Last updated 12/12/18.
What many pregnant women might not know is that shortly after birth — and even in the third trimester of pregnancy — they are at a greater risk of developing Bell’s palsy, a condition without many answers that causes malfunction of the facial nerve, commonly known as the seventh cranial nerve.
So, what is Bell’s palsy, and why do pregnant women get it? Can I pass it along to my baby during pregnancy? And is Bell’s palsy preventable?
What is Bell’s palsy?
Bell’s palsy is a paralysis or severe weakness of the facial nerve on one side of your face, understood to be caused by a swelling of the nerve that controls the face muscles. What causes bell’s palsy, though, varies and may not always be known. What we do know is that it happens a lot in pregnant women.
Often bell’s palsy appears in the mornings and sometimes lasting throughout the day into weeks, Bell’s palsy makes one side of your face droop. But it’s not just about looks — your saliva and tear production can be affected, as well as your taste buds.
Symptoms of Bell’s palsy, which begin suddenly and reach their peak about 48 hours in, include:
- Twitching, weakness, or paralysis on one or rarely both sides of the face
- Drooping of the eyelid and corner of the mouth
- Dryness of the eye or mouth
- Impairment of taste or speech
- Excessive tearing in one eye
- Pain or discomfort around the jaw and behind the ear
- Ringing in one or both ears
- Hypersensitivity to sound on the drooping side of the face
- Difficulty eating or drinking
Bell’s palsy is often confused with symptoms of a stroke (which can be terrify for pregnant women). The causes of Bell’s palsy aren’t well known, but may be due to viral infection or the common cold sore virus. It affects 40,000 Americans per year (and 45.1 out of every 100,000 pregnant women are affected), according to the National Institute of Neurological Disorders and Stroke, and often attacks people who have diabetes, the flu, a cold, or in the middle of a pregnancy.
Most individuals fully recover from Bell’s palsy — some cases are so mild they don’t require treatment and clear up on their own with a couple of weeks. Otherwise, treatment for Bell’s palsy includes medication, like steroids (which is a no go for pregnant women), and therapy, facial massage, or acupuncture to help improve nerve function and pain from Bell’s palsy over 3 to 6 months.
Why do pregnant women get Bell’s palsy?
Pregnant women are affected by Bell’s palsy three times more than non- pregnant women. Most cases of Bell’s palsy occur in the third trimester (71%) and early post-partum period (21%). But why does Bell’s palsy happen?
Research has suggested that preeclampsia, or high blood pressure in pregnant women, may be to blame — Bell’s palsy could even predict preeclampsia in pregnancy. Additionally, HELLP (haemolysis, elevated liver enzymes, and low platelets) syndrome may be associated with Bell’s palsy.
But what if you don’t have preeclampsia or HELLP? Can you still get Bell’s palsy?
We know that Bell’s palsy affects the same amount of men as it does women, and generally occurs in people between age 15 and 60. Pregnant women just may be predisposed to Bell’s palsy — though more research on Bell’s palsy is needed — because of their high extracellular fluid content, viral inflammation, or the immunosuppression characteristic of pregnancy itself. Another study suggests pregnant women’s altered susceptibility to herpes simplex viral reactivation as a reason for so many Bell’s palsy cases in the third trimester.
Meanwhile, an 11-year study in Canada identified the mean onset of Bell’s palsy as 35.4 weeks gestation. Of the 41 pregnant women observed, C-sections, pre-term delivery, and low infant birth weight were higher than expected for pregnant women with Bell’s palsy. The study suggested extra observation for women with preeclampsia or hypertension disorders during pregnancy.
Bell’s Palsy Pregnancy Recovery
Unfortunately for pregnant women, the prognosis for complete recovery from Bell’s palsy isn’t as good as the general population. Only 52% of pregnant women in one study who had complete facial paralysis within 10 days of the onset of Bell’s palsy symptoms recovered to a satisfactory level, compared to about 80% of other patients.
The problem with Bell’s palsy during pregnancy is treatment with steroids is not advisable for pregnant women due to potential harm of the developing fetus, so this may be one reason that recovery rates for Bell’s palsy are less than ideal.
Can I pass along Bell’s palsy to my baby?
Another challenge for pregnant women with Bell’s palsy is the worry that their unborn child will experience Bell’s palsy complications. About 50% of facial nerve paralysis cases in children have an unknown cause. Bell’s palsy in children can be either acquired or congenital, with causes ranging from infection and birth trauma to malformative or genetic disease.
- A long pregnancy or labor
- Use of epidural anesthesia
- Use of Pitocin, which causes labor and stronger contractions
- A large baby (fetal macrosomia), which may be seen in pregnant women with diabetes or pregnant women who deliver post-term
- Use of forceps during delivery
Acquired cases of Bell’s palsy can be due to viral infections — so don’t kiss a baby if you have a cold sore — or meningitis, and also have been associated with leukemia. High blood pressure levels in kids also has been seen in recurrent Bell’s palsy.
Children also are at risk, just like adults, of developing Bell’s palsy after a bad cold or flu. Proper diagnosis is important for treatment in children, though they do have a greater chance at complete recovery than adults.
Is Bell’s palsy preventable?
Unfortunately, there is no known way to prevent Bell’s palsy. If your baby’s Bell’s palsy, however, was caused by a birth injury, you have legal rights. Perhaps your doctor was negligent during your delivery and used forceps or vacuum delivery when he should have done a C-section, or there was a miscommunication on your birthing team, the latter of which is the top cause of birth injuries.
If your baby was hurt during childbirth, you may be eligible for compensation for the associated medical costs, plus you and your family’s pain and suffering. At Safe Birth Project, we may be able to help. Contact us today for a free legal consultation.