Herniated discs L5-S1 had surgery

[Aud1988]

About 8 years ago I had an injury which lead to a herniated disc L5-S1. Long story short I had a lumbar microdiscectomy surgery and made a full recovery.
I am now 35 and 18 weeks pregnant. This is my first baby. I am worried to give birth. The midwife has told me I am high risk and that I might need to have a c-section which I really don’t want because of the recovery. I always imagined I’d have a normal birth.
My question is has any woman that has had surgery of a budging disc delivered their child normally without a C-section? Could you have an epidural?

Hi I have a similar experience, had a microdiscectomy for disc prolapse 9 years ago and full recovery. Ive had 2 children since.

when I was having my first I did have a consultation with an anaesthetist around 35 weeks to discuss my precious spinal
surgery and check an epidural would be Ok, but they didn’t class me as high risk
per se.

as it turned out I needed an emcs with the first so no experience of vaginal birth but I had an epidural with no problems.z I chose an elcs for the second.

By the way, epidural /spinal anaesthesia is injected several spinal levels above L5/S1, so that the anaesthesia gives high enough coverage to cover the abdomen

probably best to ask the MW/your obstetrician why they think you might need a section. Re. the anaesthetic side of things, having had spinal surgery, even though it's a space or two away from where the needles go, can make things more tricky, but doesn't always by any means. Probably best to ask to see an anaesthetist in clinic if they haven't suggested it already so they can run through things properly.

I had to have a planned c-section for similar reasons. I haven’t done much physics since school, but when the obstetrician explained labour and physical forces to me to me, she was talking in terms of Newtons, which I didn’t completely understand … but understood enough to know I didn’t really want to do that to my poor little lumbar joints, they’ve been through enough already! The pressure and forces that go through the lower spine and pelvis during a normal labour are enormous. And with a L5-S1 fusion, you’ve got no possibility of movement in the joint during labour, so your spinal cord is at increased risk of compression due to the forces, compared to someone who doesn’t have lumbar fusion (or even if they only have a higher joint fused … as you already know the L5-S1 is literally the last bit of your spine and your pelvis!).

If a c-section is being actively recommended to you, it’s for a good reason - someone qualified, who’s familiar with your medical history, and knows the risks vs benefits, is making a judgment call. If you’re in the UK, the NHS don’t especially like doing planned c-sections unless it’s really the best option. They do them on maternal request but rarely suggest them, and certainly not without strong clinical evidence to support it as the best option for the individual patient.

I’d follow their advice, but if you’re not comfortable doing that and are fixed on trying an unassisted delivery, it might be smart to pack your hospital bag as though you were having a c-section (get the high rise disposable tena pants instead of normal rise, etc.!) because you have higher risk of ending up as an emergency c-section case.

Your midwife and obstetrics team won’t want to risk you coming to harm, and I imagine they would insist on emergency intervention if it started to look a bit scary. It’s in your best interests and your baby’s best interests that you have a good birth and recover well. A good birth and recovery for women like you and me, and PPs, is not going to be the same as women who haven’t had a serious history of lower spinal injury.

My c-section recovery was brilliant - must admit, I was also really worried beforehand, but I was discharged with a good amount of pain relief and had everything set up well at home because it was all planned ahead of time.

Good luck x

OP I’m really sorry, reading back I realise I got confused with another poster! If you haven’t had fusion your risk of spinal cord or nerve damage is lower than if you had the fusion. It’s still higher than someone who doesn’t have history of damaged discs, but it’s a risk you might decide you’re fine with. Please do ask your clinicians lots of questions, and explore your options fully. Contingency planning is still worth doing so you’ll be prepped for an emergency section recovery if needs be. I hope you and your baby have the best birth experience you can have 😊 x

the risk of a cord injury after L5/S1 surgery is zero - the cord terminates at L1/2 in most adults so well above that level (which is why we aim for L3/4 or L2/3 for labour epidurals... so that the chance of a cord injury is as low as possible). HTH.

I had to have a c-section for this reason and previous surgery on back. Initially I was told I couldn’t have an epidural and would need to be put to sleep but then on the day they said it would be fine and had it but then it was unsuccessful so turned out me being put to sleep anyway. I was up and about going for walks by day 7. however, I gave birth overseas and not UK although I am
British so things may be done differently . Personally I was happy to go with a c-section as didn’t wanna risk causing further injury to back as the pain prior to back surgery was horrendous and can’t even imagine having to potentially go through that and deal with a newborn. Good luck whatever way you choose

What type of injury/surgery did you have on your back?