total hip replacement and pregnancygreenspun.com : LUSENET : About Joints : One Thread
I am 34 years old and I had a total hip replacement when I was 26yrs old, that's 8yrs ago. I needed the THR as a result of congenital hip dislocation, which was left undetected until I was 3 and half. The THR was a great sucess and I am very grateful to be pain free, for the most part.
I am now eight weeks pregnant and very excited about the prospect of becoming a mother. On my visit to my GP I questioned her about the pregnancy and the implications, if any of the THR. She was very surprised that I had even mentioned it and seemed very puzzled. I then felt like I was making a fuss over nothing, after all pregnancy is not an illness! I questioned her in paticular, whether I would need a section or whether I could give birth naturally, all things being equal. She said that there is nothing to suggest that it would not be possible to give birth naturally.
I asked her if I would be referred to an orthopaedic consultant as well as the obstetrician, and she was doubtful of this as really there in no cause for concern. My husband, who should know my limitations well, is convinced that my leg span is very limited and he is very sceptical of a natural birth. My GP has never examined me and my orthopeadic surgeon of 8years ago is in a different part of the country so I cannot contact him.
I am slightly apprehensive about this and wondered if anyone has some good practical advice so I can be prepared when I see the obstetric team in a few weeks time. thanks Kelly Jones
-- kelly jones (firstname.lastname@example.org), March 09, 2004
-- sue (email@example.com), March 12, 2004.
I would just talk to the OB. If you have enough range of motion in the hip, natural birth should not be a problem.
-- Marc W. Hungerford, M.D. (firstname.lastname@example.org), March 16, 2004.
I had a total hip replacement in January 1994 at the age of 25 and gave birth to my daughter in February 2002. Now, this may depend on the type of replacement you have (mine is non-cemented, titanium, ceramic and teflon), but I would strongly advise you to make sure that everyone on your "team" knows early and often that you had a THR. My daughter's delivery was very quick (4 hours of labor, less than five minutes of pushing) and the nurse grabbed my leg and turned it at such an angle that the joint capsule ruptured. Now, two years later, my hip repeatedly subluxes and dislocates. My OB asked my orthopedist about delivery with a THR, and he didn't think there'd be a problem, but the reality is that they don't have much experience with labor and delivery for women who have had a replacement as most THR patients are done having children or beyond their childbearing years. I still have an tremendous range of motion and degree of flexibility in that hip as I have loose ligaments, but I'm very concerned as I consider a second pregnancy. Surgery to put in a new joint capsule would limit my range of motion considerably according to the orthopedist. This isn't meant to scare you, just to let you know that you make sure that everyone knows that you have had a THR.
-- Zoe Silver (email@example.com), May 11, 2004.
Thank you so much for your question. I am in the same boat as you are. I am 38 and had a THR 12 years ago. I also have found that my OBGYN does not seem to know and is not really worried . However, the truth is that she has no experience with this situation and does not really know one way or another. I plan to get a consult with an othopeadic surgeon. I don't want to risk unnessary complications in childbirth. I will post a nother message after I speak to the doctor.
-- Susan M Sfida (firstname.lastname@example.org), June 09, 2004.
I am right in the same boat as you.
I am 15 weeks with a THR that will be just over 3 years at the time of delivery.
The only information I have been able to find is a scientific study that followed a test group of 5 women w/ THR and who bore children vs. 5 women w/ THR who did not.
The purpose of the study was to see if the labour/pregnancy would affect long term wear and range BUT not the likely hood of complications DURING delivery.
The good news is - according to the study, the child bearing mothers actually improved their range. The long term affect on the prosthesis as of this point seems to be null. Good for those of us who do not want to speed up the next replacement.
The only thing they mentioned about labour was that the group ended up 50/50 in the C-section vs. Vaginal area. Again, it did not mention complications to the prosthesis itself.
Keep us posted. You look to be due first.
Best of Luck to you, Megan
-- Megan Telfer (email@example.com), July 08, 2004.
This isn't a response, but another question. I was so relieved to find your discussion, as I am considering a THR but I also want to have children. I'm 34, and I honestly don't think my hip could withstand a pregnancy, or motherhood. But I don't want to put off trying to get pregnant for too long. How long after the THR did you feel able to even think about getting pregnant? It's so hard to find information on THR's and women, especially young women. If any of you have material to recommend, please let me know. Margaret Kern
-- Margaret Kern (firstname.lastname@example.org), July 08, 2004.
In response to the last question posted, as to how soon following a hip replacement one might consider getting pregnant, I can say that I had a revision of one of my total hips June 29th, and my husband and I are planning to start trying to conceive in about a month, with the full blessing of my surgeon. (Actually, we could start trying now, but as we're aiming at a summer due date, we're going to just "practice" for a month or so before actively trying.)
