Advice?! Scoliosis and birth - really need cheering up.

[TheGabster]

Not sure if anyone knows anything about this but I have scoliosis - a curvature in my spine - and have been warned for a long time (before prg) that it could interfere with birth. Apparently it can stop the baby's access into the birth canal.

Now week 38 - head still has not engaged. LO has been head down and "very deep" in all my scans since week 20 and I can feel him pushing down. Have just been to the Guynacologist (I live in Germany) and told her about pushing pain but she said cervix is thick, plug is in place (sorry, TMI) and refused to discuss possible problems (grrrr, stuborn Germans).

Am really worried that she just does not take the scoliosis as a serious problem.

Have been having physio and the nice man said that definitely have very limited movement in the rear pelvic joint which is stopping the pelvis moving as it should. This movement apprently gives LO access to pelvic void/birth canal.

Has anyone ever come across anthing like this? Can they give me any advice?

I am really upset as poor little LO keeps trying to push down and is really hurting me, but just can't seem to find his way out?! I am in pain and feel miserable that it is probably in vain, and stuck in stupid kraut land with no family, and all usual "last few weeks" moans, and DH is working extra long hours to try and clock up flexi-time to take after the birth. Hmphh.

My sister said tell LO to head towards the light but somehow, after today, its no longer funny.

Thanks for the sympathy Fio .

Just had a nice chat/winge/vent/cry with my mum on the phone. She suggested sat nav! Hmmph.

Hi, Just seen your post and wanted to let you know my experience.

I too have a scoliosis. During my pregnancy in the UK the main concerns where: would the curve progress/give me pain due to pregnancy hormones? and would there be difficulties putting an epidural in if needed? Problems related to the baby's progress down the birth canal where never mentioned.

Like you I saw a physio through out, it mainly consisted of pilates related exercises and advice about labouring upright and keeping mobile (Active Birth). I continued seeing them post delivery which in fact was when I had most back pain. I think this was because the baby was suddenly out and my back had to adjust quickly to the change and also carrying LO in car seat etc! Whereas the bump grew gradually over the 9 months and my back had time to adjust.

I also saw a consultant anaesthetist to discuss analgesia in labour. She didn't seem that phased but admitted that it would be difficult to place the epidural if it was an emergency situation. She said I probably would need a General anaesthetic if I needed a caesarean in a hurry.

As it was, I had an induction for high BP (another story!) I used TENS and gas and air during the labour. I found it really helped to be upright and mobile. To cut a long story short I delivered vaginally but had an episiotomy to help LO out.

I personally don't think my scoliosis caused problems to the baby's progress at the birth and all my reading and discussions with medics pre birth didn't suggest it would either.

The Scoliosis Association (UK) SAUK produce a good pamphlet about Pregnancy and scoliosis that you may find helpful to read. Website: http//www.sauk.org.uk click on SAUK info and then books or telephone 020 8964 5343 or their helpline is 020 8964 1166
The pamphlet starts: "Idiopathic scoliosis is fairly common in young females, so that a question frequently asked is "What are the risks of pregnancy?" The short answer is that in most cases there will be few, if any problems"

Hope this helps!

Hey blade,

Fantastic - thanks for all your info. Unfortunately not in the UK so cant get the pamphlet, but had wondered about epi so good to know.

I found a few studies about the progression of curvature due to pregnancy, but like you so it is a snall chance - between 5 and 10% apparently.

Gas and air not an option here (Germans do not approve) but have TENS machine which I have already been using successfully, and good to know about the possible problems for after the birth so I can prepare.

Physio has already suggestion pilates, and they do special "back building" courses here once you have had your 6 weeks nod to start getting fit after the birth so already looking at courses for that.

Thanks again!! Info makes me feel better, plus of course always nice to know you are not alone!

Hi Gabster,

I also have scoliosis and had a spinal infusion 16 years ago due to a 75 degree curve. I decided to go for an elective section with my dd 2 years ago.

The spinal was tricky. The anesthetist couldn't insert the needle but luckily the consultant could.

I recovered very well - was bfing within 40 minutes and out and about with the pram within a week.

Good luck and remember that you know your body best.

I have had to births - in Germany with scoliosis. Both times the head engaged and birth progressed - slowly with ds1, but very quickly (we're talking admission at 9cm and birth half an hour later) with ds2. I had ventouse both times, but not due to my scoliosis. I had an epidural with ds1 but there was no problem putting it in. Had an episiotomy with ds1 and a second degree tear (that I hardly felt tbh, despite no pain relief whatsoever) with ds2.

