If you have scoliosis, how could the curvature of your spine complicate your pregnancy? We asked the experts to get the inside story.
Most of us only know scoliosis from that annual spine check by the school nurse. But if you're a mom-to-be who has the condition—a curvature of the spine into an S or C shape—scoliosis may make you worried at how your body will manage during the pregnancy. Long story short? You may be able to rest easy. "Women with this condition for the most part will have a very normal pregnancy without any untoward complications due to their existing spine curvature," says Justin J. Park, M.D., a board-certified orthopedic spine surgeon with The Maryland Spine Center at Mercy Medical Center in Baltimore. "In a small percentage of patients who have larger curves and a more severe scoliosis they may experience greater incidences of back pain or sciatica in their last trimester."
It's during the last trimester that those with moderate to severe scoliosis (a curvature of more than 25 to 30 degrees) may experience one-sided carrying, says Loren Fishman, M.D., medical director and back-pain specialist at Manhattan Physical Medicine and Rehabilitation, and assistant clinical professor at Columbia College of Physicians and Surgeons. "Given the extra weight and its novel distribution, it can increase awkwardness and even lead to falling. If it's severe enough, it is possible that the asymmetry will influence the blood flow to and from the placenta both from the mother's and the baby's circulation." Dr. Fishman explains that although this can be painful, uncomfortable, and make walking and sleeping harder and less comfortable, it rarely affects the actual birth process.
Are there special complications that can arise?
Dr. Park notes that women with the condition shouldn't face any specific complications related to the scoliosis. However, it is possible that at the time of delivery, women with scoliosis may have a harder time getting an epidural placed. "The abnormal spinal geometry can sometimes pose problems for the anesthesiologist who is performing the epidural."
Another pregnancy side effect could lead to increased complications for women with scoliosis. "The placenta gives off a hormone called relaxin, which loosens the grip that ligaments have on the bones they bind," says Dr. Fishman. The purpose of this is to enable the birth canal to widen, but a side effect is that the sacroiliac joint can easily be put out of kilter, and start to hurt. "This same relaxin can also mediate an effect that pregnancy can have on scoliosis: softening the ligaments can worsen the spinal condition." So what can women do? Dr. Fishman recently published a peer-review paper showing how one yoga pose, the side-plank, can help.
Is the baby at an increased risk for scoliosis?
While scoliosis isn’t necessarily a genetic condition, studies suggest that heredity could play a role. "There is a familial hereditary pattern where many patients with scoliosis also have other family members with the condition." says Dr. Park.
Dr. Fishman also notes that there are a number of genetic markers that indicate a greater propensity for family members to contract scoliosis.
Like any child, a baby born to a mom with scoliosis should have regular check-ups and the doctor should be aware of the family history of scoliosis. Like any condition, it's good to keep an eye out, but that doesn't mean your child will develop the condition.