Granted, each patient's experience is different, but I've had both my hips replaced (at age 12 and 13) and now have had both revised (the left when I was 20, and the right at 30), and after my six weeks off weight bearing was up, I've been able to return to completely normal activity within a month at the most. I've found that the biggest thing to overcome post-op isn't so much the pain (which only lasts a couple weeks or so), but rebuilding my strength after not being allowed to put weight on my operative leg for six weeks. I was cleared to go back to weight bearing four days ago, and have been off my walker completely for the past two. My leg is weak, but getting exponentially stronger each day, and I plan to be back at work in a couple weeks.
Everything I've found on the subject of total hips and pregnancy has been positive, and my orthopedic surgeon has reassured me on numerous occasions that there are no contraindications for my hips during pregnancy. Additionally, three different gyns have agreed with him, as it's something I'm particularly concerned about due to my small frame (I'm 5' tall, so I'd be concerned about delivery options even without hip replacements in place!). I agree with an earlier response that you should definitely make sure everyone in attendance in the delivery room is aware of your hip replacements, not only because of range of motion, but also because of increased risk of infection to the joint (this would be the case with any surgical procedure!). Your ob/gyn could also help assess whether your range of motion is adequate for a natural birth, I would guess, simply through your ease of using the stirrups and getting in the birthing position (I've been told shape of the pelvis has as much to do with ease of delivery as leg span). If in doubt, ask about an elective c-section.
Best of luck! Caroline
-- Caroline Kimberly (email@example.com), August 20, 2004.
Thanks for all the helpful information...I'm 32, had my hip replacement almost 8 years ago, and am pondering pregnancy vs. adoption now that I'm married. I have an anterior approach, noncemented ceramic replacement and am doing very well...but also wonder about the weight gain and ligamentous laxity involved with pregnancy, never mind the actual birthing process. With an anterior approach, our precautions are different...does anyone else have an anterior approach that has gone through this?
FYI, I am leaning toward c-section or adoption, and am barely considering natural childbirth.
-- gina epifano (firstname.lastname@example.org), December 29, 2004.
Hi there, my concern is related but not to the THR....I have hip dysplasia that may require the THR but it hasn't come to that yet. I have so much pain that I cannot sleep or walk very much sometimes....it varies from mildly uncomfortable to making me cry out in pain at times. My husband and I want to have a child and I fear that pregnancy could make my hip even worse. I have called my hip specialist but he's notoriously hard to see because he's a very successful and busy surgeon, so I'm not sure how long I'll have to wait and I think I could be pregnant now so I'm worrying about my hip quite a bit. If there is anything to consider I'd appreciate the information. My regular doctor doesn't even seem to understand my hip problems so I'm going straight to the surgeon with my questions.
-- Dawn Shroyer (email@example.com), December 29, 2004.
I had a total hip replacement May 2002, and conceived (without trying) July 2003. I was nervous and happy because we did not plan on having children, but God had different plans for us. My surgeon assured me I would have no problem giving birth, as I had incredible range of motion in that hip. I started at approx. 135 lbs. and by the end of the pregnancy topped out at 200 lbs! I had such severe water retention. I thought for sure I was going to damage the whole hip, I mean, that's alot of weight on that new little joint! On top of it, my ligaments were mush, and then the pain started in the hip. I didn't even attempt a vaginal birth. Well, I am now 9 months post partum, have lost most of the weight but have at least 20 lbs. to go. The hip pain has subsided. You forget so quickly what you went thru, but during the time, I thought the pain would never go away, and my ligaments were going to stay like gumby. Every body is different, but I hope my story will encourage some of you. A baby is worth everything, and if you want it, you can do it...your hip is built to withstand this stuff! Good luck and may God give all of you his guidance.
-- Donna Prezbyl (firstname.lastname@example.org), January 03, 2005.
Hi all, I thought i would just say a big thank you for all your responses and help.
I am happy to say that that my worries were needless. for the first time in my life i was actually "normal", in the medical context that is! The pregnancy was fine. the only problem I encountered was sciatica, but this affects most women regardless of hip replacements. I would therefore say for me pregnancy was no different from anyone else. I was very very very surprised.
I was worried about positions during labour etc and wondered whether a C section would be appropriate. I was also worried about pain management and everything else. To be honest it is a very personal thing as people are affected by pain in different ways. However, the pain of child birth is natural whereas the pain of a hip replacement isn't! In the end I gave birth completely naturally with the use of TENS and a small amount of gas and air at the end. Even the positioing was fine, even though I have very little ability to abduct my hips (not even enough for missionary position, but one finds a way!!!)My labour was 24 hours and I gave birth to a baby girl, Ynys Jones, weighing 8lb 8oz.
I had worried about pregnancy and now feel that I really shouldn't have as I was in the same category as any other woman who is pregnant.
All I would say is to make sure you are well informed of all the options and you write a clear birth plan. Don't dismiss natural child birth until you have all the facts. The key is being well informed and relaxed, not easy when you have other issues to consider I accept.
I wish you all the best of luck and thank you all once again for your responses. kelly Jones
-- kelly jones (email@example.com), January 05, 2005.
