Scoliosis is a sideways curvature and twisting of the spine, often resembling a “C” or “S” shape. It can range from mild to severe and affect individuals of any age, though it often begins in childhood or adolescence. Pregnancy causes many physiological changes, leading to concerns about how pre-existing conditions like scoliosis might be affected. This article explores the relationship between pregnancy and scoliosis and how to manage the condition during this period.
Does Pregnancy Worsen Scoliosis?
For most women, pregnancy does not worsen their scoliotic curve. While individuals with scoliosis may experience increased discomfort or back pain, this differs from an actual increase in the spinal curve. Studies suggest that changes in spinal curvature are minimal, especially if the curve was stable before pregnancy.
However, evidence suggests women who previously received orthotic treatment might have a higher risk of curve progression during pregnancy. For individuals with severe curves (Cobb angle > 40-50 degrees), closer monitoring may be advised. Increased back pain is often related to pregnancy’s physiological adaptations, not structural changes to the scoliotic curve.
How Pregnancy Affects the Spine
Pregnancy causes physiological changes that can impact the spine and contribute to discomfort, even without worsening the scoliotic curve. Hormonal shifts are a factor, particularly increased relaxin, estrogen, and progesterone. Relaxin, produced by the ovaries and placenta, helps loosen ligaments and joints throughout the body, especially in the pelvis, in preparation for childbirth. This ligament laxity can lead to increased joint mobility and instability in the spine, contributing to pain.
Weight gain during pregnancy, especially in the abdomen, shifts a woman’s center of gravity forward. This shift causes postural changes, such as an increased arch in the lower back (lumbar lordosis). These changes place additional stress on spinal muscles and ligaments, which can be more pronounced in a scoliotic spine, leading to increased back pain and muscle imbalances.
Strategies for Managing Scoliosis During Pregnancy
Managing scoliosis discomfort during pregnancy involves strategies to alleviate pain and support spinal health. Physical therapy is often recommended, with exercises aimed at improving core strength, flexibility, and posture. Prenatal yoga and Pilates, for example, can strengthen spinal support muscles and enhance body awareness. A healthcare professional experienced in treating pregnant individuals with scoliosis should tailor these exercises.
Pain management can include non-pharmacological approaches like heat or cold therapy and massage to relieve muscle tension. Supportive measures are also beneficial; maintaining proper posture, using supportive footwear, and adjusting sleeping positions with pillows can help. Maternity support belts provide additional support to the lower back and abdomen, redistributing weight and reducing spinal strain. Discuss scoliosis with your obstetrician and consider consulting an orthopedic specialist for a management plan.
Scoliosis and the Birthing Process
There are considerations for labor and delivery when an individual has scoliosis, though these rarely prevent a safe birth. A common concern is epidural anesthesia. While spinal curvature or prior fusion surgery can present technical challenges for epidural placement, it is generally safe and effective. Anesthesiologists may require advanced notice and recent imaging to accurately locate the injection site, especially with significant spinal rotation or hardware.
Scoliosis rarely prevents a vaginal delivery; rates of vaginal delivery and Cesarean sections are similar for women with and without the condition. Birthing positions might need adjustment to maximize comfort and effectiveness. Open communication with the healthcare team, including the obstetrician and anesthesiologist, is important to ensure a birth plan that addresses scoliosis and optimizes comfort and well-being.