Childbirth after a spinal fusion

[littlemissh]

Hi does anyone know if it is possible to have a natural childbirth after having a spinal fusion (L5/S1) ?

I was advised to have a c/s for this exact reason - sorry thats probably not the answer that you were hoping for - but this may vary down to the individual obs consultant.

Thanks RoseWater, that is what I've been told as well. Can I ask, did you have a general anesthetic or an epidural?

I'm awaiting a disc replacement (apparently the more modern version of a spinal fusion - presuming you had this done for disc degeneration/prolapse). I'm having an ELCS as a result - it was my choice but both my obs and ortho consultants said that unless you have the most incredibly straight forward vaginal birth (which can't be guaranteed) there is risk of further damage - so personally for me was a no brainer.

I'm having a spinal (but then my knackered disc is high up and yours is probably lower back) but that said I'm not sure why they couldn't do it as they are going in around the spine not between vertabra.

Good luck :-)

Thanks Gurraun. Unfortunately I was to young to have a replacemet disc (I was only 20 at the time & the fear was that it would have to be replaced in 20 years) and a spinal fusion was the only alternative. That said it has worked wonders and I'm more active than before I had a slipped disc. The thought of having an epidural is too much for me, I've had so much surgery on my back (4 epidurals already plus 2 big ops) that it tends to be ultra sensitive! I hope it all goes well with your op

Neither - I had a spinal anaesthetic as they were concerned that the usual location that they would inject for epidural may exacerbate my problem (L5/S1 - same as yours).

My ortho cons said if I really wanted to try for a vaginal birth then if there were no complications during my pregnancy, I could try on the understanding that I would have to have an emergency c/s.

Good luck!

Found some posts on this forum about women having natural births with what sounds like similar conditions
www.steadyhealth.com/Scoliosis_Pregnancy__Herring_rods_placed_in_spine_Birth-t96500-0-asc-10.html
I think its best to avoid having an epidural.
You could consider using the pool.
Selina

I gave birth a month ago after having most of my spine fused 16 years ago (scoliosis - 2 harrington rods). I gave birth perfectly normally - vaginal delivery. I was advised against an epidural by the anaesthetist, but the spinal consultant said that it was do-able if necessary (but you really need to go with whatever the anaesthetist on this says).

You will need to speak to an anaesthetist and probably get advice from the spinal consultant at the hospital where you are planning to give birth. And do it ASAP. The midwives should refer you - INSIST on it and get your GP to help out with this if necessary. When you get referred make sure they make it clear that you need to be seen quickly and not put on a 12 month waiting list!

It took me a LOT of discussion and to-ing and fro-ing to convince the obs/MWs that I didn't need to have a caesarean, but once I'd got the necessary advice from a spinal consultant that it was ok to aim for vaginal delivery they respected the decision and helped me in finding alternative pain relief options as I wouldn't be able to have an epidural. In the event I had a fantastic labour and didn't need any pain relief (more by good luck than anything else). But if I had needed the drugs I had plenty of options. Please do speak to as many people as you can at your hospital, don't take the first opinion if it is not the answer you want (I was told by 2 obstetricians that I would definitely not be able to deliver vaginally and spent the first 6 months of my pregnancy worrying about it), take your x-rays along if you have them and let me know if you want any more information.

Good luck.

remefentanil was the drug recommended to me by the way i think.

I had a discectomy (L4/L5) with no fusion and had a vaginal birth with DD. (I also have two lower prolapsed discs which haven't been operated on.)

That said, full labour went on for 5 days and no-one could work out why DD couldn't turn or get in position so progress was extremely slow (obviously - it took 5 days!) until they induced me. It was suggested afterwards that the back problems/spinal damage could have been the problem (but no-one could give me any good advice on it pre-birth). DD was very very nearly an emcs (ventouse before fully dilated) but I'm glad I went through with it. (The midwives were great which helped.)

I had an epidural after the induction drip, for which a consultant anaesthatist had to be consulted at 4am, which wasn't fully effective but i was warned about that. (I had to see an anaesthetist earlier in the pg to allow this to go ahead.) I wanted to use a pool, but the induction pain meant this couldn't happen. In the hospitals I was in, the preferred site was L4/L5 which meant they had to do something different in my case.

Obviously, I didn't have a spinal fusion, but I wouldn't immediately see a reason why you couldn't try for a natural birth if you wanted. OTOH I had a CS for my second DC for other reasons and had a spinal (not the partially ineffective epidural) - had that not worked I'd have had to have GA. The consultant did try for a natural birth (another induction), but labour didn't start at all.

TBH I found it impossible to get any decent advice.

Good luck with the birth anyway.