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Rebecca Middleton did not anticipate that during her pregnancy, she would spend the last three months confined to a wheelchair. Her initial trimester was marked by severe nausea and sickness, but it was around four months in that she began experiencing intense pelvic pain. “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 recalls. After seeking help for her discomfort, she was referred to an NHS physiotherapist and diagnosed with a severe form of pelvic girdle pain (PGP), commonly referred to as symphysis pubic dysfunction.
Pelvic joint issues are a frequent complication in pregnancy, affecting approximately one in five women to varying degrees. For Rebecca, the severity of her condition brought on fears about her mobility and her ability to care for her newborn. “I was terrified, would I ever walk again? How would I have my baby, how would I care for it?” she explains. Although the pain diminished after giving birth, Rebecca continued to encounter significant challenges. Basic tasks like walking, lifting her son, and pushing a pram remained difficult. “I was disabled for seven months and had to have someone helping me all the time,” she says, adding how hard it was not being able to perform the everyday care expected of a new mother.
Before her own ordeal, Rebecca had not been aware of PGP. Since then, she has become an advocate by volunteering for The Pelvic Partnership, a charity that works to raise awareness and support women affected by this condition. The organisation stresses that PGP is treatable with timely and appropriate intervention. They recommend seeking personalised manual therapy at the earliest signs of symptoms and obtaining referrals for NHS physiotherapy through a GP or midwife. If support is initially denied, the charity advises pursuing a second opinion. Alongside physical treatment, referrals to maternal mental health services can be valuable in managing the emotional toll of living with PGP.
Experts express concerns about the current gaps in awareness and research related to pelvic girdle pain. Dr Nighat Arif, a specialist in women’s health, highlights the importance of early recognition to prevent long-term disability, stating, “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.” Gynaecologist Dr Christine Ekechi emphasises the limitations caused by insufficient research, which lead to ongoing pain issues often going unaddressed post birth. “We don’t necessarily see them unless they then come back into a gynaecology clinic presenting with pain. So we don’t have a great understanding as to the proportion of women that have persisting pain that has started off during pregnancy,” she notes.
Victoria Roberton, coordinator at the Pelvic Partnership, offers an example of how improved awareness can make a difference. Like Rebecca, Victoria was unfamiliar with PGP when she first experienced it during pregnancy. Despite following advice to stay active and participating in NHS physiotherapy sessions by phone and online, her pain worsened, making even sitting unbearable. Eventually, she was mostly confined to home until after her baby’s birth. When pregnant again, Victoria decided to seek private physiotherapy to avoid long NHS wait times. Her treatment involved thorough assessments, joint mobilisation, and learning new movement techniques to reduce hip discomfort. Although she continues to experience some PGP symptoms four years later, understanding her condition helped make her second pregnancy far more manageable.
Rebecca’s experience with her second pregnancy was also more positive. Aware of her susceptibility to PGP, she accessed treatment early on, preventing the condition from becoming as debilitating as before. She has now fully recovered just two months after giving birth, a significant improvement compared to the two years it took following her first child’s birth. Reflecting on her journey, she says, “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 describes the prior five years as “five years of hell” caused by the pain and lack of understanding surrounding the condition
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