Ehlers-Danlos Syndrome (EDS) is a group of connective tissue disorders that can affect many aspects of a person’s health, including their pregnancy, labour, and postpartum experience. The condition often involves hypermobility, fragile tissues, and skin that bruises or scars easily. For women with EDS, these characteristics can pose unique challenges during childbirth, requiring careful management and support. I wanted to write this to give you as much knowledge as possible about how to help yourself during labour and birth – if you have hyper mobility or EDS.
Key Ways EDS Can Affect Childbirth
1. Slight Increased Risk of Premature Labour
This is because the connective tissue weaknesses associated with EDS can sometimes lead to:
- Weakened Connective Tissue: The cervix may begin to dilate too early due to weakened connective tissue.
- Uterine Complications: Reduced tissue integrity may contribute to uterine instability or early contractions.
- Preterm Birth: Higher risk of early pre-term birth in some cases, which may lead to extra monitoring and possible medical intervention.
2. Pain Sensitivity and Management Challenges
- Amplified Pain Perception: Women with EDS may experience heightened pain during labour due to sensitive nerves and lax joints.
- Epidural Considerations: Due to potential complications with spinal anatomy or increased sensitivity, epidurals may require special consideration or expert administration.
- Ineffective Anesthesia: Some individuals with EDS report reduced efficacy of local anesthetics, making pain management strategies crucial.
3. Joint Instability and Injuries During Labour
- Pelvic and Hip Dislocations: The hypermobility of joints can lead to instability, increasing the risk of dislocations or injuries during pushing or certain birthing positions.
- Less Defined Pathway: This increased laxity can create a less structured birth canal, making it harder for the baby to rotate in the pelvis and find the ideal position. When rotation does not occur as expected, the baby may remain and in some cases are born, in positions such as:
Occiput Posterior (OP): Baby’s back is against the mother’s back, which can lead to a longer and more painful labour.
Transverse Lie or Oblique Positions: The baby is sideways or diagonal in the womb, which typically requires intervention.
Face or Brow Presentation: Less common but possible due to abnormal fetal positioning in hypermobile mothers. - Post-Labour Pain: Joint strain during childbirth may require physical therapy for recovery.
4. Tissue Fragility and Healing Issues
- Tearing and Surgical Complications: Fragile skin and tissue increase the likelihood of severe perineal tearing or complications from cesarean sections.
- Slower Healing: Poor wound healing and increased bruising may occur postpartum, necessitating extra care to avoid infection and support recovery.
5. Postpartum Complications
- Prolapse Risk: The weakening of pelvic floor tissues can lead to a higher risk of uterine, bladder, or rectal prolapse.
- Postpartum Hemorrhage: Increased tissue fragility can contribute to difficulty in controlling bleeding after delivery.
Strategies for Managing Childbirth with EDS
- Personalised Birth Plan: Develop a detailed birth plan with healthcare providers that considers individual EDS symptoms and potential complications.
- Monitoring for Cervical Insufficiency: Early screening for cervical weakness and potential use of cerclage or progesterone supplementation to support pregnancy if you have experience of miscarriage.
- Pain Management Planning: If you want to, work closely with anaesthesiologists to find effective and safe pain relief strategies tailored to EDS needs.
- Joint and Position Support: Use supportive birthing positions and minimize unnecessary pressure on joints to reduce injury risks. A physical therapist may provide guidance on positioning.
- Enhanced Postpartum Care: Proactive management for wound care, pelvic floor support, and physical therapy to promote healing and long-term recovery.
Emotional and Psychological Support
- Trauma Awareness: Women with EDS may face added stress due to fears about complications or previous difficult medical experiences. Articles like this don’t help, but I think informed decision making is important. Emotional support from doulas, therapists, or support groups can be invaluable during your pregnancy.
- Empowered Decision-Making: Ensuring women with EDS feel informed and supported in their choices will lead to a more empowered birth experience.
While Ehlers-Danlos Syndrome presents unique challenges in childbirth, with proper planning and individualised care, women with EDS can have safe and empowering birth experiences. Collaborative care that respects the physical and emotional needs of EDS patients is key to supporting their journey through pregnancy and beyond.