It's public knowledge that Princess Eugenie had corrective surgery for severe scoliosis when she was 12. People with titanium rods fused to their spines like Eugenie may not be able to have an epidural during childbirth, and though Eugenie's delivery was healthy, that doesn't mean it wasn't without some complications. "When we have a patient with a history like this, we have them meet with the anesthesiologists before labor, to see if indeed they are candidates for epidural anesthesia," explains Dr. Mary Jane Minkin. Eugenie and her husband spent extra time planning for this specific birth.
"It really depends on exactly where the rods are placed in the spine," she continued. "Basically, the epidural space is around the spinal cord itself, and the nerves from the spine pass through this space, out to the rest of the body. You want the numbing medicine — basically, truly fancy novocaine! — to bathe the nerves as they pass through this space out to the rest of the body. So a lot depends on exactly what the spine surgeons did operatively. If indeed she is not a good candidate for an epidural they will help come up with a plan for her for pain relief. We can certainly use some opioid pain medications during labor."
"The major issue for most people isn't so much having had the back surgery itself — it's really how much back pain are they in baseline before getting pregnant. The pregnant belly just puts more pressure on the spine, sort of swinging it forward, and the more weight that a mom gains, unfortunately, the worse the discomfort can get," Minkin continued. "So if one has had back problems, the stronger the shape she can get herself into before pregnancy, the better — to strengthen her core, so she can end up with less pulling pressure from her back."