This ensures the pregnancy can continue without the need for medical intervention.