Intense back pain and brittle bones at just 29 – all because I had a baby
Reaching into the back of the car, Georgina Howard unclipped the baby seat and lifted it towards her.
It was hardly heavy — her daughter, Mia, was just two weeks old — but Georgina felt a sudden, agonising pain tear across her back.
‘I’d never felt anything like it,’ says Georgina, 36, a website manager from Nottingham.
'I was only 29 but felt like an old lady. My husband would have to brush my hair and help me shower,' said Georgina Howard who was diagnosed with osteoporosis
‘It started between my shoulder blades, then spread across my upper back and surged down my arms. Even breathing was agony.’
Over the next few days the pain intensified, spreading down her back.
‘I knew painkillers can be passed on in breast milk, so I struggled on without them,’ says Georgina.
‘But after two weeks, I could barely stand up straight or walk, so finally I made an appointment to see my GP.’
Her GP said she was simply feeling the natural toll of pregnancy on the body.
‘He said most mums suffer back pain during and after birth.
'I felt silly for bothering him, and left with a prescription for painkillers that were safe to take while breastfeeding.’
But Georgina was suffering from far more than post-birth backache.
At the age of just 29, she had osteoporosis, triggered by her pregnancy — and the agony in her back was in fact a fractured spine.
Osteoporosis, where bone density declines leaving the skeleton brittle and fragile, is best known as a condition common among post-menopausal women, caused by falling levels of the hormone oestrogen, which is vital for strong, healthy bones.
However, a woman’s bone density also temporarily drops during the latter stages of pregnancy and breastfeeding, as her body provides calcium for her growing baby.
Georgina spent two months in agony, until a scan revealed her spine was fractured (pictured with daughter Mia)
In most cases, the body adapts. But for a small number of women, bone density becomes so low that osteoporosis occurs, and patients can suffer the agony of fracturing or breaking bones — either during birth or up to 12 weeks afterwards.
The danger zones include the back, hips and wrist, where the bones are more porous and spongy.
Dr John Stevenson, consultant metabolic physician at the Royal Brompton Hospital, London, says: ‘It’s a rare form of osteoporosis — and because it is a rare condition, cases may be missed or misdiagnosed.’
Georgina spent two months in agony, and made countless trips to her local surgery before she finally found out what was wrong with her.
‘I was only 29 but felt like an old lady,’ she recalls.
‘My husband, Jeff, would have to brush my hair and help me shower. At night, it hurt too much to lie down, so I’d sit up, propped by pillows, crying.’
Finally, she returned to her GP’s surgery — and refused to leave without a referral to a consultant.
Thanks to private insurance, she had an appointment with a back specialist at Park Hospital, Nottingham, within days, and was stunned when a scan revealed her spine was fractured in five places.
Further tests showed her bone density was significantly lower than usual, and a specialist told Georgina she had pregnancy-associated osteoporosis.
‘I’d heard of osteoporosis but thought it was something that affected only older women,’ she says.
‘I wasn’t even 30!’
Sarah Leyland, a senior nurse at the National Osteoporosis Society, says experts are at a loss to explain why pregnancy-related osteoporosis affects some women and not others: ‘One suggestion is that, for some women, pregnancy triggers a sudden reaction in a previously normal skeleton.
‘Another thought is that the woman starts pregnancy with an already low peak bone mass, and the normal bone loss that occurs in pregnancy then causes further bone thinning — triggering osteoporosis-related fractures.’
Dr Stevenson says hormonal changes may also be to blame.
He explains: ‘Ordinarily in pregnancy, levels of the hormonal form of vitamin D increase in order to enhance calcium absorption from the gut, and also to encourage the breakdown of bone which is “reabsorbed” by the body as another form of calcium.
‘This provides the extra calcium needed during pregnancy.
‘However, studies have found that in women with pregnancy-induced osteoporosis, their vitamin D hormone levels didn’t increase.
'As a result, the mother’s natural calcium stores are depleted. But why this should happen we simply don’t know.’
'I'll never be able to run or do anything that puts pressure or impact on my spine,' said Georgina
While for most women bone density improves within 12 to 18 months of weaning, for those with pregnancy-induced osteoporosis, the condition causes permanent damage to the internal structure of the bones, leaving them with a compressed spine and loss of height — as Georgina discovered.
Scans showed two vertebrae in her spine had compressed.
‘I was shocked to learn I’d lost three inches and was now 5ft 8in,’ she recalls.
‘And I could see in the mirror that there was a definite curve to my upper back.’
Women with osteoporosis are usually treated with bisphosphonates — powerful drugs that slow down bone loss in the body.
However, these are usually licensed only for post-menopausal women, and doctors are reluctant to give them to women who haven’t ruled out more children because the long-term effect on a developing baby’s skeleton is not yet fully understood.
Georgina was instead put on strong painkillers, and took calcium supplements and a drug called calcitonin, which slows bone loss.
Unfortunately — and unusually, among sufferers of pregnancy-associated osteoporosis — her density levels did not improve at the rate expected and her skeleton remained dangerously weak.
She was unable to return to her high-pressured job in marketing.
Instead, she set up a legal firm with her solicitor husband. Hardly surprisingly, she was anxious about getting pregnant again.
‘Jeff and I had always planned two children, but I was terrified of the osteoporosis.
‘Then, in 2008, I was a passenger in a car that bumped into another vehicle at traffic lights,’ she recalls.
‘It was a tiny collision, and most people would have had slight bruising — but I suffered two broken ribs. I was shocked that I was still so vulnerable.
'If that could happen after a minor bump, what effect would another pregnancy have’
After much soul-searching, she and Jeff decided to adopt.
‘As the process got under way, I felt a sense of loss for the second child I’d never be able to have, but I told myself that we were doing the right thing.’
However, in spring 2009, Georgina was stunned to discover she was 17 weeks pregnant.
‘It was a complete shock — but there was never any question of not going ahead with the pregnancy,’ she says.
Adoption plans were abandoned — and Georgina made an emergency appointment to see her consultant.
‘My consultant assured me I would be monitored throughout and given increased calcium and vitamin D to strengthen my bones.
‘I was advised not to breastfeed because of the drain it can have on calcium levels.
'And with no further children planned, I could start taking bisphosphonates immediately afterwards.’
She says giving birth again was nerve-racking.
‘With every push, I could feel pressure building in my spine and I was terrified I was going to fracture.
'After an hour, I insisted on help — and Theo was born by ventouse, weighing 10lb 5oz. It was such a relief for him to be in my arms.’
However, exactly two weeks after Theo’s birth, she lay awake one night aware of a growing pain in her upper back.
‘I can remember thinking “It’s happening again”.
‘I had X-rays straightaway, which showed four fractures. But this time at least I knew what was happening and received the right support from the outset — strong painkillers and bisphosphonates.’
Sarah Leyland says women who experience severe back pain and loss of height in late pregnancy or post-birth should see their GP and ask to be assessed by a rheumatologist.
Because she is now at higher risk of a fractures, Georgina has annual check-ups and bone density scans.
‘I’ll never be able to run or do anything that puts pressure or impact on my spine — and I worry how osteoporosis will affect my health in old age,’ she says.
‘But if this is the price for having two healthy children, I wouldn’t change a thing.
'I just hope my story will mean other women can avoid what’s happened to me.’
National Osteoporosis Society (nos.org.uk), tel: 0845 130 3076 or the helpline on 0845 450 0230.