will this be a problem for a vbac?

[lillymonster]

I have a birth defect issue in my back, and my sister believes she has it. I found it on x-rays when I had back pain when I was in my 20s. I have about 3-4 vertebrae fused to my pelvic bone, so it's one piece on my left side. I also have some extra ones, but that's not a big deal I was told. When I told my OB during my first pregnancy, she gave me a rather annoyed look and said something like "that won't matter, your front pelvic bones would crack to allow room"

So flash forward to the birth, I was induced and had terrible back labor, I felt like someone was pounding an ice pick into my hip on my left side, no relief or waves, just constant pain. The epidural didn't work on that area at all. I told the nurse who freaked out basically that no one told her about this issue, and I heard her tell the OB and the OB told her basically to shut up and blew her off. Baby had descended to the point OB could use a vacuum attempt, but I needed a c-section. The next day the OB said to me I would always need a c-section because my babies would be too big for me (dd was 8 pounds) but if I had a normal 6 pound baby, it would be okay.

I always believed my section was unnecessary, brought on by being induced, but now, I guess fear has set in and I am worried if this will cause issue again. Should I tell my midwife and risk maybe she will agree with my old OB or not mention it all and take a risk it might be another painful birth and emergency c-section because my pelvic area can't expand? I felt the whole time I needed to move my leg around something, but of course had to remain in stirrups

I'll add my sister believes she has the same issue, and she had a c-section, then with her second had a UR. She complained of the same "ice pick" pain.

[rainbowmoon]

was your baby OP? I had the ice pick pain with my c/s baby's labor but not with my VBAC and it was because babe was OP during my first labor. It seriously felt like something was electrocuting my spine and pelvis for hours and hours. worst pain EVER. I have broken my tailbone in the past and have pretty bad scoliosis so I wondered if that was part of the problem but it turns out it was babe's position. I had a successful VBAC with my next babe and best of all none of that searing horrid pain.

I wouldn't keep the info from your MW though. I would also get a second opinion from a chiro/DO as I would be skeptical of what the dr. told you. about the fused vertebrae being a birth defect.

Do you know if these are lumbar vertebrae? I am thinking not because you say it's fused to your sacrum (and if it's the sacral vertebrae it is supposed to be like that- 4-5 vertebrae fused together as well as 3-4 vertebrae to the coccyx ) I am not understanding how this is determined a birth defect though if this is the case as the fusing happens much later in life normally in your late teens/ early to mid 20's. (And is supposed to happen) and isn't something you are born with.

[2boyzmama]

I have an injury to my lower back and pelvis that makes pregnancy and childbirth very difficult for me, but I've had three vaginal deliveries. In my case I had horrible back labor (yep, the ice pick feeling you're describing) and I ended up with symphasis pubis diastasis pretty badly (I assume my body separated in front because of the injury in the back...similar to what your OB said)

I will say that my first birth was my hardest because of inteventions that led to me being in bed. I think with any kind of back/pelvis issue, being upright in labor is essential. Hands and knees took all the pressure off the back of my pelvis, which instead put the pressure on my symphasis pubic (which hurt like the dickens!) but it made it possible for me to deliver a 10lb baby.

SO...it is possibly possible...depending on the specifics of your pelvis. Only a dr/chiro/physical therapist will be able to give you a better answer with your xrays in hand. I would think that getting multiple opinions is a good course of action.

That said...a cousin of mine had a severe femur fracture that required numerous surgeries. Her hip/pelvis did not heal correctly, and led to severe issues with her during labor. She had a c/s after pushing (naturally, no drugs, and using the squatting bar, towel, hands and knees, etc) for 4 hours. Her dr reviewed her xrays again after the birth and concluded that she would be unlikely to ever deliver vaginally. She chose a repeat c/s, but did wait for labor to start naturally.

So yes, sometimes physical problems, whether congenital or as a result of injury, can impact the body's ability to birth naturally.

[lillymonster]

Originally Posted by rainbowmoon

was your baby OP?

yes, so that explains it and makes me feel better. I don't know about my sister though, but DD was sunny side up

Originally Posted by rainbowmoon

I wouldn't keep the info from your MW though. I would also get a second opinion from a chiro/DO as I would be skeptical of what the dr. told you. about the fused vertebrae being a birth defect.

The first person to tell me was a physical therapist. I think I was like 18-20ish. I went back to a friend/chiro who took recent x-rays, like when DD was 9 months or so, and agreed. He joked about me being "deformed", so I assumed it wasn't normal. I got a diagnose card from the physical therapist, but I can't find it, that explained where it was. I'll have to contact chiro again and ask if he can provide something I can give the midwife so I don't get stuff wrong when I explain it.