FWIW I was also told it would be unlikely that I could have a normal birth.

Where are you in Krautland ?

Thanks everyone - thanks for all your stories and info. I'm feeling a lot happier about it all now . Still not sure if I want an epi, but nice to know that the option is there if I want it. Especially as they don't do Gas and Air here apparently.

Fairly sure head still not engaged and only 10 days to EDD but I have a check-up tomorrow so will see what the expert says. I am starting to think I might just have made DS so comfy that he's not keen to come out!

HI Berolina - great to hear stuff relevant to DE. I am near Munich, by the way. Are you down South too?

I too have scoliosis (S shaped curve) and have had 3 babies, first two vaginally and last one by c/s.
I was never aware of any problems regarding the actual progress down the birth canal, but (having attended a Sauk conference in London two years ago) there is such a variety in the severity of the curves, and hence I would imagine the shape of different women's pelvic areas and body shapes generally. If you have a more severe curve (or for example a C shaped curve with a strong pelvic lilt) then I guess the descent down the birth canal might be more of a problem.
The area I was always worried about was pain relief, because I was keen to have an epidural and I was worried that it might cause a problem. In fact, during my first birth I begged my DH not to tell the midwife during labour that I had scoliosis in case they wouldn't call the anaesthetist. He ignored me and it turned out not to be a problem. During my last elective C/S, I did make a point of including this information in my birth plan but the anaesthetist described my scoliosis as a mild one and didn't have any difficulty putting the spinal block in.
FWIW, I saw a Consultant scoliosis specialist in London in the very early stages of my last pregnancy and he sort of advised me not to have any more children on the grounds that the more I had, the more likely I would pass it on to someone.

Evelynrose - I wasn't aware that scoliosis had been proven to be hereditary. Granted my treatment (a metal rod and 10 months in a body cast) was 16 years ago but they were at pains to assure my parents that it was not hereditary.

I'm going to have to do a bit of research as I have a dd and as you probably know Scoliosis is a condition which affects females more than males.

I was (B-W) - now Berlin though.

I don't think it is always hereditary - mine is acquired - caused by lack of orthotic treatment after surgery for a dislocated hip left my legs different lengths.

Yama - oodles of sympathy for the surgery. I have only a mild case and it was found well after puberty so surgery was never suggested. My 14 year old niece was also diagnosed last year and had the op (in December) and it all sounds awful but she is recovering well.

Have also heard about prevalence in females and mild genetic links, but I am not convinced. Food for though I suppose.

My physio now thinks that the lack of mobility in my sacro-iliac joint might be due to the fall I had at Xmas so that would make more sense. I have another Guynie appointment tomorrow so hoping to bully the Dr into a corner and get some answers - easier said then done with Germans though!! At least I don't have to worry about being rude in the process - its perfectly socially acceptable here!! he he

Berolina - Berlin, kewl! Spent a month there training and it was great fun. Love Bavaria though, must admit. Mind you, would be more fun if we had snow right now!

Will let you all know if he finally drops !!

Gabster

Can you ask for an elective section in Germany?

yama, the London SAUK conference was divided into different sections one of which dealt with the issue of hereditary and where scoliosis was found in the world, the sexes etc. It was really interesting.
It is more common amongst females, I think they said this was something to do with female puberty and growth spurt starting earlier. My consultant definitely seemed to think their was genetic link and I think the conference basically came to the conclusion that the average person knows so little about their family tree that it is likely to be lurking somewhere. They also put up a number of statistics and graphs showing genetic links. That said, I'm the only person in my extended family known to have had it.
Out of interest, how has your surgery and rod fared over time?

Gabster - I believe the operation has advanced greatly over the years. I bet your niece will be fine soon. Am I right in thinking that she won't have to wear a body cast? Hope not anyway. I was 15 - teenagers are very resilient.

Evelynrose - thanks for letting me know about the SAUK conference. It sounds really interesting. I'll see what I can find online. My back and rod have been fine over the years. Unless I'm naked nobody would be able to tell that I have such a severe curve. I do get pain now and again but I imagine everyone does. I look at the positives: I take a lot of care of myself, I never lift anything heavy, I have good posture, I get out of the hoovering. I suppose I quickly risk assess every situation and what I'm hoping is that I avoid hurting myself.

Gabster: Hope all was OK at your gynae appt. Will be thinking of you and willing baby down! Good luck with your labour when the time comes.

