back injury and vbac — The Bump
VBAC

back injury and vbac

I had a LONG labor 45 hours with DD.  28 hours natural failure to progress.  Got epidural, slept, woke up tried to push when I was at ten cm and she wouldnt come out. Ended up having a CS and hated it.  I wanted to have a vbac with this one but just injured my back last week.  I have 35 days til edd.  Im in physical therapy.  My hip socket in my lower back keeps popping out of socket and we have to keep putting it back in.  Physical therapist says if I have and epidural I will not feel the pain anyway, but wonder if it will be possible to put back in right after delivery.  When its out of socket I can barely walk.  My next apt with OB is Tuesday.  He was supportive of VBAC before but already has an apt for CS because I had all the problems with the first and she was over 8 lbs.  He thinks this one is going to be bigger.  He just wanted to have the date set incase I changed my mind.  Im really nervous about the vbac now.  What do you think of this?  Any suggestions on what to ask the OB on Tuesday.
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Re: back injury and vbac

  • The way I see it, you're going to have the hip issue regardless so you may as well try the VBAC. I think it'd be worse dealing with the hip popping post CS honestly.
  •  I would think it would be better for your body to try for the vbac.  You already have a lot going on, major surgery will probably make your bck injury recovery even harder, imo.
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  • hi, I'm a physical therapist who treats pregnancy and postpartum patients. a common problem in pregnant women is sacroiliac joint, or SI joint, dysfunction. I would guess this is what you have based on stating the pain is in the back. the pain is generally in the dimple of the back, or radiating down the buttock. if this is your pain I would definitely recommend a vbac.  it shouldn't cause the pain, as single leg activities generally are the cause, but your therapist should be able to teach you the correction technique if it was a problem after delivery. I also highly recommend the serola SI belt  to prevent the problem until your core gets stronger. if you go into labor out of alignment some people believe that could prevent vaginal delivery. I don't, but I also have SI problems and had a c section, so who knows. if it is your hip joint that is dislocating, which is super rare, your therapist should be able to have you trial positions in the session to see if they are ok or not. if you have any further questions please don't hesitate to ask.
  • imagejulie83:
    hi, I'm a physical therapist who treats pregnancy and postpartum patients. a common problem in pregnant women is sacroiliac joint, or SI joint, dysfunction. I would guess this is what you have based on stating the pain is in the back. the pain is generally in the dimple of the back, or radiating down the buttock. if this is your pain I would definitely recommend a vbac.  it shouldn't cause the pain, as single leg activities generally are the cause, but your therapist should be able to teach you the correction technique if it was a problem after delivery. I also highly recommend the serola SI belt  to prevent the problem until your core gets stronger. if you go into labor out of alignment some people believe that could prevent vaginal delivery. I don't, but I also have SI problems and had a c section, so who knows. if it is your hip joint that is dislocating, which is super rare, your therapist should be able to have you trial positions in the session to see if they are ok or not. if you have any further questions please don't hesitate to ask.

    Im pretty sure thats what she said it was.  She doesnt really work just with pre and post pregnancy.   I talked to her about delivery and she said that I just need to talk to my dr tho.  Thank you for your input.  It makes me want to stick with the vbac.  How long do these SI problems usually take to heal?  She actually showed my husband how to put me back in place but even when Im adjusted it I still feel a constant pain.  Ive been using the tens unit and doing my stretches and using moist heat.  I hope this gets better soon.  She said its from my ligaments being so loose.  I was bending over helping my 55 lb daughter do something and she slipped.  I had to catch her and bear the weight.  I could barely stand up and couldnt walk.  It was a terrible pain.  I guess it is common tho. 

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  • So it sounds like the SI joint is what the problem is.  With the SI joint dysfunction I recommend doing the correction technique as needed/daily and doing the stretches/tens to manage the pain until the baby comes.  As soon as you go into labor if you could do the correction technique that would be great, it won't hurt anything if you don't need it. 

     Good question as far as how long will it take to get better. The hormones from pregnancy cause it to be problematic throughout pregnancy, and if you  breastfeed afterwards the hormones will stay until about 3 months AFTER you wean.   Disclaimer, I am still nursing my son 2x/day and he is 15 months, so I am by no means suggesting that you don't breastfeed, just giving you a heads up. 

     After delivery I would get a serola SI belt to wear when you are taking care of your kids and then either go to PT or start core strengthening (pilates could help) once you are cleared for exercise. Once your core is strong, and the relaxin is out of your body, it should resolve, although you will be more susceptible to this problem throughout life if you step off of a curb wrong, or move from sit to stand on one leg instead of two feet.

     Good luck with your vbac, please update us after delivery!

     

  • Thank you Julie, I will keep you posted. 
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