Hi All, This is great information! What I'm wondering is if anyone has any experiece with pregnancy before THR. I'm 36 years old and need a hip replacement but am struggling over whether to have surgery to replace my hip first or get pregnant first? I'm not getting any younger to get pregnant but I also don't want to feel rushed into major surgery b/c the clock is ticking. I don't know what to do? I'm in pain now with my hip, although managing through yoga and glucosamine, and wonder if the added weight of pregnancy would make it so miserable that I would resent being pregnant. That is the last thing that I want... Any help out there?
Thank you!! Kristi
-- Kristin Ford (firstname.lastname@example.org), January 06, 2005.
This isn't really a response to your question..but i thought since their are a few who are asking...THR or Baby first??? I tolo am getting up in age..35..and don't want too keep being in "limbo" about this issue. I have arthritis...unsure sure if it is RA or AS...but it has only affected my r wrist and R hip. I do have alot of pain...whick=h i am on meds for the pain and arthritis...so i know i will have to get of when pregnant. I thought maybe i would try & lose some wt and then see how the pain is. and also try specific hip exercises to strenghten it. I can undersatnd how you ladies feel...it is so frustrating to wait...feeling like you will NEVER be able to have a child. It is great(but sad) to know i am not the only one struggling with this. thanks for listening!!!! michelle
-- m.dworaczyk (email@example.com), January 15, 2005.
HELLO. I'M 36, NO KIDS (YET???) (NO PROSPECTS FOR A HUSBAND AT THIS POINT EITHER) BUT WOULD HAVE A CHILD IN ANY CONDITION IF HAD THE OPPORTUNITY. I STARTED TAKING SAM-E FOR THE PAIN, 800 MG A DAY, AND IT SEEMS TO BE WORKING INCREDIBLY WELL. THE ARTHRITIS WEBSITE SAID IT'S O.K. FOR THE LAST TRIMESTER OF PREGNANCY TOO. SO I COMMITTED THAT TO MEMORY FOR MY FUTURE USE. LADIES, DO SOME RESEARCH ON IT, GO TO INFORMATIONAL SITES AS WELL AS SALES SITES. IT'S PRONOUNCED "SAMMY". IT'S SUPPOSED TO BE AN ANTIDEPRESANT, BUT IT WORKS AS AN ANTI-INFLAMITORY, WITH NO SIDE EFFECTS! I'M ABLE TO DELAY THR, HAVE HAD EACH SIDE PAO, AND OTHER MISC SURGERIES THRU LIFE. THIS IS THE BEST I HAVE FELT. I CAN WORK NOW WITH ALMOST NO PAIN.AND GOOD LUCK ON THE BABIES!!
-- CARLA MOORE (MOORE.CARLA@SBCGLOBAL.NET), January 15, 2005.
Hi all. I was looking for information on just this and its been wonderful to read everyone's experiences. I am 32 years old and expecting my first child in September. Its only early days yet but since i've had both my hips replaced i thought i'd do a bit of research on the topic. Everyone's responses have been so helpful and given me some things to think about that i would not have thought of before. I also have limited movement in my hips (missionary is doable but difficult) and i'm curious to see how i go with a natural birth. I've been told by friends that i will need a C-section but Kelly if you did it (and i imagine your range is similar to mine) i dont see why i cant. Has anyone had experiences with birthing pools? I wonder if this eases the pressure on the hips? Thanks Stephanie
-- Stephanie Oud (firstname.lastname@example.org), January 25, 2005.
Hi everyone I just wanted to post my story her. I'm 22 yeard old and I have an 8 month old daughter that was born 6/22/04. at the age of 17 I had both of my hips replaces this was cause by a tremendous amount of steriods i had to take in order to live to fight back my lupus. but anyways in the fall of 2003 I became pregnant, it was a surprise. thru out my pregnancy I contacted my ortho surg and he kept telling that he saw no problem with me delivering vaginally. during my preg i had no problem, no pain no problems at all, just the normal things. But when it came to child birth it was a different story. I was in labor for 22 hours, pushed for 3 and they ended up using the vacuum to help me deliver my pricess. Like i said she was born in june, that sept I disclocated my hip and in nov it happend I again. by the time I went to see the doc he said i had to have a total hip revision, which happened 12/9/04. It hurt so bad, i could not spend time with my daughter (which hurt even more) and now I always have some pain in the hip and i don't trust the thing. If any is pregnant or considering it, please think about. I know a c section a surgery but a 100% sure it is less painfull and a revision. Please think about it, these doctors don't know how it going to affect each one of you personally, if you don't make the choice they won't make it for you. if anyone has any question or just want to talk, I'm sooooo open to talk to anyone, I don't want anyone to have to go thru this pain and separation from fam and child. thank you to Kelly for starting this I have been looking for something like this forever. God Bless all of you Gissel
-- Gissel Orellana (DRGISSEL@aol.com), March 02, 2005.