When Rebecca Middleton became pregnant, she had no idea that she would end up in a wheelchair for the final three months before she gave birth.
Rebecca had had a difficult first trimester dealing with nausea and sickness, and began to develop pelvic pain four months into her pregnancy.
« I could hardly walk, I’d always had some problems with lower back pain in my life. But nothing that significant and it escalated quite quickly, » she says.
After complaining about the pain, she was referred to an NHS physio, and eventually diagnosed with an extreme case of pelvic girdle pain (PGP), also known as symphysis pubic dysfunction.
Problems with your pelvic joints are a common symptom of pregnancy, affecting one in five expectant mothers to some degree.
« I was terrified, would I ever walk again? How would I have my baby, how would I care for it? »
After giving birth, Rebecca was in less pain, but she still struggled with basic things like walking, lifting her son or pushing a pram.
« I was disabled for seven months and had to have someone helping me all the time, » she says.
« I just couldn’t do the things that you should be able to do in looking after a baby, it was a really challenging time. »
Prior to becoming pregnant, it was an issue Rebecca was unaware of and since her experience she volunteers for The Pelvic Partnership, a charity which helps raise awareness and support women with this condition.
It says the condition is treatable with the right action.
As soon as your symptoms start, the charity advises you get hands-on individualised treatment, including manual therapy, and ask for a referral for NHS physiotherapy from your GP or midwife.
If you aren’t offered this support initially, the charity suggests going back to your GP or midwife and asking for a second opinion.
They can also refer you to maternal mental health support to help you manage the emotional impacts of living with PGP.
Dr Nighat Arif, a women’s health specialist, says higher awareness and early assessment could prevent patients like Rebecca needing wheelchairs or crutches.
« Without that early identification based on a really good understanding of the female body, we leave some of these women with negative effects for life, » she says.
Victoria Roberton, co-ordinator at the Pelvic Partnership, is an example of how awareness can help.
Like Rebecca, she didn’t know what PGP was when she began experiencing the condition during her first pregnancy.
She tried to stay as active as possible as advised and was referred to NHS physio sessions online and by phone, but found the pain worsening as her pregnancy progressed.
« They gave us exercises, stretches to do. By this point I couldn’t do any of them. It was too painful, » she says.
It got to the point where even sitting became uncomfortable for Victoria, and she was largely homebound until her baby was born.
The pain lessened after the birth of her daughter, but she began experiencing the same problem when she became pregnant with her second child.
It’s not an option for many mothers, but Victoria said given her medical history she decided to pay for a private physio as the NHS wait for referral was long.
The physio gave her a full assessment and hands-on treatment including joint mobilisation, and taught her different ways to move her body to not aggravate her hip joints, which helped ease the pain.
Victoria still struggles with a degree of PGP today, four years on, but her second pregnancy was much easier to manage because she understood her condition and how to handle it.
Rebecca’s second pregnancy has been similarly a much more positive experience.
This time round she knew she was at risk of PGP and was able to have it treated throughout her pregnancy before it became debilitating.
She has made a full recovery from PGP, just two months post birth compared to two years for her first child.
« I’m probably in better shape now than I was before either of my children because I now know what caused that pelvic girdle pain, and have had it fully treated and resolved with manual therapy, » she says.
« It was five years of hell because of the pain I was in because of a lack of knowledge and understanding about the subject. »
