Pelvic Bone Problems After Childbirth

What Pelvic Bone Problems Can Happen After Childbirth?

Congratulations! You made it through labor and delivery, and your bundle of joy is finally here. So why are you still hurting?

Some women feel pain in their pelvis long after they've given birth. If this happens to you, it may be because of a pelvic bone problem.

What is the pelvis? 

The pelvic region (or pelvis) is a ring of bones at the bottom of your spine. It stabilizes muscles and protects organs in your lower belly. Nerves and blood vessels also run through the pelvic region. 

The pelvis includes: 

  • Hip bones
  • The tailbone (coccyx)
  • The triangular bone at the bottom of the spine (sacrum)

Sometimes, giving birth can damage the bones in the ways described below. Pelvic bone problems are painful. But they usually get better on their own.

Broken Tailbone

The tailbone is at the bottom end of your spine. If your baby moves through the birth canal very quickly or at the wrong angle, it can bruise or break your tailbone. It's more likely if your doctor delivers your baby with forceps.

The pain can last for weeks or months. It may hurt when you sit down, stand for a long time, use the bathroom, or have sex.

There are ways to ease the pain:

  • Use heat or cold. An ice pack or a heating pad may make you feel better.
  • Use a pillow. You may find it more comfortable to sit on a special pillow that has a hole or notch beneath your tailbone so you don't put any pressure on it when you sit.
  • Sit differently. It could help to lean forward when you sit. This may ease pressure.
  • Try medicine. NSAIDs like ibuprofen can help pain and inflammation. If yours is serious, the doctor might give you an anesthetic or a steroid shot. Either one could give you long-term relief.
  • Go to physical therapy. You’ll learn some ways to relax your pelvis such as breathing deeply and completely relaxing the muscles of your pelvic floor.
  • Have surgery. If a lot of time passes and nothing eases your pain, the doctor may suggest surgery to remove your tailbone. This is often a last resort, and it isn't common.

Continued

Pelvic Girdle Pain

If your baby's head presses on your pelvic bones a certain way during childbirth, it may create a gap between two bones at the front of your pelvis. These bones come together through connective tissue called ligaments. They often stretch more easily during pregnancy, and this can lead to pelvic girdle pain. Your doctor may call it a separated pubic symphysis or postpartum pubic symphysis diastasis. There may be swelling or bleeding when the ligament stretches and the bones come apart.

The gap can be painful. That pain can last for 3 to 8 months. It may hurt when you walk, and you may have trouble walking normally. You may also be in pain when you sit or stand for a long time.

Tell your doctor about your pelvic pain so they can treat it and suggest ways for you to feel more comfortable as you heal. Your bones may or may not return to their original starting points. But they'll move closer together and the pain will go away.

To ease pain and help your pelvis heal:

  • Take medicine. The doctor might tell you to take NSAIDs like acetaminophen or naproxen to help with pain. You may only need to take them for a little while.
  • Use support. Your doctor may ask you to wear a brace, girdle, sling, or other device that wraps around your hips and pulls your pelvic bones together. This can help you feel better faster.
  • Lie in bed. If the pain is too much or it's difficult to walk, the doctor could suggest bed rest. But this isn't a long-term solution.
  • Move -- but not too much. As soon as you're able to get up, the doctor will ask you to walk and be active. But don't push too hard. If your pelvic area hurts, it's time to take a break.
  • See a physical therapist. A therapist can teach you how to strengthen your muscles and ease your pain.

In some cases, treatment for a separated pubic symphysis may involve surgery to place screws and a plate to realign the pelvic bones. 

WebMD Medical Reference Reviewed by Brunilda Nazario, MD on July 30, 2020

Sources

SOURCES:

European Journal of Physical and Rehabilitation Medicine, "Postpartum coccydynia: a case series study of 57 women."

Mayo Clinic: "Tailbone pain: How can I relieve it?"

Nemours Foundation: "Your bones."

Annals Academy of Medicine, "Symphysis pubis diastasis after normal vaginal birth: a case report."

The Spine Journal, "A treatment and outcomes analysis of patients with coccydynia."

National Childbirth Trust: "Pregnancy related pelvic girdle pain (PGP) in pregnancy."

Journal of the American Board of Family Medicine, "Symphysis pubis separation during childbirth."

Nordic Federation of Societies of Obstetrics and Gynecology: "Pelvic girdle pain (symptomatic pelvic girdle relaxation, pelvic joint syndrome)."

Annals, Academy of Medicine, Singapore, "Symphysis pubis diastasis after normal vaginal birth: A case report."

American Academy of Orthopaedic Surgeons: “Pelvic Fractures.”

StatPearls: “Postpartum Pubic Symphysis Diastasis.” 

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