I have slight scoliosis and had to have a general anaesthetic when I needed an emergency section with DS1, still a bit sad about that but had Ok labour with DS2 and was given an epidural for an urgent but not emergency section for DS3 ie. the anaesthetist could manage when he could take his time.

I have had spinal fusion for scoliosis and my consultant recommended a section because of this. Unfortunately there wasn't time to see a orthapaedic surgeon for their opinion so I went with the section advice. There was a lot of fuss about seeing the anaesthetists as there might be problems with the epidural but when it actually all happened there were no problems (although it took a bit longer to work than usual). Ended up having a GA as well but only because the epidural ran out.

It's interesting to see that women do give birth natually following fusions, I'm now pregnant again and wondering whether to try VBAC. My husband is dead against it in case I damage my back, he thinks its a gamble not worth taking. I'm worried that if I do insist on trying for a natural birth and damage my back it'll be my own fault . Is it a case of 'better the devil you know' even though I had a dreadful c/s the first time round?

Sorry - forgot the say the most important thing - good luck with the birth. My son was very very low down for about 4 weeks before he arrived, literally felt like he was going to just fall out (it's a pity they don't )!

He all

Sorry I've been off line a few days - been a bit poorly (just exahustion - lack of sleep).

By way of update - Baby still not engaged, cervix very slightly thinner (sorry, TMI) and basically, LO is in no rush to arrive at the moment.

Pushing in hips is apparently the baby trying to widen them so even though there is no way you can say I have slim hips, apparently I have a narrow pelvic opening. Will my pre-preg clothes ever fit me again?!

DD next week so will find out what the protocol is for going overdue here then I suppose.

Rochwen - yes, I can go elective. Was offered it earlier, but not sure I am up for it. Recovery is so much slower - and you just don't know if you don't try,do you?!

Yama - thanks for more kind words! Yes, resilient is the right word! Whenever I talk to my niece, all she says is "..and I'm about 3 inches taller..." bless her!!

Right, time for another cup of raspberry leaf tea.

G

Gabster - good luck. Please let us know how you get on.

Bilbomum - I'm sorry to hear that your epidural ran out. I know what you mean about anaesthetists making a fuss. I too have had a spinal fusion and had to have a special meeting with an anaesthetist before my elective section. He decided that he could probably give me a spnal block but that an epidural wouldn't work. I expected to see him on the big day but it was another anaesthetist who couldn't insert the needle. Luckily the consultant could.

It all went very well and recovery was quick. I hope that whatever you decide for your next birth works out well.

By way of update - had another Gynie visit today.

LO still not engaged and now officially overdue - so I have a hospital appointment for Saturday. They will monitor the baby (apparently) and then decide if they are happy for me to wait longer, want to induce in the hope that contractions will make him engage or otherwise, its the good old CS for me. Oh goodie - all three options sound such fun .

Oh well, at least I suppose I will find out soon enough whether LO is just lazy, or whether my stupid body is all screwed up.

Wish me luck.

Hi Gabster,

Sorry LO not engaged yet, but it's not like it is your fault! Sounds like they still think you can deliver vaginally, hence the induction. Will be thinking about you and little one tomorrow.

Quick word of warning Germans like inducing early, often earlier than would be necessary. With ds2 they wanted to induce me at 40+10, although there was no clear need to. He saved me by arriving at 40+8. Most women can safely go to 42 weeks. When, and why, to induce is something you should raise with them. Good luck!

I have scoliosis too (blimey, aren;t there a lot of us?) but my curvature is high up (t3-t5): I did ask a consultant about it when I was PG but she said it was nothing to worry about, and I had a vaginal birth with just gas and air (though I was late and had to be induced, but I don't think that was because of the scoliosis). Good luck! Hope your LO arrives safe and sound without too much trauma.

Another scoli here - had fusion in my teens. Apart from slight back ache never had any difficulties (wish I thought of using it to get out of the hoovering years ago though!!) and wasn't aware that giving birth might be more problematic (apart from being advised to avoid epidurals). Have had 3 LOs without any problems - all popped out very quickly - in fact first one I delivered myself at home sitting on the toilet! Here's hoping you have an equally easy time of it.

Think my condition is hereditary - my half sister and two of our cousins on that side of the family have it - although no-one from earlier generations that we are aware of. Will have to keep fingers crossed that none of our DCs develop it - but certainly wouldn't put me off having any more!