Scoliosis and Pregnancy: What to Expect

Scoliosis ranges from mild to very severe, and higher severity levels can cause more overt effects and potential complications. In mild and moderate cases, symptoms can be subtle, and a pregnancy is unlikely to be affected, but when severe, increasing back pain may develop.

For patients recently diagnosed, how scoliosis can affect a current or future pregnancy is an understandable concern. Scoliosis isn’t known to affect fertility, progression, nor complicate the pregnancy or labor. In severe cases, however, back pain can increase, and epidural placement needs to account for the spine’s unnatural curve.

Scoliosis can affect more than just the spine, but its primary effects don’t include fertility, pregnancy, and/or labor issues.

Primary Scoliosis Effects

Each case of scoliosis is unique, which is why treatment plans need to be fully individualized for specific results.

Scoliosis causes the spine to bend unnaturally to the side and rotate.

Although scoliosis is progressive and progression is triggered by growth, not all cases of scoliosis are painful. Adults are more likely to experience scoliosis pain because when growth stops, scoliosis becomes progressive.

Scoliosis pain can involve muscle tension, muscular imbalance, back pain, and radiating pain in the extremities due to nerve compression.

Pain is the primary symptom of adult scoliosis, particularly in cases of degenerative scoliosis that affect older adults, are caused by degenerative instability, and are almost always progressive and painful.

Although adults are also affected, scoliosis is most often diagnosed in children; the most prevalent type overall is adolescent idiopathic scoliosis often diagnosed around the onset of puberty.

The primary symptoms of childhood scoliosis are postural changes such as uneven shoulders and hips. Additional changes to watch for include rib flaring, arm- and leg-length discrepancies, disruptions to proprioception, balance, coordination, gait, and pelvic obliquity.

Ill-fitting clothes can also be a sign of childhood scoliosis as the body can develop a prominent lean to one side that makes necklines hang unevenly and shirt sleeves and pant legs appear to be different lengths.

The more posture is affected, the more healthy movement patterns are disrupted as the asymmetrical condition disrupts the body’s overall symmetry, and while pregnancy can make it harder to maintain good posture due to weight gain and muscle/ligament strain, there are a number of benefits to maintaining healthy posture during pregnancy.

Scoliosis ranges widely in severity, and the effects of mild and moderate scoliosis can be subtle, while severe scoliosis and atypical cases can cause complications that are the most likely to impact pregnancy.

Scoliosis and Pregnancy

While scoliosis is progressive, many cases are highly responsive to treatment, especially with early detection and a proactive treatment plan, so pregnant patients undergoing treatment are less likely to develop complications that affect their pregnancy.

In severe cases with large complex curves, lung capacity can be affected, and while this is not a common effect of scoliosis, in cases of thoracic scoliosis with a lot of rotation, the disruption to the position of the rib cage can compress the lungs.

In the later stages of pregnancy, varying degrees of breathlessness can develop as a potential pregnancy effect in women without scoliosis, so if severe scoliosis is further disrupting lung function, some pregnant women with scoliosis may experience increasing breathing problems.

An additional potential effect is increasing back pain. Back pain is a prevalent part of regular pregnancies without scoliosis, and if severe back pain is felt because of the scoliosis, the added pressure/weight on the spine and its supportive structures can make back pain worse.

Curve progression isn’t known to increase during pregnancy, and in typical cases of mild and moderate scoliosis that are undergoing treatment, many increasing effects and potential complications can be avoided.

Scoliosis Treatment During Pregnancy

Pregnant women can continue scoliosis treatment, although conservative less-invasive methods are necessary.

Nonsurgical scoliosis treatment offered by the Scoliosis Center of Utah is individualized and patient-centered, so treatment plans are customized around a number of key patient/scoliosis factors, and pregnant women need treatment plans modified for the best results and appropriate pain management, when needed.

During pregnancy, the focus of treatment may shift away from achieving a significant curve reduction and move more in the direction of pain management and preserving spinal flexibility and function.

Scoliosis-specific exercise can help maintain core strength: beneficial both for scoliosis treatment and a healthy delivery and recovery.

Scoliosis and Fertility

When it comes to young females diagnosed with scoliosis, when they hear it’s progressive and treatment needs are ongoing, I’m often asked if scoliosis will affect an adolescent’s future fertility.

The main effects of scoliosis are felt in the spine and its immediate surroundings, not in the reproductive organs.

There isn’t a noticeable difference in pregnancy rates in women with or without scoliosis, so the spinal condition isn’t known to affect a patient’s ability to get, or stay, pregnant.

Scoliosis and Labor

Scoliosis also isn’t associated with complicated or premature labor, but when it comes to epidural placement, a patient’s scoliosis needs to be taken into account.

The epidural’s ability to deliver numbing pain medication through a small tube inserted directly into the epidural space of the lower back requires precise placement, and if a patient’s lower spine has an unnatural curve and rotates, a recent X-ray is needed to ensure the injection is delivered precisely and effectively for optimal results.

Conclusion

What to expect when you’re pregnant with scoliosis is not much different than what to expect for women without scoliosis.

Scoliosis is a progressive spinal condition that mainly affects the spine and its surroundings, although its effects can be more widespread in severe and atypical cases.

A goal of conservative treatment is to work towards preventing progression and increasing symptoms, along with the potential for developing complications.

Here at the Center, pregnant women have their treatment plans modified accordingly, and because our approach is customized, the focus of treatment can shift to symptom management, if needed.

Scoliosis isn’t associated with fertility problems, premature births, or birth defects. Scoliosis also isn’t known to cause complicated labors and/or involve lengthier postpartum recovery periods.

What healthy pregnant women with scoliosis can expect is a healthy pregnancy and to continue their conservative treatment throughout the pregnancy.

Scoliosis isn’t known to increase curve progression, and patients can expect a vaginal birth, like women without scoliosis.

In severe cases of scoliosis, back pain can be an issue, and as back pain is a regular pregnancy effect in most women, increasing back pain can be expected, especially in the later stages of pregnancy.

In severe, atypical scoliosis cases, or scoliosis that’s left untreated, restricted lung capacity can become a complication, and pregnancy can further exacerbate these effects due to fluctuating hormones and a loss of space within the thoracic cage.

Curve severity helps shape a patient’s experience of scoliosis, pregnant or not, so for scoliosis patients contemplating pregnancy, it’s important to be actively treating the scoliosis leading up to and throughout the pregnancy.