Question: Is Pregnancy After Spinal Fusion Safe?
Answer: Yes, generally speaking, although some extra precautions may be required.
I don’t have any personal experience with this one, but I’ve done some research and here’s what I’ve found.
While there isn’t a ton of info online about pregnancy after spinal fusion, there’s lots of anecdotal evidence suggesting that it’s entirely possible to have a safe pregnancy and delivery with a surgically fused spine. However, there are some extra things to consider.
Wait Until You’re Fully Fused
While I know these things don’t always go according to plan, it’s best to postpone getting pregnant until you’re fully fused. The general consensus seems to be about one year post-op, which should be enough time for your bones to fuse and to reduce the risk of a failed fusion.
I’d suggest taking it a step further and not leaving it to chance. Request imaging to confirm that your fusion is solid before trying to conceive. A year is a good rule of thumb, but it’s not a guarantee. Sometimes it can take longer than a year to fully fuse.
Be Prepared for a C-Section
Having a spinal fusion doesn’t automatically mean that you’ll need to have a C-Section – I’ve read a number of accounts from women who had safe vaginal deliveries after a fusion. However, you (and your OB/midwife) need to be prepared for the possibility of a C-Section. There are a couple of reasons for this. First, if your lumbar spine is fused, the range of motion in your pelvis is likely to be limited, which may place an unsafe amount of pressure on your spinal cord during a natural delivery.
Also (less commonly) the structure of your entire pelvic region may shift after a fusion. This could potentially alter the positioning of your birth canal, which could complicate a vaginal delivery. I didn’t find much information about this, but I wanted to mention it, as it may be of particular concern to someone with a high grade spondylolisthesis.
Possible Issues with an Epidural
So here’s where a vaginal delivery can get tricky. If your birth plan includes an epidural, you need to be aware that your spinal fusion may make this very difficult, if not impossible. There are other options for pain relief, like a spinal block or IV meds. But the most important takeaway is that you need to discuss your birth plan with your OB and anesthesiologist ahead of time. Considering how difficult it may be to administer an epidural, your anesthesiologist may refuse to even attempt it without prior planning.
So keep in mind that if you choose to have a vaginal delivery, you may be signing up for a natural (medication-free) delivery. This is a completely personal choice – just make sure you have all the facts before you make a decision.
I was able to find a couple of articles on pregnancy after spinal fusion (here and here), but most of the above info came from various pregnancy forums and a spondylolisthesis support group on Facebook. I’d love to include your story in this conversation. If you’ve been pregnant after a spinal fusion or if you have an knowledge on the subject, will you add it to the comments?
For more commonly asked questions, visit my Spinal Fusion FAQ page.