Coccyx Fracture & Vaginal Birth During Pregnancy: What You Need to Know

Question
Hello, I am currently 26 weeks pregnant and am starting to put together my birthing plan. As a child I broke my coccyx and was wondering if there is any way I could check if it healed in the right position for a vaginal birth? My mother seems to remember the doctor saying it would heal well but we have no real way to make sure. I have all my hopes set on a vaginal birth and my mid-wife thinks I'll have no problems but when I talked to my doctor she seemed to think differently. Hope you can help, Lore

Answer
The most important thing for you to remember is to stay off your back and off your bottom during labor and delivery.  Don't lie on your back, don't lean back against a reclined bed.  Lie on your side if you need to rest during labor.  Get up and stand, squat, or (best) get on hands and knees for pushing.  Vertical positions allow your tailbone to curve out and away from your pelvis.  In contrast, lying or semi-reclining on your back puts all your weight on your tailbone, forcing it to curve inward and creating a bony obstruction to the baby's descent.  This can sometimes cause a fractured tailbone even in women with a previously-undamaged coccyx.  Your midwife should be more familiar with these position and their effects on delivery.  Doctors are not trained to think about anything except the standard woman-on-back delivery position, which is why she is concerned.  Follow your midwife's directions, and stay off your bottom during the birth, and you should be fine.