Giving birth after back surgery - anyone else?

[sloathy]

Hello

I am 31 weeks with DC1. Two years ago I had a very nasty disc prolapse which had to be operated on. Since then the same disc has has another minor prolapse which was treated using local anaesthetic injected into my back. Since I got pregnant my back has actually felt much better - maybe someting to do with change in posture?

Anyway, I had an appointment with the anaesthetic consultant today to discuss whether this history might cause any issues during labour. I didn't think there would be any problem so was a bit taken aback when he seemed quite concerned and advised me very strongly to go to hospital very early in labour and to make sure I see an anaesthetist straight away so that a canula can be sited for an epidural when I'm in the early stages. He said it would be too dangerous to try and site it if I'm too far along as it may be difficult to do because of the scar tissue in my back etc and I would need to be very calm and still for them to attempt it. He said that if the canula was sited I didn't actually have to have the numbing stuff injected through it unless and until I needed/wanted it - i.e. if I needed a c-section for some reason or decided I wanted the pain relief. The most worrying part was that he said that if they can't get a canula into me and I do end up needing a c-section I would have to have a general anaesthetic - the thought of this makes me very sad - to know nothing about the birth of my little one and not hold him straight away would be heart breaking I think.

He quite clearly said that a water birth (which would have been my ideal) is a no-no so now having to re-think my birth plan. I'm very open minded about the whole giving birth process and was prepared to just see how things went - but now I feel upset for some reason. I guess because choices are being taken away from me and it feels like its all going to be quite "medical" from the very early stages. Also worried that midwifes might not be keen to get an anaesthetist to me early on in labour.

I know at the end of the day that all that matters is that he comes out safe and sound but I just wondered if anyone else had experience of giving birth after back surgery and how things went?

Thanks

[Claireybella]

Hi Sloathy. I had a back op (disk had crumbled) back in 2005. My back was also a lot better when I was carrying my little one and I was told that if I wanted an epidural that it wouldn't be worth it because the drug wouldn't travel through the scar tissue. Luckily I only had gas & air anyway and Daniel was born 3 weeks early on Boxing Day 2009.

I have to say that since then my back has been really bad at times so I have to go see a Chiro every 6 weeks and it really gets me down but then I look at Daniel and start smiling again.

It scared me when my anaesthetist said there's no point in having an epidural but then when my waters broke it never came into my head, I just did what was needed. They have to tell you what may not happen or can't happen as that's their job so try not to worry too much. As long as when you go in on the day the staff on shift know your situ all will be fine and you will suddenly have a natural mummy impulse of just do what's best for the baby.

I had a bad time afterwards because my after birth wouldn't come out naturally and I insisted that Daniel went out of the room because I didn't want him to hear me crying! Serioulsy motherhood just makes you do what's best for him/her.

x

[Labradorlover]

I would go back and ask to speak to others at hospital rather than just anasetic consultant (who's job it is to give epidurals ).
No back op here, but lots of injections into my sacroilliac joints previously. Which put me off an epidural. But I didn't want one anyway as I felt that having one would increase my risk of having a CS. Felt CS would cause more back problems for me long term.....
IMO that if you are "used to pain" giving birth will be endurable. I was induced and didn't think I was really in labour till I was 10cm. Just thought I had a sore back, tummy and needed a poo......
I also kept mobile, used a tens, and gave birth lying on my side keep take the pressure off my spine/pelvis.
Post birth though, all the lifting and carrying of DD was very hard on my back, but I think it would have been way worse had I had more interventions.

[Labradorlover]

Forgot to add, try and keep as fit as possible now so you are fit to give birth. I was walking my dogs every day till I went into hospital.
Good luck.

[violetwellies]

I havnt really thought about this til now... had quite a few broken bones in spine, in m/c accident when a teenager, surgery in my ealy 20s as some of the discs had calcified...

Im getting some sciatica now (28 weeks) which Im guessing is just the bairn squishing a nerve as it dosnt 'really' hurt.

Is it all going to go to pot during labour?

[SelinaDoula]

Would you consider a Doula to support you?
Did he say why a water birth is a no go? It sounds quite sensible to me, for pain relief and mobility.
It doesn't sound like there is a reason why you shouldn't plan for a natural birth/waterbirth even a homebirth!
Selina

[mouffloncake]

Hi sloathy

I read your post with interest & wanted to reply to say youre not alone.

I had major spinal surgery in 2000 to corrct a double scoliosis which resulted in a spinal fusion & a load of metal work inserted. I have 3 discs left. 1 prolapsed, 1 is degenerate.

Recently, I had a consultation with the anaesthetist who told me I am not suitable for epidural or spinal block & like you, if for whatever reason I should C section, I would need a generl. (I react very badly to generals & take a long time to recover so would rather not lol).

Have they discussed morphine or pethadine with you, could this be an option?
This has been ruled out for me as it makes me too unwell.

