QuestionMy husband and I have been trying to conceive for 14 months. I am 37 years old and we have been to a fertility specialist. We have been diagnosed with unexplained infertility. The next step to try is IUI, and then IVF if that doesn't work. We are also starting to talk about adoption. Here is my question.
Six years ago I had back surgery. I had a discectomy and laminotomy on L4/5 and L5/S1, after rupturing the bottom two discs in my back after falling down a flight of stairs.
I had a long miserable recovery from the surgery, and lots of physical therapy. I had been completely pain free up until about a year ago.
For the past year I have been in a great deal of pain in my lower back, but it comes and goes. I see a chiropractor periodically and go for massages. We do not know why I am in pain, but one cause could possibly be from scar tissue. My chiropractor has told me that due to my back surgery, I may not be able to have an epidural. She also said I may have a higher increase for back labor and needing a c-section. Would I have to be put completely out? Also, what would a pregnancy do to my back? I am trying to get these answers before I decide if we should start with fertility treatments, or just go for adoption. I cannot reach my original surgeon as he no longer practices in my state. Any advice would be greatly appreciated!
Thanks.
AnswerHi Joyce,
You have some valid concerns, and definitely these are concerns you want to address before attempting a pregnancy.
The fact that you were completely pain free for several years and now all of a sudden have a great deal of pain is a red flag - something is going on in there that's different. Maybe it's scar tissue, maybe not...I would strongly encourage you to see a doctor - if your old doctor passed on his practice to someone else, or else another doctor in that field. The pain you are having isn't normal, and finding out what is causing it, whether scar tissue or not, is going to be key in figuring out how a pregnancy might affect your back.
You may be more likely to experience back pain during labor (although because you are unfortunately used to back pain, it may surprisingly be much more manageable for you) I work with couples in labor, I've had several moms with previous back surgery, and some had back pain during her labor and some did not. All of them handled the pain of labor much better than most women - again, because they unfortunately were used to dealing with chronic pain.
However, back pain during labor isn't necessarily back labor - back labor is caused by baby's position and also brings along with it a longer labor and harder pushing stage and a higher risk of cesarean along with the back pain. So if you have back pain in labor because of your injury and not because of the baby's position, you're not getting everything else that normally goes along with back labor.
Once you get the current back pain under control and have a current diagnosis as to what causing that pain, I would suggest taking all your records to an obstetrician or a midwife (or both!) and discuss how they think your back would react to a pregnancy.
As far as an epidural or spinal and whether or not that is a possibility for you, the only way you can find that out is to discuss it with an anesthesiologist who works in labor and delivery. You can call your local hospital, explain that you have a back injury and need to set up a consult to find out whether or not epidural or spinal anesthesia would be an option for you during labor. If it is not an option and you needed a cesarean, they would have to use general anesthesia. You would still have other options for pain during labor, but it would fall either in the natural options categories (shower, bath, massage, etc) or narcotics.
If you do decide to try for a pregnancy and epidural/spinal is not an option, I would strongly recommend that you consider using a midwife or OB who does a lot of births without an epidural, and therefore will be more open to you doing the things you need to do to manage your labor. I would also strongly recommend that you consider getting a doula for your birth; a doula provides professional labor support, and can help both you and your husband and help make the labor more bearable and easier to get through, so that hopefully you won't need any pain medication.
So the first step is getting your current back pain resolved - after you do that, you can pursue whether or not pregnancy will have an adverse effect on your back and what your options are for pain relief in labor.
I wish you the best and hope your back pain is resolved soon and that you are able to move along with plans for your family, whether by pregnancy or adoption. Good luck!
