What is spina bifida?

Spina bifida is a birth defect involving the development of a baby's spine and spinal cord during the first month of pregnancy. It can cause several problems depending on its severity.

About 150 babies are born with spina bifida in Australia every year.

What are the different types of spina bifida?

Spina bifida occulta, the mildest form of spina bifida, causes a small gap in one or more vertebrae, with no opening in the baby’s back. Many people with the condition do not even know they have it, which is why it can be referred to as ‘hidden’ (occulta) spina bifida.

Meningocele occurs when a fluid sac pushes through the gap between the vertebrae. It generally does not cause any nerve damage because no part of the spinal cord is contained within the fluid sac. However, some people with meningocele may have minor disabilities.

Myelomeningocele is the most severe type of spina bifida. The spinal canal is open and a portion of the spinal cord or nerves is exposed in a sac that pushes through the opening that may or may not be covered with spinal membranes (meninges). This kind of spina bifida can cause moderate to severe disabilities.

What are the symptoms of spina bifida?

The signs and symptoms of spina bifida vary depending on the type and severity of the condition.

There are usually no signs or symptoms with spina bifida occulta, although you might see a tuft of hair, small dimple or birthmark on a baby’s skin above the affected area.

Signs and symptoms of meningocele and myelomeningocele – such as membranes sticking out, a bulging fluid-filled sac or exposed tissues and nerves – are visible at birth, if they are not detected earlier.

Spina bifida can cause problems such as:

• muscle weakness in the feet, hips or legs
• loss of feeling in parts of the skin
• bladder or bowel incontinence
• hydrocephalus (fluid on the brain)
• learning difficulties
• spine problems such as scoliosis
• sexual problems
• Chiari malformation (where part of the brain pushes down into the spinal canal)

Spina bifida only affects the part of the body that receives its nerve supply from the open area of the spine or below that area. It does not affect the brain, heart, chest or arms

What are the risk factors for spina bifida?

There is no single identifiable cause for spina bifida. The evidence suggests that genetic and environmental factors, such as diet, can contribute to the development of spina bifida.

You are more likely than others to have a child with spina bifida if you:

• have a low folate diet
• have previously had a baby with spina bifida
• have been taking certain anti-seizure medications
• have obesity

You are also more likely than others to have a child with the condition if the baby’s father has a family history of spina bifida.

How is spina bifida diagnosed?

Spina bifida may be diagnosed during the ultrasound scan and blood test that is carried out at week 12 of pregnancy or during the morphology scan that is performed at week 19 to 20.

If tests confirm that your baby has spina bifida, your health team will discuss what this means and your options. Your doctor or midwife will be able to refer you to specialist counselling services and provide you with important information and advice.

You can also call Pregnancy, Birth and Baby on 1800 882 436 to discuss your options regarding your pregnancy with a maternal child health nurse.

How is spina bifida treated?

There is no cure for spina bifida. Treatment will depend on how severe the spina bifida is, and whether surgery is an option to minimise the risk of infection and future disability.

If severe spina bifida is detected early enough in pregnancy, fetal surgery might be possible. It must be done before 26 weeks of pregnancy. Surgeons can open the uterus to repair the baby’s spinal cord, which can limit disability after birth.

If surgery is left till the baby is born, the exposed fluid sac and spinal cord must be repaired in the first 48 to 72 hours after birth to reduce the risk of infection and potential further spinal cord damage.

If the baby has hydrocephalus, surgery to insert a narrow tube known as a ‘shunt’ to relieve fluid pressure on the brain may also be performed.

How is spina bifida managed?

Someone with spina bifida may be able to manage the condition in part by:

• using mobility aids such as limb splints or braces, crutches or a wheelchair to help walking or moving
• using a catheter to help empty the bladder and prevent infection
• managing learning difficulties in problem solving and handling new tasks

Some or all of these health professionals may also be able to provide support:

• continence nurse
• neurologist
• occupational therapist
• orthopaedic surgeon
• paediatrician
• physiotherapist
• social worker
• urologist

Can spina bifida be prevented?

Having enough folate in your diet and taking a folic acid supplement for at least 1 month before conception, and for the first 3 months of pregnancy, is the best way to prevent spina bifida.

Foods high in folate include:

• green leafy vegetables (broccoli, brussels sprouts, cabbage green beans)
• legumes (leafy vegetables (broccoli, brussels sprouts, cabbage green beans)
• fruit (oranges, avocados and bananas)
• wholegrain cereals

If you take anti-seizure medication or other regular medication, discuss with your doctor before taking folic acid supplements in preparation for pregnancy.

Resources and support

Other languages

Do you prefer other languages than English? Health Translations Victoria offers translated information about spina bifida in Arabic:

• Hydrocephalus and spina bifida
• Spina Bifida — bladder management
• Spina bifida — an introduction to bowel management