Scoliosis In Pregnancy: How It Affects Pregnancy And Labour
Here’s all you need to know about scoliosis in pregnancy and if it’s possible for women with this condition to have a baby safely...
Scoliosis is a condition where the normally straight spine curves or twists to form a C or S shaped curve. If you have scoliosis, you are probably concerned if it will affect your baby, pregnancy and/or delivery. So here’s all you need to know about scoliosis in pregnancy and if it’s possible for women with this condition to have a baby safely.
First, the good news. In most cases, there are no proven risks to mother and baby because of scoliosis, during pregnancy, labour or delivery.
There is no increase in the risk of miscarriage, stillbirth, or birth defects. Even women who have had spinal fusion surgery to treat scoliosis, can get pregnant.
Doctors do recommend women having surgery for scoliosis to wait for at least six months after the surgery to become pregnant. This is the time needed for healing of the spine.
Women with congenital scoliosis or early-onset scoliosis and those with weak muscles and heart problems should seek medical advice before becoming pregnant.
Congenital scoliosis is usually associated with neuromuscular conditions such as muscular dystrophy or poliomyelitis. There could be breathing difficulty and restriction of the lung size because of these birth defects. There is also a reduction in oxygen levels, which would harm the growing foetus, and may also cause heart strain in the mother.
In cases of severe scoliosis, getting pregnant can be a bit riskier than usual because:
- Back pain can be significantly worse for women with severe curves
- Breathing problems may occur later in the pregnancy, because the uterus pushes the diaphragm higher and decreases capacity,
- Both the baby and the scoliosis curve may need to be closely monitored
To prevent complications, women with severe scoliosis should consult their doctor before becoming pregnant.
Pregnancy affects women with scoliosis pretty much the same way as women without scoliosis.
One common symptom many pregnant women experience is back pain. In this case, it is usually difficult to tell whether the pain is from the pregnancy or scoliosis.
However, if you had back pain before pregnancy due to scoliosis, it does increase the risk of lower back pain during pregnancy.
Also women with severe scoliosis, and with severe curvature of the spine may experience more pain and discomfort, breathing problems or weight-bearing difficulties, especially later on in the pregnancy.
In general, during pregnancy, the growing uterus exerts pressure on the diaphragm making it difficult for the mother to breathe. You will also experience breathlessness because of the increase in progesterone hormone that raises the rate of respiration. For those with scoliosis, the spinal curvature might worsen the problem .
In case of back pain, ice or cold compresses can help. Some pain in the muscles can be alleviated with warm compresses or by sitting in a warm tub or jacuzzi (which is not too hot). Maternity support belts can be worn that support the lower back and stomach, allowing freer movement.
Swimming is also a great exercise during pregnancy, as the water will help support the stomach and also allow for freer movement.
Strengthening exercises, such as pelvic-tilt exercises can help strengthen the back and relieve pain. Always consult your doctor before starting any exercise program.
Also, after the delivery, the curve could worsen if you tend to hold the baby only on one side. It is good to invest in a good baby carrier to balance the infant’s weight.
Another concern for women with scoliosis is whether pregnancy will make their scoliosis worse. Studies say that scoliosis does not increase during pregnancy. As long as the curve has already stopped progressing, the weight gained during pregnancy does not increase the curvature.
Women in their third trimester should be careful with their back since the ligaments are more relaxed due to the pregnancy hormone relaxin. It could lead to an increase in Cobb angle (a measure of spinal curvature) that results in leg, hip and back pain.
Among patients who had prior orthotic treatment, there is some evidence to suggest that women experiencing one or more pregnancies had a higher risk of curve progression compared with never-pregnant women.
Research shows that labour and delivery is virtually the same for women with mild to moderate scoliosis as it is for women without scoliosis.
In the past, it was common practice for doctors to opt for a C-section delivery in case of patients with scoliosis. Nowadays, more women are finding that a vaginal delivery is possible, and with no major complications.
The position during labour and delivery is important for the patient’s comfort and the most comfortable position will vary for each patient.
Vaginal delivery poses challenges for some women with scoliosis. When scoliosis involves the hips in pregnant mums, they can experience “stalls” (when a woman is in active labor and her labour slows down or stops) during labour due to malpositioning of the baby. Weakness due to scoliosis may make pushing during labour more difficult for some.
Also, in some cases, taking an epidural for pain relief might be difficult. Do discuss with your doctor about the type of delivery and pain management options, so you’ll know what to expect.
There may be concerns among scoliosis patients about taking an epidural for pain relief during labour. For the info, an epidural is a local anaesthetic that is injected into the spine and numbs the nerves that carry the pain impulses from the birth canal to the brain.
An epidural is usually given in the space just below the end of the spinal cord. For some scoliosis patients it can be difficult to receive an epidural.
This usually happens if they have had spinal fusion surgery or if the scoliosis is in the lumbar (lower) spine.
If the scoliosis is in the mid to upper back though, there should be no issue in taking an epidural.
Still, it is important for pregnant women with scoliosis to discuss epidurals and pain management with their doctor before going into labour.
There is no "yes or no" answer to this question.
Around 30% of adolescent idiopathic scoliosis (AIS) patients have a family history of the condition. The inheritance pattern of adolescent idiopathic scoliosis is unclear because many genetic and environmental factors appear to be involved.
However, having a close relative (such as a parent or sibling) with adolescent idiopathic scoliosis increases a child's risk of developing the condition. This risk is higher in girls than in boys.