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  1. #1
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    Default C-section due to back injury - feeling guilty.

    Hi I am hoping for some gentle and supportive advice please. This will be long sorry.
    I am 33 and currently 31 weeks pregnant with my first baby. Six years ago I hurt my back and I have had severe chronic back pain ever since. I am in pain pretty much every day to varying degrees. I had an operation 4 years ago which didn't really help so since then it's been a matter of acceptance and managing which I generally do well except for when I have a serious flare which I struggle with. I work full time and push myself really hard, I don't let this interfere with my life as far as I possibly can. The problem is in the L4 lumbar joint down to my sacroiliac joints. Pregnancy has aggravated things significantly which I was expecting. I have pre-existing sacroiliac joint dysfunction, and now pregnancy related symphysis pubis dysfunction. I've had the src shorts since 11 weeks and can barely walk without them on and I have not had 1 pain free day during pregnancy which is wearing me down but I'm doing ok. I am limiting myself to 2 panadeine tablets per day (let's not even go into the guilt I feel about that) but have doctors approval to take endone as required but trying to avoid if I can. I am used to pain it would be worse if I wasn't. I am under the care of a back surgeon, pain specialist, obstetric physios and obstetrician.
    This brings me to my issue. Before getting pregnant I thought I would have a natural birth. Dealing with so much pain during pregnancy has me terrified that I may do further damage to myself during a natural birth. I have been advised by the back surgeon that I can have a natural birth but not to have an epidural in a natural birth due to the risk of injury. My physio suggested a c-section but otherwise everyone says I can do natural if I want. My concern is that I may do further damage (e.g. Have heard many stories of women hurting their back in labour and delivery), sometimes I struggle to have a bowel movement due to the pressure in my lower back - how then can I sustain pushing? And I am scared of aggravating the chronic pain receptors even more. All of this is leading me to an elective c-section which the physios and doctors are fine with but I feel like I am being a wimp. Natural birth may be fine and a great experience to know that my body can do it. But if it doesn't go well the outcome could be very bad for me. The reason I prefer the c-section is that it is more predictable. I understand the risks associated and the recovery time. I have great home support and my hubby will be off work for 4-5 weeks to help. I am also encouraged by the fact that I can go to rehab after 6 weeks to start my recovery from this serious flare up.
    i don't really know if I have a question as such. Has anyone had a c-section due to a back problem? I am scared of the c-section and scared of the alternative but the c-section seems more calculated and predictable which is important. Either way this baby is going to have to come out one way. I guess the other factor is that who knows there may be something else that comes up preventing a natural birth so I might be stressing about a decision out of my hands! Thanks for reading, I just needed to get this out of my brain as it's been upsetting me a bit lately.

  2. #2
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    I can't help from a personal experience perspective, but have you spoken to an anaesthetist? I would be questioning the risk between an epidural v spinal. A spinal is the usual form of anaesthetic in a caesarean as it's the safest option for Mum and baby, plus you're awake for the op. If your back surgeon says an epidural is too risky, what is his opinion on a spinal? I would make sure you get a chance to speak to all the relevant experts before the birth so you're 100% aware and committed whichever way you go

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    Thank you - the surgeon said no epidural in natural as he believes there is a risk of further injury due to positioning and possible lack of feeling so he is strongly against it. He said either spinal or epi is fine for a c-section though as no risk of positional injury. I plan to meet with the anaesthetist prior to discuss pain management post-op. I do not want uncontrolled pain as I know it leads to a cycle of chronic pain which I'm in now but can't really resolve as trying to avoid too many painkillers while bubs is still inside. Good pain management is one of my top priorities!

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    to be honest - I would go for a c/s

    if you cannot have an epi with a natural birth - if you have a vb and do have pain issues (likely if you have issues with bowel movements) .. then you will end up with an emergency c/s and a high risk of that being under a general.

    A c/s is not the worst thing in the world. What matters under this circumstance is having bubs arrive safely and you in a position and condition to be able to care for bubs.


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    My advice is for this and almost everything else in mothering.....

    Do everything you can to let go of the guilt! Push the guilt aside and ask yourself what you really want. Trust your instincts. You know your body and this baby better then anyone.

    If you decide on a vaginal birth perhaps consider TENS and a birthing pool as pain management options.

    X

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    Definitely don't feel like a wimp! You sound like you have been suffering terribly with pain throughout this whole pregnancy.

