Rates of neurologic injury from childbirth is around 1%.[i] There are approximately 131.4 million births every year.[ii] That means over 1.3 million women are affected by neurologic injuries from labor and delivery. In the United States alone, there are about 4 million births a year,[iii] resulting in approximately 40,000 women sustaining a neurological injury from childbirth. Nerve damage in the lower extremities is part of this.
Neuropathy is described by Dr. Helen Webberley as “the term used to describe a problem with the nerves, usually the ‘peripheral nerves’ as opposed to the ‘central nervous system’ (the brain and spinal cord).”[i] The peripheral nervous system is a network of 43 pairs of sensory and motor motor nerves that connect the brain and central nervous system (the spinal cord) to the entire body. These nerves control the functions of sensation, movement and motor coordination. These nerves are fragile and can be damaged.[ii]
Dysfunction of a single nerve, such as the common peroneal nerve, is called a mononeuropathy. Mononeuropathy means the nerve damage occurred in one area. Certain body-wide conditions can also cause single nerve injuries.
Damage to the nerve disrupts the myelin sheath that covers the branch of the nerve cell, called the axon. The axon can also be damaged, which causes more severe and long lasting symptoms. Mononeuropathy describes the dysfunction of a single nerve and means the damage occurred in one area. From childbirth, women can injury to one foot/leg or both.
- Tingling & numbness
- Pins & needles & hypersensitivity
- Loss of ability to detect changes in heat & cold
- Loss of co-ordination & the perception of movement
- Burning, stabbing, lancing, boring or shooting pains (often worse at night)
- Changes in the skin, hair or nails
- Increased pain (sometimes excruciating and/or unrelenting)
- The loss of ability to feel pain [iii]
Motor symptoms include:
- Muscle weakness, causing unsteadiness & difficulty performing even small movements
- Muscle wasting/atrophy
- Muscle twitching & cramps
- Muscle paralysis [iv]
Common nerves damaged caused by childbirth include:
- Lumbosacral Plexus
- Lateral Femoral Cutaneous Nerve
- Femoral Nerve
- Common Peroneal Nerve (foot drop)
- Sciatic Nerve
- Obturator Nerve [v]
Several terms and phrases are used to diagnose damage to one of these nerves. Neuropathy, nerve damage, and nerve palsy are the terms used to describe a nerve being damaged. Then combine these with the nerves above, such as peroneal neuropathy or femoral nerve palsy. A few other terms used to diagnose this issue include (but are not limited to) lumbosacral plexopathy, postpartum bilateral femoral neuropathy and mononeuropathy of the femoral nerve.
Most have one side of their body affected, though it is possible for both sides of the body to have damage (in which case the term “bilateral” is added to the diagnosis term, i.e. bilateral femoral nerve damage).
Injury during Childbirth
While quite rare, women damage one of these nerves in several ways during labor and delivery. These include:
- Prolonged pushing (especially with prolonged hip flexion, such as required in the lithotomy position or in stirrups, or not changing positions)
- Prolonged squatting or hyperflexion of the knees (without moving or changing positions)
- Incorrect usage of stirrups
- Compressions by usage of forceps or vacuum
- Compression of the nerve by the baby’s head
- A very large baby
- Malpresentations (baby angled in an abnormal way)
- Cephalopelvic disproportion (the baby’s head is too large to enter or pass through the birth canal)
- A wide incision at cesarean section [vii]
Women who suffer from any sort of birthing injury, including nerve damage, have a unique set of challenges, as they not only need to heal and recover themselves, but they also must care for a newborn. Women suffering from neuropathy/nerve damage after childbirth have difficulty walking or cannot walk at all. The inability to feel, control, and/or move part of their body can be isolated to a specific body part such as their foot/ankle (foot drop), or be as widespread as from toes to upper hip. Often any touch to the skin cannot be felt or creates a tingling sensation. During recovery, women can suffer from pain, pins and needles, tingling, cramping and muscle tightness. Many women’s muscles atrophy due to lack of use. Women with nerve damage have an increased chance of falling, an event even scarier when caring for a baby. Recovery time varies widely, from a few weeks to several months. A small subset of women affected never fully recover, suffering from pain, weakness, and numbness continually. Testing often done by OBGYNs and/or neurologists include MRI and EMG, with physical therapy and foot/leg braces being some of the most common recommendations for recovery. For more information on recovery, visit the “Recovery” page.
Read More about Damage to Specific Nerves:
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[i] Webberley, Helen. Neuropathy: Causes, Symptoms and Treatments. 18 Mar 2016. http://www.medicalnewstoday.com/articles/147963.php
[ii] John’s Hopkins Medicine. Health: Peripheral Nerve Injury. 26 Aug 2020. https://www.hopkinsmedicine.org/health/conditions-and-diseases/peripheral-nerve-injury
[iii] Webberley, Helen. Neuropathy: Causes, Symptoms and Treatments. 18 Mar 2016. http://www.medicalnewstoday.com/articles/147963.php
[iv] Webberley, Helen. Neuropathy: Causes, Symptoms and Treatments. 18 Mar 2016. http://www.medicalnewstoday.com/articles/147963.php
[v] McDonald, Alison et. al. Obstetrical Nerve Injury. Spring 2008. http://www.mncyn.ca/wp-content/uploads/2013/08/volume31.pdf
[vi] Image Credit: Visual Dictionary Online by Merriam Webster. http://www.visualdictionaryonline.com/human-being/anatomy/nervous-system/peripheral-nervous-system.php
[vii] McDonald, Alison et. al. Obstetrical Nerve Injury. Spring 2008. http://www.mncyn.ca/wp-content/uploads/2013/08/volume31.pdf
Other information above has been compiled from personal anecdotes from women with neuropathy from childbirth.