Intrapartum care for women with pelvic girdle pain: a midwifery perspective

Author(s): E. Nightingale - Pages: 51–57

Abstract

Pelvic girdle pain (PGP) affects up to 20% of the birthing population. Sufferers report pain of varying severity and frequency in and around the pelvic joints, in the hips and groin, and in the lumbar or thoracic spine. This pain is associated with activities of daily living. Pelvic girdle pain is understood to be caused mainly by mechanical dysfunction, i.e. asymmetry in any or all pelvic joints, or the lumbar spine, with muscle tightness in or around the pelvic joints possibly causing additional effects. Relaxin levels also play a role, but a much smaller one than was previously thought. This paper discusses intrapartum care for women with PGP from a midwifery perspective. Sufferers need particular specific, but easily organized, interventions to assist them in experiencing optimum health during the childbearing year. Chief among these are: community-based self-referral physiotherapy services; better-informed and aware midwives, general practitioners and other healthcare professionals; and coordination and careful communication between all healthcare providers. Perhaps the most obvious, but least frequently achieved, intervention of value would be a named midwife for each woman in order to provide caseload midwifery, and thus, follow the woman through her whole pregnancy, birth and post-birth recovery with her baby.

Keywords: intrapartum care, midwifery, pelvic girdle pain, women’s health.