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Pregnancy & Childbirth After PAO
Many patients considering or recovering from a Periacetabular Osteotomy (PAO) want to know how the procedure may affect future pregnancy and childbirth. The good news: most individuals who undergo PAO can become pregnant and safely deliver healthy children. PAO corrects the position of the hip socket, stabilizes the joint, and restores function—without limiting fertility or eliminating the ability to have a vaginal delivery.
This guide explains what to expect, how PAO affects pregnancy, and when to discuss specific concerns with your hip preservation surgeon and obstetrician.
Can I Get Pregnant After PAO?
Yes. PAO does not reduce fertility and does not interfere with the reproductive organs or pelvic anatomy responsible for conception. Most patients can safely pursue pregnancy once their hip has fully healed.
How long should I wait?
Most hip preservation surgeons recommend waiting 9–12 months after PAO before becoming pregnant. This allows:
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The bone cuts to fully heal
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Strength and mobility to return
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Normal gait mechanics to stabilize
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Pain and inflammation to resolve
Your surgeon may recommend a longer interval if healing was delayed or if combined procedures (e.g., hip arthroscopy) were performed.
Will I Need a C-Section After PAO?
In most cases, no. PAO does not narrow the birth canal or restrict the pelvis in a way that automatically requires a Cesarean section. Many patients are able to have a healthy vaginal delivery.
However, a C-section may be recommended if:
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You have significant residual hip stiffness
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There is persistent pain with extreme hip flexion or abduction
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Your obstetrician identifies other reasons unrelated to the hip
Important note: PAO does not change pelvic outlet size, and the acetabular reorientation does not obstruct vaginal childbirth.
Are There Restrictions on Labor Positions?
While most birthing positions are safe, some patients are more comfortable avoiding:
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Deep hip flexion
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Extreme wide abduction
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Positions requiring prolonged hip rotation
Commonly used and well-tolerated positions include:
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Supported squat
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Side-lying
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Hands-and-knees
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Semi-reclined
Your obstetrician or pelvic floor physical therapist can help identify the most comfortable options for you.
How Does Pregnancy Affect the Hip After PAO?
During pregnancy, hormonal changes—especially relaxin—can increase ligamentous laxity. This may cause:
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Temporary soreness in the groin, front of the hip, or low back
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Fatigue-related hip discomfort in late pregnancy
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Mild instability symptoms in patients with generalized hypermobility or EDS
Most symptoms improve postpartum.
Importantly, pregnancy does not reverse the correction achieved by PAO.
Can I Have an Epidural or Spinal Anesthesia?
Yes. The PAO procedure does not alter the spine or affect the ability to receive:
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Epidural anesthesia
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Spinal anesthesia
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Combined spinal-epidural techniques
You should inform the anesthesia team about your surgery, but PAO does not limit access or increase risk.
What Should I Tell My OB-GYN?
Bring up your PAO history at your first prenatal visit. Key information to share:
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Date of surgery
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Whether hardware remains in place
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Any residual stiffness or movement limitations
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Your surgeon’s recommended timeline for delivery positions
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Whether you experience pain with hip flexion or abduction
Most OB providers have cared for patients with orthopedic surgeries, but providing this detail helps them plan.
Will Pregnancy Affect My Long-Term PAO Outcome?
Current evidence suggests:
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Pregnancy does not compromise PAO correction
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Pregnancy does not accelerate arthritis
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Patients generally return to their pre-pregnancy activity level
Some patients may experience temporary soreness postpartum, especially when lifting or carrying infants, due to core weakness or ligament laxity. Physical therapy often helps.
When Should I Contact My Hip Surgeon?
You should check in with your hip preservation specialist if:
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Hip pain increases or becomes sharp during pregnancy
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You experience catching, locking, or instability sensations
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You have questions about safe labor positions
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Your OB-GYN recommends a C-section solely because of PAO
We are always happy to collaborate with your obstetric team.
Summary
Most individuals who undergo PAO can safely:
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Become pregnant
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Have a vaginal delivery
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Receive an epidural
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Return to normal activities postpartum
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Maintain long-term hip function
With proper guidance and communication between your hip preservation surgeon and obstetrician, pregnancy after PAO is both common and safe.
