Congenital spine abnormalities are common. These anomalies can be associated with other anomalies and different degrees of symptom severity. In pregnant women multidisciplinary planning and considerations of special needs may be necessary as summarised in this review. Recommendation for caesarean section should, for most parts, be made on obstetric indication only. Neuroaxial analgesia during birth and anaesthesia for caesarean section is seldom contraindicated in women with back abnormalities. However, in tethered cord, it is important to avoid iatrogenic damage to the conus when placing spinal anaesthesia.