Postpartum Pubic Symphysis Diastasis  

After giving birth, the bones at the front of your pelvis can sometimes move apart without breaking. This area is called the pubic symphysis. This is where the 2 pubic bones meet with a piece of cartilage in between. During pregnancy, these bones can separate a little bit, about 4-5 millimeters, due to pressure and hormones. Sometimes, they can separate up to 9 millimeters. If the separation is more than 10 millimeters, it is called pubic symphysis diastasis (separation). This can cause pain in the lower part of your pelvis, especially when you move or walk.  

Managing Pain During Everyday Movement and Activities: 

1. Wear an abdominal binder  

• Apply an ice pack to the pubic / groin area for 10-15 minutes. Do this up to 3 times a day. Make sure to wait at least 30 minutes between each use. 

• Ice/cold packs can help relieve pain and reduce swelling.  

• Ice packs should not be placed directly on the skin.Use a towel as a barrier to protect your skin. Check your skin for redness, discomfort or irritation before, during, and after you apply ice.  

• Try to keep your knees together as much as possible. Move only as your pain allows. 

• Separating your knees apart can put pressure on the front of your pelvis and make your pain worse (imagine wearing a pencil skirt during movement).  

• Use a dressing table or bureau for changing and other infant care.  

Activities to Avoid While Having Pain: 

• Placing your weight/standing on only one leg (sit down on the bed to get dressed) 

• Twisting and bending while lifting 

• Crossing your legs 

• Carrying a child on your hip 

• Carrying anything in one hand (wear a backpack on both shoulders) 

• Sitting on the floor 

• Standing or sitting for long periods of time 

• Heavy lifting or pushing heavy objects 

Sleeping 

• Place a pillow between your legs and lay on your side. This is to help support your pelvis. You can also place a pillow behind your back to help you stay in this position while sleeping.  

Getting in and out of Bed with Less Pain 

Getting into bed 

1. Sit on the bed where you want your hips to be. 

2. Keep your knees together and lift both legs onto the bed. 

3. Roll onto your back while keeping your knees together. 

Getting out of bed 

1. Roll onto your side.  

2. Slowly lower your legs off the bed while keeping your knees together.  

3. Use your arms to push yourself up to a sitting position.  

How to Lift Your Baby Safely 

• Squat down by bending at your hips and knees,keeping your back straight. Bend gently to come to the height of the surface. 

• Align your hips, knees and toes.Spread your weight evenly through your legs. 

• Carefully lift your baby and straighten your legs. 

Walking 

• Take shorter steps to reduce pubic stress and pain. 

• It may help to slide your foot along the floor.  

• If you are unable to walk forward, try walking backward. It may be less painful.  

• You may need a walker to help reduce pain, especially right after birth.Do not carry your baby while using a walker. 

Stairs 

• Try to limit how often you use the stairs each day.  

• Going up and down the stairs may be painful. Taking one step at a time may reduce stress on your

  pubic area. Hold onto a railing for support if possible.  

• Going up the stairs: Lift the stronger/less painful leg onto the higher step first. 

• Going down the stairs: Lift the weaker/more painful leg onto the lower step first. 

Tips on Getting In and Out of a Car 

Getting into the car:  

1. Open the car door. 

2. Back up to the seat of the car until the back of your legs touch the seat.  

3. Sit down by bending your hips back.  

4. Bring your legs into the car,keeping your knees and lower legs together. 

Getting out of the car: 

1. Keep your knees together as you lift your legs out of the car. 

2. Place both feet on the ground. 

3. Push off the seat to help you stand up. 

Safe Exercises After Childbirth 

While you are still in the hospital and for the first weeks after giving birth you can safely do these exercises if they do not make the pain worse. If any of the exercises hurt, stop right away.  

Diaphragmatic breathing:  

• Lie on your back with your knees bent.  

• Place both hands on the upper part of your stomach.  

• Breathe in slowly through your nose and out slowly through your mouth.  

• Raise your hands when you breathe in and lower your hands when breathing out.  

• Do this exercise 10 times. Repeat it 3 times a day.  

Gentle transverse abdominis isometrics:  

• Breathe out and gently tighten your deep abdominal (belly) muscles by pulling your belly button in toward your spine (like a deep huff).  

• Hold this while you take10 normal breaths.  

• Do this exercise 10 times. Repeat it 3 times a day.  

Gentle pelvic floor squeezes:  

• Breathe out and gently tighten your pelvic floor muscles on an exhale, like you are stopping the flow of urine or holding back gas. 

• Hold this for the length of your exhale, then relax on inhale.  

• Do this exercise 10 times. Repeat it 3 times a day.  

Gentle gluteal (butt) squeezes:  

• Lie on your back with your legs straight.  

• Squeeze your butt muscles together for 3-5 seconds.  

• Do this exercise 10 times, Repeat it 3 times a day.