Woman faces a form of paralysis after birth
Key Takeaways
Postpartum nerve injuries are rare, but they can be severe.
Some women discuss their experiences online and advocate for more awareness of—and increased prevention efforts for—these conditions.
Reagan Smutny suffered bilateral femoral nerve damage after giving birth to her first child in 2015.[] This caused her to develop temporary paralysis in her lower body and longer-lasting nerve damage. Her experience led her to start a website that educates others about the risks of nerve damage after giving birth; provides resources for those who may be struggling; and shares her and other women’s stories.[]
Some researchers say that postpartum nerve injuries occur in up to 1% of people who have recently given birth, while other health organizations suggest that figures range from 0.3% to 2%.[][] Cases are sometimes attributed to aesthesia, but they are more often caused by the physical process of giving birth, researchers say.[]
While researchers say that most cases of postpartum nerve damage resolve within 2 to 6 months, the timeframe and severity of symptoms can range. For instance, minor nerve damage may lead to temporary numbness in the groin or legs or muscle weakness in the legs.[] More severe nerve damage can lead to longer-lasting symptoms and paralysis, impacting a person’s quality of life.
Childbirth-induced femoral nerve damage, which impacts the legs and can cause paralysis, may occur from strain and pressure on pelvic nerves, such as when the baby’s head or other body parts press down on the mother’s pelvic nerves during delivery.[] The injury may also be a result of the position someone is placed in during childbirth. Some symptoms can be temporary, but damage from the condition may be longer-lasting.
More research may be needed to fully understand how to prevent childbirth-induced nerve damage. A collaborative effort between doctors, patients, and other healthcare providers during birth may also be important in reducing risks. Some organizations, like the Anesthesia Patient Safety Foundation (APSF), suggest that anesthesiologists can play a role in reducing risks from nerve damage by helping patients understand potential risks before administering anesthesia—a factor that places patients at increased risk. Risks may vary based on the individual’s anatomy and the concentration and placement of anesthesia, such as in an epidural near nerve roots, the foundation says.
Additionally, the APSF says that anesthesia could indirectly impact risks for nerve damage.
“Although this has not been explicitly studied, it is reasonable to assume that patients with a dense analgesic block may be more likely to have compressive nerve injuries, as the local anesthetic may inhibit nociceptive warning signs of neuropathic pain,” the APSF says.
On her website, which she clarifies is not intended for medical advice, Smutny writes that childbirth-induced nerve damage does not always get the attention it deserves, demonstrated by how well—or poorly—some healthcare providers are trained in preventing the condition.
Smutny discusses tips that may help prevent nerve damage following a vaginal birth, such as:
Talking to the patient about nerve risks they may encounter during delivery.
Suggesting that the patient change positions or stretch out every 15 minutes or so—or however often you deem medically necessary.
Encouraging hip and leg movement, particularly if the patient has had an epidural.
Determining, before the patient begins pushing, whether the fetus is at a safe height in the body—or if the patient should wait a little longer.
Assessing how long a patient has been in labor and whether continuing could put them at risk for nerve damage. If a patient has been pushing for a long period of time, consider whether other approaches, like a C-section, should be utilized.
Discussing risk factors with your patient before using forceps to assist with delivery, as they may increase risks for nerve damage.
What this means for you
Postpartum nerve damage resulting from pain and pressure on the pelvic nerves can, on rare occasions, impact people after giving birth. You may want to discuss these risks with patients before delivery and suggest that they take breaks to stretch or change positions during delivery in order to assess their mobility.