Birth with fusion

[Newmumma795]

Hello, I’m pregnant with my first baby and really excited but a bit nervous about delivery because of my scoliosis fusion. As you can see in my Xray I’m fused from my lower thoracic spine and the top part of my lumbar spine. I have been referred to talk to a anthesis but it will not be until 36 weeks which doesn’t give me much time to prepare mentally for a birth plan. I am just want to be awake for the birth of my child and no under general anesthesia. I was just wondering if anyone has managed to give birth naturally/ with a epidural or had to have c-section with similar fusion to me. Sorry for the long question, but any reassurance would be appreciated x

As far as I know abnormalities in the spinal structure are a contraindication for an epidural and it may be dependent on your case and the anaesthetist at your hospital. I would ask your midwife during your next apt what is your hospitals policy.

Are you not under a consultant?

In general, the difficulties with epidurals and metalwork in the back are 1) that it may not be possible to get the needle in the right place, 2) the implications of infection are far more serious than without metalwork, 3) the epidural is unlikely to work even if it does go in the right place because of scar tissue due to the surgery. For those reasons, most anaesthetists won't encourage siting an epidural if there's metal work. If I had had back surgery and was thinking about labouring I'd want to be somewhere that had remifentanil PCAs as a pain relief option.

Re. spinal anaesthetics - there may be a bit more scope for attempting a spinal, but again a much higher risk of either not getting the needle in the right place/the local not spreading well enough for anaesthesia.

A clinic appointment with an anaesthetist is a really good idea for all women who've had back surgery so they can look at the imaging (hopefully there's a bit more than the one pic the OP's posted); know what the exact history relating to the back is and examine what things look like now; look at any other anaesthetic risk factors (eg. is there anything that would make a GA unusually high risk or any other major contraindications to regional anaesthetic). With all of that info, they can discuss with a patient and the obstetricians where any anaesthetic difficulties might arise (or whether it all looks reassuringly straighforward) and help with planning delivery (eg. weighing the pros and cons of labouring/emergency c-section/elective section from the anaesthetic PoV). (doi: obs anaesthetist)

I have CP and at the time had a rod in my pelvis and femur and was recommended a CS which was booked
i went into labour at 37+12 and end up as a crash CS
i would advise you to go with medical advice
Its not the way you give birth but the safety and welfare of Mother and baby.

If they are recommending a GA I'd go.for it. It is more important to be physically healthy for the lifetime of your child than to be awake for the labour in my opinion.

Is there a Scoliosis Society or similar where you could find a larger group of people who've been through this?

There’s a group on Facebook called Scoliosis UK - I’d really recommend joining and popping this question up, there will definitely be other women with fusions who will be able to advise about their birthing experience. My DD also has scoliosis and was fused from T3-L1 a few years ago. That group was a godsend for us! Such a wealth of information and experiences

Thanks all for the advice. I have a appointment with the anthesis this week so hopefully they will shed more light on what my options are ☺️