Originally Posted by rainbowmoon

Do you know if these are lumbar vertebrae? I am thinking not because you say it's fused to your sacrum (and if it's the sacral vertebrae it is supposed to be like that- 4-5 vertebrae fused together as well as 3-4 vertebrae to the coccyx ) I am not understanding how this is determined a birth defect though if this is the case as the fusing happens much later in life normally in your late teens/ early to mid 20's. (And is supposed to happen) and isn't something you are born with.

I was under the impression it wasn't normal because well the physical therapist said it may or may not cause pain, but the chiro friend I saw said it was exactly as I described, and that it can cause pain, so I assumed it wasn't something normal.It's only on my left side. I also have a few extra vertebrate (I was told at the base or very end of my tailbone) and in that small area I have scoliosis. My father had missing vertebrate. So it was assumed it was a genetic thing.

[rainbowmoon]

well if it's the sacral vertebrae it is normal and is supposed to be like that. Here's a bit of info. or maybe you have some sort of variation they are calling a birth defect such as the extra vertebrae. But since they are not fused when you are born that is what I find confusing. That was why I thought maybe it is a lumbar vertebrae. I would be curious to know the name of the birth defect when you get it sorted out!

[lillymonster]

Originally Posted by rainbowmoon

well if it's the sacral vertebrae it is normal and is supposed to be like that. Here's a bit of info. or maybe you have some sort of variation they are calling a birth defect such as the extra vertebrae. But since they are not fused when you are born that is what I find confusing. That was why I thought maybe it is a lumbar vertebrae. I would be curious to know the name of the birth defect when you get it sorted out!

I asked DH to contact the chiro and ask to get the x-rays or diagnoses. He went into business for himself recently, so I am not sure who carries the records and knows the most info, but he was the last person to do the x-ray.

[rainbowmoon]

That will be interesting to find out. I am sure you will be a good candidate for VBAC even so but really you need to know what you are dealing with first! I would still get a second opinion too. Good luck!

[HeatherB]

It sounds like if you have freedom to move around (as everyone should) and to birth in any position, that you will have a great shot at a VBAC. It is certainly possible for pelvic injuries or "deformities" to impact birth, but we KNOW that induction, baby's position (yours being OP), and lithotomy can adversely affect a birth. I wouldn't be surprised with the story or outcome even if you didn't have unusual vertebral issues.

Definitely get the x-rays and talk with your MW. I'm pretty sure you'll be just fine!

[lillymonster]

I got the old files from the chiro and they were totally pointless, just diagnostic codes. Ugh! That is why he left the practice. I have to track him down personally.

Anyway - I guess my DH is still stuck on the OB saying "I'd recommend repeat c-sections for you, maybe if you had a 6 pound baby, it would squeak by, but your babies are going to be too big for you" I still remember her exact words 4 years later. DH was in the room, so he believes her word for word...

Yet NOTHING about this is written in her notes or records that I got from the hospital, so I would assume if it was a serious health issue, that it would be written down some where right? I mean it wouldn't be right for her to leave out important information like that?? Heck, she wrote down her recommendations for acne medication, so I think not being able to have vaginal birth would be kind of important to record.

I might just be in panic mode and it's really nothing to worry about. Now to convince DH - even with a hospital VBAC he is freaking out.

[kltroy]

Well the issue you bring up itself shouldn't preclude a vaginal birth. However, if your SI joints are fused or less mobile for whatever reason, or the joint at the front of your pelvis are, this may be problematic. You will probably not have a sense of whether this is the case until you try birthing again. Sometimes one birth defect is identified, but there may be others that fly below the radar.

[lillymonster]

Originally Posted by rainbowmoon

That will be interesting to find out. I am sure you will be a good candidate for VBAC even so but really you need to know what you are dealing with first! I would still get a second opinion too. Good luck!

The chiro said he remembered off the top of his head, but he is getting x-rays to verify. He said L5 was fused to my sacrum. He doesn't see that as anything that would cause issue in childbirth. He guessed the OB said what she did because she thinks my pelvis is too narrow, but it has nothing to do with the fusion.

So I am relieved. I have no idea why I panicked about it, but I know it shouldn't be an issue now. I don't believe my pelvis is too narrow.

[rainbowmoon]

I think you are probably going to be fine and get your VBAC! I would still chat with your MW about this I bet she will have some reasonable advice and some reassurance for you. I think sometimes doctors are just quick to make a decision/assessment and sometimes don't think how it will come across. Your old OB sounds like she was talking out of her butt so who knows. Maybe she just wasn't super experienced and that was just her opinion. I have received some advice like that when the OB has been faced with a particular complication/situation that they are not experienced with and turns out they were wrong! So...try not to worry and good luck!