Separated at Birth

Wear a brace and wait. Until last month, that was my entire treatment plan. The brace should push everything back together, I was told, and as my hormones (Relaxin) returned to normal the pain should cease. In most cases this is true.

I’m not most people. (And neither are the approximately 100 women around the world who gave birth today who now have diastasis symphysis pubis.)

All five of the pregnancy books I read (Yes, five.) mentioned the likelihood of some degree of pelvic girdle pain. This was generalized to include hips, groin and lower back. In each it was described as usually mild and usually gone after delivery. I didn’t have any pelvic pain during pregnancy. I had some pain in my right SI joint that was fairly intense in the last weeks. I was told it was most likely round ligament pain. When I went into labor I had no understanding that I could come home with my son and a permanently separated pelvis.

For me, the cause was likely the way my son was positioned as he made his way through the birth canal. He came out with his left palm against his left cheek. It’s a position he still loves. But it meant his elbow had to make the turn around my pubis. The best guess the midwives had for me was that his elbow repeatedly bumped into my pelvis and my body did what it needed to to get him here that Sunday afternoon.

Even now I think every day how lucky we are that he wasn’t injured. Better me than him any day, every day. His elbow needed room, but this is not his fault. (Son, if you ever read this, I need you to believe me. This was not your fault. My body was designed to do what it did so you could be born safely. It worked.)

As I mentioned in an earlier post, I didn’t really know I had separated my pelvis until the second day of my son’s life, when we returned for a checkup at the birth center. I couldn’t walk without leaning slightly forward onto the balls of my feet, putting my hands on my husband’s shoulders and back and taking baby steps with my knees together. Even with all of those adjustments, it was extremely painful and difficult to get around.

When we met the midwife Tuesday morning, she watched me walk and told me everything she knew about how to treat this condition: Get a band called a pelvic binder and wear it all the time. Or take the belt of your bathrobe and tie it around your hip bones as tightly as you can. Or do both at the same time. Use a walker for as long as it feels necessary and be patient. It may take a few months, she said, but it should heal itself.

I left with a prescription for pain medication and the news that my son’s bilirubin was high. I waited four more days to take any of the medicine because it was likely to make the little guy sleepy and he already was so lethargic. I got two refills – a total of 60 pills – and weaned myself off of them by the time I went back to campus six-weeks postpartum. We got a binder on the way home and I wore it all day every day for the first eight weeks. When we were home I added the robe belt, too.

Our family doctor agreed with the midwives’ suggestion of the binder and assessment that I didn’t need an x-ray. She told me she could refer me to an orthopedic specialist if necessary. At about four and a half months, we’d had enough. Six weeks later I had my first appointment at our local orthopedic clinic. A week later – as our son turned six months old – we met with Dr. Sojka at the KU Med Center. That brings us to today – 10 nights from surgery.

An important note: I believe what happened to my pelvis would have happened no matter where I delivered. I would recommend a birth center to anyone who wants a natural, comfortable experience and doesn’t have a reason to need a NICU, etc. I had the labor I wanted – no medication and no episiotomy. I was able to listen to my body and eat, drink and change positions as often as I wanted. My son was alert and attentive from his earliest minutes. Given the choice, I would choose a birth center again without hesitation.