Life’s been ticking along nicely as I have slowly waddled towards the beginning of the third trimester.
As with a lot of pregnancies I have unfortunately hit a couple of hitches. I was doing so well and felt great but I am now dealing with two pregnancy nasties in the form of SPD and gestational diabetes. Oh joy! I feel well in myself but the SPD is bringing lots of aches and pains plus affects how easy it is to move about.
SPD, or Symphysis pubis dysfunction, affects your pelvis and is now more commonly known as Pelvic Girdle Pain. The symphysis pubis is where your pubic bone meets in the middle at the front of your pelvis; SPD causes pain in this joint due to the extra swelling and weight experienced during pregnancy. Symptoms include back, hip and thigh pain, a grinding or clicking sensation in the pubic region, pain is the perineum as well as causing difficulty in widening legs, moving in bed, bending over and managing the stairs. For me I have experienced all of these. It started with a bit of lower back pain and hip pain and this then progressed to a pressure underneath. I had put it down to just being normal pregnancy aches and pains, really didn’t think much of it. But I did mention it to the midwife who advised me to self refer myself to the physiotherapist.
It is thought to be caused by your bodies reaction to the hormone relaxin. Relaxin is a hormone that prepares the body for labour and makes our joints a little more flexible to allow safe passage for the baby on their way out into the big wide world. You are at a higher risk of developing this if you have had previous lower back or pelvic girdle pain, have experienced the condition in a previous pregnancy, a history of trauma to the area or are in a physically demanding job. Well, being a nurse in an emergency department I can safely say my job is very physically demanding and I did have trauma to my hip as a child. Being a clumsy accident prone child, the first day we moved to Milton Keynes, I managed to injure my hip running around the park with my older sisters and had to have it realigned.
I will not go into treatment as I would hate to give the wrong information out but there are a few things that I have personally found helpful. I was advised to take the stairs differently. On my first trip to the physiotherapist I was assessed and they discovered my right side was worse than my left side. So when going up the stairs I was advised to take them one at a time using my left foot first; coming down the stairs I have to remember to reverse this and go right foot first. I was also advised to sleep with a pillow between my legs (classy!) but I am a fidgety sleeper so this does not work for me. Other tips I was given was to ensure I do my pelvic floor exercises and if the pain is very uncomfortable I will sit on my birthing ball for short periods of time. I also have a very ‘attractive’ support belt that I wear when I am at work or out and about. If you need one of these I recommend checking Amazon out as I paid less then £20 for mine and my physiotherapist informed me it was a very good one to use, here is the link to the one I purchased.
So…onto Gestational Diabetes…! I was under the impression that every expectant mother was tested for this but I learned that this is not the case. You are only tested if you are considered as an ‘at risk’ mother. To be considered at risk you have to have a BMI of over 30, have a parent or sibling with diabetes (either type I or II), having a larger baby in a previous pregnancy (as in 10lb or more!) and/or be of south Asian, Black or middle eastern heritage. Additionally, it is thought women with PCOS are at a higher risk of gestational diabetes, amongst other complications such as pre-term labour and preeclampsia.
The glucose tolerance test is organised through your midwife here in the U.K and is a fasting blood test. It’s a long wait around as well! I had to go to my local hospital nice and early one Saturday morning, and as it was fasting I’d had no morning cup of tea! Torture! I had my first sample of blood taken and made to drink a glucose drink, very similar to the lucozade sports pouch drinks but much sweeter, and told to go and wait for two hours. The worse thing about this was the drink was of a decent size, tasted grim and I was made to drink it in front of the phlebotomist! I was still not allowed to drink/eat anything but was allowed to sip water. Luckily the unit had some recliners so I sat with my feet up for a couple of hours and had dragged my mum along for company. After the two hours were up I had to have a second sample of blood taken and was sent on my merry way!
I was not overly concerned as I didn’t feel like I’d had any symptoms, I felt well and really didn’t think it’d happen to me if I’m truthfully honest! Ignorance is bliss isn’t it! But actually I was very high risk due to my BMI and the fact my Dad has type II diabetes, aside from the PCOS.
I was less than impressed on how I was told though. I had attended my annual asthma review and there was a note on the screen for the asthma nurse to tell me my results were a little high and that the diabetes clinic would be in touch. Great! That told me nothing! Plus I didn’t hear for over a day from them so I was fretting for some time! Not good for baby Lewis! When I did eventually hear, I really didn’t like the nurses attitude. She assumed I was over weight, with a poor diet and spoke to me like I didn’t have a clue! But she did book me into the diabetes clinic for next week so I am hoping she will be less judgemental face to face! This has also generated extra monitoring for me and baby. I am also booked in for regular consultant visits and foetal growth scans to monitor his size.
Gestational Diabetes is a form of diabetes that only affects you during pregnancy. It is thought that it occurs when the hormones your body produces during this time make it harder for your body to deal with insulin and so results in an insulin resistance. It generally goes away after birth and if managed correctly it shouldn’t cause too many issues. If blood sugars are not controlled however, there are some associated risks, hence the extra monitoring. Well known risks include preeclampsia, large birth weight babies, or macrosomia, or at the other end of the scale it can cause polyhydramnios, which is when there is too much amniotic fluid and this can lead to pre-term labour and birth complications. Other issues include needing to be induced with or without a c-section, baby can be at risk of low blood sugars at birth and jaundice and in very rare cases still birth is a risk. There is additionally a higher risk to you and your baby of developing type II diabetes in later life.
It is managed through regular monitoring of your blood sugars, you may have to take oral medications or you may even have to inject insulin. As well as this diet and exercise play a huge role in controlling blood sugars too. My major issue is that my SPD prevents me from being too active. I have days where I barely feel anything, but if I over do it on these days I will pay for it the next day. My diet is on the whole pretty good, I struggle when at work to eat as well as I do when at home due to shift patterns not always allowing me to eat a proper cooked meal like I would if I was at home but I try to manage these the best I can. Luckily my long shifts have been reduced and I am in a period of using all my annual leave up before I go off on mater it’s so I am really just chilling out at home mostly these days other than the odd shift at work!
I don’t recommend being ‘Doctor Google’ and you should always get things checked out with a registered health professional but I have found Diabetes UK, Baby Centre and the NHS very good sources of information!