The consultant did however suggest birthing pool plus gas & air to start. I have also been offeren a drug called Remifentanil as plan B. Altho only used once or twice a year during labour, it is a very effective drug that is fast acting & burnt off quickly in the body which means little crosses the placenta. Like all drugs, there are pro's & con's.
I believe there is a hospital in Belfast which uses this drug & their epidural rate has dropped by 50% as the women elect this over epidural.

My anaesthetist has given me his home & mobile number should i wish to call for a chat. He has even told me to contact him as soon as I go into labour regardless if he is on call or not, so he can prep the team for my arrival!

I feel very reassured having found a consultant willing to give me options.
Can you have a consult with a specialist?

[japhrimel]

Do you want an epidural? Although having a canula for epi would mean that you could have an epidural for pain relief or a spinal for CS, not having one is still your choice and GA is always an option if an EMCS was needed.

Personally I'd push to go for a water birth and hope to minimise the chances of you needing an epidural in the first place! One thing to consider is that the canula will almost certainly be extremely uncomfortable during labour, so just having that put in would increase your risk of needing the pain relief IMO.

I had to have a CS after failed induction and with my hyperlordosis, it took an hour and 3 tries (plus bringing in the top consultant!) to get the spinal in. If my ctx hadn't stopped and I hadn't been able to use my natal hypnotherapy to keep myself super calm and still, I would've had to have a GA too. As it was it was fine, but they were surprised I coped as it's really really uncomfortable even without ctx (thank you hypnotherapy!).

[mamalocco]

Also had surgery for scoliosis and had to bring it to my consultant's attention that an epi might not be the way to go! Sloathy - I felt exactly the same about the prospect of having a c section under a general (consultant told me dd1 was breach and therefore quite likely - as it happens he'd mistaken her bottom for her head which proves they don't always know what they are talking about!!).

In the end have had three straight forward deliveries without any pain relief. Delivered dd1 myself sitting on the toilet (no that wasn't in the birth plan!), ds nearly popped out in the hospital car park (made it inside with 2 minutes to spare) and dd2 was born in a birthing pool - no problems.

Best of luck.

[mouffloncake]

mamaloco that's reassuring to hear. Have you much spine fused? I'm done between t2-l3.

I hope sloathy is feeling a little mote reassured too. It's good to hear from somebody who's been there & done it.

[sloathy]

Hi all,

Sorry I've not come back sooner. Thank you very much for all of the replies and advice.

It's my L5 S1 disc that is shot although the couple above it are quite "dried out" as well. So it's my very lower back that's the issue and the consultant did say that the epi normally goes in higher than that so hopefully there wouldn't be a problem but he was still iffy about trying to do an epi when I'm in established labour. Of course I get that he was talking from his point of view and he did emphasise that he was talking from the perspective of an anaesthetist only and that from that perspective he would not want to be trying to site an epi too late in the day because of the extra care that would be needed given the pathology of my back. He didn't mention the possibility of it not actually working just that it may be hard to find the right spot.

I've discussed it with my midwife who things the anaesthetists plan sounds sensible.

The water birth is a no-no because I couldn't get in the water with the canula sited because you can't get in the pool until 5-6cm dilated and this is after the point at which he would ideally site the canula.

I don't particularly want an epidural but I honestly don't know how I will feel as this is my first and it makes some sense to me I guess to at least have the canual sited when I'm in early labour so that they have the best possible chance of siting it correctly so that if I do need an EMCS I won't have to have a general. To be honest, not having a general is more important to me than not having an epidural (if that makes sense). My sister has had two EMCS after complications and my mother also had complications having me and my sister so my family history when it comes to giving birth is not great - although I understand that that doesn't necessarily mean it will be the same for me.

I also have a fear that I may prolapse the disc badly when pushing which would lay me up for as long afterwards as having a CS would!


I now have an added complication in that baby is breech. Still a few weeks left to turn though so trying not to overthink that factor.

[r0zebud]

I know its hard, but try not to worry about everything, it makes things much tougher! I didn't know the extent of my back problems until they tried to site a canula. I'd had a back problem since a riding accident when I was younger, but it was just pain and usually fixed by a good session with the chiro! DH joked with the anaesetist that I was up for any drugs going, so we were offered remyfentinol, self administered by pushing a button when you feel the contraction coming on. About half way through for some reason I changed my mind and asked for an epidural, they made several unsuccessful attempts to site the canula, which drastically slowed down an already slow labour, before I called them off and asked to revert to the remy. In hindsight, I wish I had just stuck with the remy, the pain from the attempts to site was worse than my post-labour pain for the following days, I've got a cracking photo of all their attempts. It wasn't down to incompetence but my "craggy" spine. Anyway, if they have remy on offer, I would grab it! It was much better being able to control the drugs myself and it felt like I had more control.

I understand your worries about an cs, but try not to worry about that side of things, focus on the positive!

Good luck when the time comes :)

[Laura0511]

Hi

I know this is an old thread but I just wondered the outcome? I'm due to have back surgery imminently but I am planning on trying for a baby after my 30th at the end of May. I already have a 4 year old son and having him caused my pelvis to move out of line which I think has caused the prolapsed disc over time. Any info would be greatly appreciated thanks x