Can I Have a Natural Birth After Pelvic Injury and Surgery?

Is natural childbirth suitable for someone with a pelvic injury?

Hello, doctor.
I was in a car accident on October 26 of last year and was diagnosed with a pelvic fracture, with a crack in the pubic bone.
After treatment, I had steel screws and plates inserted for stabilization.
At the end of March this year, during a follow-up appointment, the doctor assessed that the bone had healed.
I was scheduled for a second surgery to remove the hardware on April 18, but last night, on April 2, I found out I am pregnant.
I discussed this with my orthopedic surgeon, who suggested that the hardware be removed after delivery.

I would like to ask if, with the steel plates and screws still in my body, I can only choose a cesarean section for delivery, or if a vaginal delivery is also possible.
Will the screws in my body affect the baby's development in the womb? I would appreciate your answers to these questions.
Thank you.

Mi Xiao Lu, 20~29 year old female. Ask Date: 2018/04/03

Dr. Huang Jianzhong reply Obstetrics and Gynecology

On October 26 of last year, I was involved in a car accident and was sent to the hospital for examination, where I was diagnosed with a pelvic fracture and a crack in the pubic bone.
After treatment, I had steel nails and plates inserted for stabilization.
At the end of March this year, during a follow-up appointment, the doctor assessed that the bones had healed.
I was originally scheduled for a second surgery to remove the hardware on April 18 of this year, but last night, on April 2, I found out I was pregnant.
After discussing with the orthopedic surgeon, the doctor recommended that the hardware be removed after delivery.

I would like to ask:
1.
Since the steel plates and nails are still in my body, will I have to choose a cesarean section for delivery, or is vaginal delivery also an option?
Answer: To be cautious, a cesarean section will be chosen.

2.
Will the presence of the steel nails in my body affect the baby's development in the uterus?
Answer: The steel nails in the body will not affect the baby's development in the uterus.

Reply Date: 2018/04/03

More Info

When considering the possibility of having a natural birth after experiencing a pelvic injury and subsequent surgery, it is essential to take into account several factors related to your medical history, the nature of your injury, and the current state of your health.
Firstly, pelvic injuries, particularly those involving fractures, can have varying degrees of impact on the birthing process. In your case, since you mentioned that you suffered a pelvic fracture and had surgical intervention with the placement of steel plates and screws, it is crucial to have a thorough discussion with both your orthopedic surgeon and obstetrician. They will be able to assess the specifics of your injury, the healing process, and how the presence of the surgical hardware might affect your delivery options.

Generally, if the pelvic bones have healed properly and there are no complications or ongoing issues related to the injury, many women can still opt for a natural birth. However, the presence of surgical hardware does introduce some considerations. The steel plates and screws themselves typically do not pose a direct risk to the baby’s development in utero. They are made of biocompatible materials and are designed to remain in the body without causing harm. However, the structural integrity of the pelvis and any potential complications arising from the injury or surgery should be evaluated.

Your healthcare providers will likely consider the following factors when determining your delivery method:
1. Pelvic Stability: If your pelvis is stable and has healed correctly, natural birth may be possible. Your doctor will assess the alignment and strength of your pelvic bones.

2. Risk of Complications: If there are concerns about the risk of complications during labor, such as the potential for the hardware to shift or cause pain, a cesarean section may be recommended.

3. Previous Birth Experience: If you have had a previous successful natural birth, this may influence the decision to attempt another natural delivery.

4. Monitoring During Labor: If you choose to attempt a natural birth, it is essential to deliver in a facility equipped to handle emergencies, should complications arise.

5. Consultation with Specialists: Engaging in discussions with both your orthopedic surgeon and obstetrician will provide a comprehensive view of your situation. They can work together to create a tailored birth plan that considers your specific needs and circumstances.

In conclusion, while it is possible to have a natural birth after a pelvic injury and surgery, it requires careful evaluation and planning. The presence of steel plates and screws should not inherently prevent you from having a natural birth, provided that your pelvis has healed adequately and there are no other complicating factors. Always prioritize open communication with your healthcare team to ensure the safest and most informed decision for you and your baby.

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