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For many patients who undergo periacetabular osteotomy (PAO), questions about future pregnancy and childbirth are among the most common—and most anxiety-provoking. Understandably so. PAO is a major pelvic surgery, and it’s natural to wonder how it may affect pregnancy, labor, and delivery.
The good news is that many patients go on to have healthy pregnancies and successful deliveries after PAO. However, thoughtful planning and clear communication with your care team are essential.
This guide walks through what patients should know before becoming pregnant, what to expect during pregnancy, and how PAO may factor into delivery decisions.
Can You Get Pregnant After PAO?
Yes. PAO does not prevent pregnancy and does not affect fertility in most patients. The procedure is designed to preserve the hip joint—not interfere with reproductive organs.
That said, timing matters. Surgeons typically recommend waiting until:
Bone healing is complete
Strength and mobility have returned
Hip symptoms are stable
For most patients, this means waiting at least 12 months after surgery before attempting pregnancy, though recommendations vary based on individual recovery.
How Pregnancy Affects the Hip After PAO
Pregnancy places unique demands on the musculoskeletal system, including:
Increased joint laxity due to hormonal changes
Shifts in posture and center of gravity
Progressive weight gain
For patients who have had PAO, these changes can lead to temporary hip discomfort, stiffness, or fatigue—particularly in the later stages of pregnancy. Importantly, this does not mean the surgery has failed.
Most pregnancy-related hip symptoms are:
Mechanical rather than structural
Temporary
Manageable with activity modification and physical therapy
Ongoing pain, instability, or sharp symptoms should always be evaluated.
Does PAO Affect Vaginal Delivery?
This is one of the most common questions patients ask.
Having PAO does not automatically require a C-section. Many patients are able to deliver vaginally after PAO, depending on:
Pelvic anatomy after healing
Hip range of motion
Comfort with positioning during labor
Obstetric considerations unrelated to the hip
Some surgeons may recommend imaging or consultation prior to delivery planning, particularly if there are concerns about pelvic dimensions or hip mobility.
Ultimately, the decision between vaginal delivery and C-section should be made collaboratively between the patient, OB-GYN, and orthopedic surgeon.
What Should You Tell Your OB-GYN?
Not all OB-GYNs routinely care for patients who have had PAO, so proactive communication is important.
Patients should be prepared to discuss:
The type of hip surgery performed (PAO)
The timing of surgery relative to pregnancy
Any residual hip symptoms or limitations
Hip range of motion restrictions, if present
Surgeon recommendations regarding labor positioning
Many patients find it helpful to bring written documentation or a summary of their surgery to prenatal visits.
👉 We provide a printable guide to help patients communicate key information to their OB-GYN.
Pain Management and Activity During Pregnancy
During pregnancy, pain management options are more limited. Non-pharmacologic strategies are often emphasized, including:
Prenatal physical therapy
Activity modification
Supportive devices
Gentle strengthening and mobility work
Patients who had PAO should avoid pushing through pain and instead focus on maintaining comfort and joint stability throughout pregnancy.
👉 What Pain to Expect After PAO & How It’s Managed
Will Pregnancy Damage the Hip or Undo the Surgery?
In most cases, pregnancy does not compromise the correction achieved by PAO.
The surgery permanently reorients the hip socket, and once healing is complete, normal pregnancy-related changes do not reverse that correction. Long-term outcomes are generally favorable when patients:
Allow full recovery before pregnancy
Maintain strength and conditioning
Address symptoms early if they arise
Life After Delivery
After childbirth, some patients notice:
Temporary hip stiffness
Muscular weakness
Fatigue during return to activity
A gradual return to exercise and, when appropriate, postpartum physical therapy can help restore strength and confidence.
For many patients, PAO enables an active life—including pregnancy and parenting—without chronic hip pain.
Key Takeaways
Pregnancy after PAO is common and often successful
PAO does not prevent pregnancy or require automatic C-section
Communication with your OB-GYN is essential
Temporary discomfort can occur, but long-term outcomes are typically favorable
If you’re considering pregnancy after PAO—or have questions about your individual situation—a hip preservation specialist can help guide you through planning and expectations.
