Birth after L5/S1 discectomy?

[Ajb92]

Hi,

I am currently 25 weeks pregnant with my first baby. I had a L5/S1 discectomy for nerve pain in Jan 2024, I have suffered with low back ache on and off since surgery but the nerve pain is much better. My pregnancy so far has been pretty positive and manageable pain wise. I am now wondering what’s best to do in terms of delivery of my baby. I’ve seen a consultant who didn’t really offer much help, she said a c-section may be best but I am worried about the long term effects of it maybe making my back worse. I’m also worried about epidural/spinal etc. Anyone been through the same? I am also seeing an anesthetist in a few weeks to discuss pain relief etc. ideally I’d like an unmedicated water birth but not sure if this is realistic! I’m seeing a physio, having regular massages and doing Pilates before and throughout pregnancy which I think has helped.

I had L5-S4 so slightly different. I opted for a vaginal birth but ended up with a c section under general for reasons not related to my spine. We had pre-empted the need for a c section and the midwives referred me to anaesthetics to discuss the birth but they won’t see you until around 30 weeks ish. I saw the consultant and they scanned me to see where would be best to do a spinal tap on the day so they were prepared. I had an epidural during my spinal surgery and didn’t want another so we opted for spinal tap which sadly didn’t work on the day. Hope that’s a bit helpful even though slightly different but best of luck 😊

PS the c section hasn’t caused any change in my back pain - just I’m EBF so now can’t take any of the pain meds I was on pre-baby!

Thanks for your reply, what do you mean the spinal tap didn’t work? Did you end up having to have a general? How has your recovery been/how’s your back?

The spinal tap didn’t work as I only had one area they could use but it went into my leg instead (just one of those things). I was also still pushing as once you start you can’t stop and baby just needed to be born so had to do a GA for speed as time wasn’t on our side but next time I think I’d opt for an elective to make it a bit more chilled. My back is still painful now but I have a big baby and can only have paracetamol & ibuprofen now. I probably could have stronger stuff but it’s just my preference whilst EBF but be guided by your Dr on that. I wasn’t allowed a water birth as couldn’t get out the water quick enough but I have mobility issues anyway so you may be different now. I tried wearing a sling but sadly baby is heavy and it hurts my back too much

Hi OP, glad you're doing better after your surgery. I've had 2, both at L5/S1 and vaginal birth was never contraindicated for me. I met with an anaesthetic consultant antenatally who reviewed my notes and scans. Advised that I may have a patchy block with epidural due to scar tissue. And may need a spinal if c section, or if no time then a GA, as epidural may not be effective enough.

Most of this was true for me in the end. Birth did not go as I'd hoped - had a long induction and epidural (which Id hoped to avoid.) The epidural was patchy but didn't bother me. Then an unplanned c section where it took a long time to get the anaesthetic just right. Minor in the grand scheme of things, though.

C section/anaesthetic had no impact on my back. No worsening pain, nothing. As baby gets heavier I've begun experiencing LBP again but that's a separate issue😅

I would say everyone's case is different, so Im not sure if they will say the same about a vaginal birth for you. It was never even mentioned to me to consider a c section because of my back. So just maybe clarify why that was mentioned to you so you have all of the info. I found meeting with the anaesthetist really beneficial and hope you will too. Good luck with the rest of your pregnancy😊