Is Vaginal Delivery Possible After SI Joint Fusion?

Pregnancy After SI Joint Surgery

If you’ve been diagnosed with sacroiliac (SI) joint dysfunction and are considering becoming pregnant, you might wonder if you can have a vaginal delivery after a minimally invasive SI joint fusion procedure, like iFuse.

Having a minimally invasive SI joint fusion procedure should not change the size of your pelvis or otherwise affect the anatomy of the pelvis. As such, an iFuse procedure should not affect your ability to become pregnant or your ability to carry a pregnancy to term.

Delivering a Baby After SI Joint Surgery

The bigger question is: Is natural childbirth possible or will you possibly require a Cesarean section (C-section)?

First, it’s important to understand how the sacroiliac (SI) joint works. This joint is located in the pelvis and transfers weight and forces between your upper body and legs. A normal sacroiliac joint has a small amount of normal motion of approximately two to four millimeters of movement in any direction. The sacroiliac ligaments in women are less stiff than in men, which allows the mobility necessary for childbirth. Increased motion is associated with pregnancy.

When the SI joint is injured or degenerates over time, it can cause low back or spine, pelvic, leg, or buttock pain. A series of specific diagnostic tests are required to diagnose where the pain is originating.

The iFuse Implant, available since 2009, is a small, triangle-shaped implant designed to stabilize and fuse the sacroiliac joint. Fusion of the SI joint will limit the ability of the SI joint to relax during pregnancy and to open during delivery. This may or may not influence your ability to have a vaginal delivery. There are examples of women who have had a unilateral iFuse procedure and then gone on to have a successful vaginal delivery including patients who participated in several iFuse prospective clinical trials. There is no high-quality clinical study that has evaluated the question of vaginal delivery in SI joint fusion patients. You should always discuss delivery options with your doctor to determine the best course of action.

Making Your Delivery Decision:

Before scheduling your SI joint fusion procedure, be sure to talk to your doctors -- your SI joint doctors and your obstetrician or general healthcare provider -- about your individual circumstances, including your general health, plans for having children, and your delivery wishes. Also be sure to ask about how your SI joint symptoms might be affected by carrying a child during pregnancy. Input from your doctors will enable you to make the best informed most collaborative delivery decision.

If you are pregnant and have already had SI joint fusion, let your doctors and healthcare providers know about your implants long before labor and delivery. If you and your care providers decide upon a C-section, it is best to know well in advance to make appropriate plans. If you elect to attempt a vaginal delivery, it is prudent to schedule the delivery in a facility that is prepared for a C-section should that become necessary.