[1] Risk factors associated with this injury include cephalopelvic disproportion, rapid second stage of labor, epidural anesthesia, severe abduction of the thighs during delivery, or previous trauma to the pelvis.

Common signs and symptoms include symphyseal pain aggravated by weight-bearing and walking, a waddling gait, pubic tenderness, and a palpable interpubic gap.

Relaxin, in conjunction with progesterone, can cause a physiological separation of the pubic symphysis during pregnancy that typically measures 3–5 mm and is most pronounced in the first trimester and returns to normal size within five months postpartum.

Patients will often exhibit tenderness to palpation of the pubic symphysis and symptoms will be exacerbated with specific movements such as the transition from lying down to sitting and standing, climbing stairs, or lifting heavy loads.

Questions related to specific movements such as climbing stairs, turning in bed, changes in gait and stride length, pain with carrying any weight, or difficulty urinating or defecating should be discussed when obtaining a history of present illness from these patients.

[citation needed] Other diagnoses that may present similar to pubic symphysis diastasis that must be excluded prior to making a diagnosis include mechanical low back pain, perineal lacerations, sciatica, urinary tract infections, pelvic and lower extremity vein thrombosis, neoplastic processes, septic arthritis, osteomyelitis, pubic osteolysis, and osteitis pubis.

While X-Ray is the gold standard to identify a separation of the pubic symphysis, a decision must be made in regard to which imaging modality to utilize that is patient and case-specific.

[3] An X-ray film obtained in the AP view of the pelvic inlet and outlet will show a marked gap between the pubic bones.

Images will show degrees of soft tissue injury, inflammation of the subchondral region and the bone marrow[8] and any abnormal posturing of the pelvic joints.

MRI can show a more detailed view of soft tissue injuries that may be associated with pubic symphysis diastasis, and is radiation-free, thus making this imaging modality ideal for the pregnant patient.

Conservative treatment includes bed rest, analgesic medications that include anti-inflammatory agents, physiotherapy, and a pelvic brace to provide support and stability.Patients undergoing bedrest typically do so with a pelvic brace in place and are placed in the lateral decubitus position with the application of external heat or ice packs.

Cesarean section is often offered to patients by their healthcare providers if the separation measures greater than 15 mm in order to avoid further pelvic and sacroiliac injuries.