Scoliosis, a condition characterized by a sideways curvature of the spine, affects many individuals. For those contemplating pregnancy or already expecting, a common question arises regarding how this spinal curvature might interact with the physiological changes of gestation. Understanding the potential influences of pregnancy on scoliosis, and vice versa, can help individuals navigate this period with informed care.
Pregnancy and New Scoliosis Development
Pregnancy does not cause new scoliosis in adults. Adult-onset scoliosis, also known as degenerative scoliosis, typically develops from age-related wear and tear on the spine, such as disc degeneration. Other factors contributing to adult scoliosis include genetics, osteoporosis, or injury.
The physiological changes of pregnancy do not initiate new spinal deformities. While back pain is common during pregnancy (affecting 40% to 80% of pregnant individuals), this pain relates to hormonal shifts, weight gain, and changes in the body’s center of gravity, not the development of a new spinal curve.
Impact of Pregnancy on Existing Scoliosis
For individuals with existing scoliosis, pregnancy can influence their spinal curve. Hormonal changes, especially increased relaxin, loosen ligaments and joints throughout the body, including the pelvis and lower spine. While relaxin prepares the body for childbirth, this increased laxity can contribute to spinal instability and discomfort. This hormonal influence, combined with other changes, may lead to slight curve progression, though changes are often minimal if the curve was stable pre-pregnancy.
Weight gain during pregnancy also adds mechanical stress to the spine, increasing pressure on existing curves. As the uterus grows, the body’s center of gravity shifts forward, leading to compensatory postural adjustments like an increased arch in the lower back. These shifts can exacerbate back pain and discomfort, especially in the lower back and hips, due to added strain on muscles and joints. Individuals with more severe curves or those who have had spinal fusion surgery may experience more pronounced discomfort or a higher risk of slight progression.
Managing Spinal Health During Pregnancy
Managing spinal health during pregnancy, especially with pre-existing scoliosis, involves several practical approaches to alleviate discomfort and support the changing body. Maintaining good posture is important, as the growing abdomen shifts the center of gravity and can strain back muscles. Practicing correct body mechanics, such as squatting to pick up objects instead of bending at the waist, helps reduce strain.
To manage spinal health:
- Engage in safe and gentle exercise to strengthen back muscles and improve flexibility.
- Utilize low-impact activities like swimming, walking, and prenatal yoga.
- Consider physical therapy for tailored exercises and pain management.
- Use supportive devices, such as maternity belts, for abdominal and lower back support.
- Consult a healthcare provider for personalized advice and monitoring.
Delivery and Recovery Considerations
For individuals with scoliosis, specific considerations for labor and delivery are often discussed with their healthcare team in advance. Epidural pain relief is generally possible, even with a spinal curvature or prior spinal fusion surgery. However, epidural needle placement might be more challenging due to the spinal curve or surgical hardware, making it important for the anesthesiologist to be aware of the individual’s specific spinal anatomy. Advanced planning and review of pre-pregnancy imaging can help ensure safe and effective pain management options.
Most women with scoliosis can have a vaginal delivery; scoliosis does not typically increase the need for a Cesarean section unless other obstetric reasons exist. While some individuals with significant curves might experience difficulty pushing or issues with baby positioning due to hip alignment, specific exercises and chiropractic care can improve body balance and aid in optimal baby presentation. Postpartum, continued spinal care is important as the body readjusts. Physical therapy can assist in strengthening core muscles, improving posture, and managing any lingering discomfort during recovery.