    I don't have a back injury but did have an elective c-section last year due to a posterior baby who was too big for my small pelvis. The thought of a c-section was daunting as I had no idea what to expect but I spoke to a friend who had had two and she talked me through the process and what to expect. In all honesty it was so much better an experience than I imagined, I think because it was planned and not a rushed emergency c-section. My recovery was much much better than I could have ever expected and probably a better recovery than I would have had had I attempted to deliver DS vaginally.

    Talk to whatever professionals you need to but in the end the most important thing is a safe delivery for you and your baby regardless of the method on which your baby enters the world.

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    The thing that resonates and stands out to me with your thread/post OP, is the 'feeling guilty' part and I know it's easier said then done, but please don't feel guilty, you have absolutely nothing to feel guilty for or about. Mother guilt has at times been one of the biggest banes of my life, but it's futile, it just clouds your judgement/rationale and makes you feel terrible, when you don't need it. You are most certainly not a 'whimp' either, so try not speak of yourself with such negative words, you have been dealing with chronic pain for years, you are pretty amazing I think.

    I really hope that by putting your thoughts down here, that you feel a little better about things and I am so sorry you had such a terrible time and with the constant pain which wouldn't be easy by any stretch. I would keep up with your Physio and Specialists teams and see how you feel closer to the time, reassess the pros and cons and with a little bit more clarity then make your decision.

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    Quote Originally Posted by gingermillie View Post
    Thank you - the surgeon said no epidural in natural as he believes there is a risk of further injury due to positioning and possible lack of feeling so he is strongly against it. He said either spinal or epi is fine for a c-section though as no risk of positional injury. I plan to meet with the anaesthetist prior to discuss pain management post-op. I do not want uncontrolled pain as I know it leads to a cycle of chronic pain which I'm in now but can't really resolve as trying to avoid too many painkillers while bubs is still inside. Good pain management is one of my top priorities!
    Ah, I'm with you now. It's not so much the epidural itself but the effect of the epidural numbing sensation and potential of a birth injury. In that case, I would think about caesarean. There's no guilt, shame or any other negative word to choosing to have a caesarean if that's what's right for you.

    A bit out of left field, but has anyone ever spoken to you about sterile water injections? We give them to women with back pain in labour. They're super effective for a lot of women, and if you were still contemplating a vaginal delivery they might provide you with some relief from your chronic pain too. One of my colleagues has an old back injury and has been known to get colleagues to give her sterile water injections on days when it's really bad. They sting like buggery for 30-60 seconds (often described as green ant bite), but for some women it's worth the pain to get rid of the back pain. Some women have repeat injections of them once they start to wear off it's so effective. Coupled with a tens/water immersion +/- gas and air it might be enough to get you through. In saying that, only you know what your pain is like and what it takes to manage it.

    Only you can decide what's best for you. The doctors are just there to guide you and make recommendations/offer opinions. They're not there to make the decision for you.

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    Hi OP I can't talk specifics about your situation but just wanted to add 2 things I thought of when I read your post. (BTW I had an elective csect 9 weeks ago on advice from doc due to big bub not engaged and degraded placenta)

    1. The guilt thing - I know it well too 😕 one thing to remember that helped me is rather than telling myself not to feel that way / that I shouldn't feel guilty / let it go....I allowed myself to feel it and be upset/grieve and then it passed much easier. I think sometimes it just adds pressure and makes it impossible to release these things when we get so caught up in needing to not feel that way. (ps this approach worked for me when BFing didn't work out)

    2. Make sure you have a chat to your doc about potential "side effects" of csect. The big one for me was Bub having fluid on the lungs and having to be in neonatal ie not with me for 2 nights. Apparently this is common with csects and apparently (insert sarcasm) my doc mentioned it when we were trying to decide whether to have a csect but I don't remember. It wasn't emphasised I guess is my point.

    I don't know if knowing it was highly likely would have changed my mind, but I would have felt more emotionally prepared you know.

    Hope that helps. And I really hope you have a wonderful experience no matter what you decide. I think you're very brave to make it this far given your pain levels! 😎👏

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    Oh man there are so totally no prizes for doing things the hard way.

    Have the C section and feel good about it. Put it this way - if you were a labouring horse and in chronic pain the vet wouldn't hesitate to help the horse out by intervening.

    You deserve the same level of care at least surely.

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