Can A Woman Give Birth Vaginally After Coccygectomy?

Can A Woman Give Birth Vaginally After Coccygectomy?
  • Giving birth to vaginally can cause or worsen coccyx pain (tailbone pain, coccydynia).
  • During childbirth for a vaginal delivery, the baby passes through the birth canal, which can cause pressure and trauma onto the coccyx.

Recently I was asked whether giving birth to vaginally would be likely to  worsen the tailbone pain in a woman who had previously undergone coccygectomy (surgical  amputation or removal of the coccyx, tailbone)

  • Theoretically, if a person’s coccyx was removed, it is therefore “out of the way” and no longer obstruct the birth canal.
  • Still, most people have some degree of ongoing discomfort/pain in the coccyx area even after coccygectomy. So there is a risk that pregnancy and especially giving birth can make the pain even worse.
  • Certainly no one can guarantee whether a vaginal delivery will or will not flare-up a given individual’s pain, even after coccygectomy.
  • I do not know of any published study showing how patients do with giving birth vaginally after coccygectomy, so there is not really any substantial research-based data upon which a given person can make their decision.
  • So some of the decision comes down to what makes the most sense for a given woman.
  • For my own patients, if someone had a coccygectomy and is now considering giving birth vaginally, I generally use their current level of coccyx pain as a ballpark indicator of how much risk there would be for the vaginal delivery flaring up the pain in that area.
  • (If the pain in the coccygectomy area is already pretty bad, then most likely the labor/delivery will make it even worse, in which case it may make sense to consider delivering via C-section [cesarean section]. Alternatively, if the patient had an excellent outcome after coccygectomy and has had multiple years with little or no pain in that area, then they probably have a significantly better chance of delivering vaginally without a substantial flareup, although of course there are no guarantees.)
  • There is no one “right” answer that will work for *all* patients.
  • Each patient needs to discuss the options with their in-person treating physicians.
Female Pelvis, showing the Uterus, Sacrum, Coccyx, Tailbone, etc.

Female Pelvis, showing the Uterus, Sacrum, Coccyx, Tailbone, etc.

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- Patrick Foye, M.D., Director of the Coccyx Pain Center, New Jersey, United States.

Patrick Foye, M.D.
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Patrick Foye, M.D.

Founder and Director at Tailbone Pain Center
Dr. Foye is an expert at treating tailbone pain (coccyx pain).

His personable, private-practice office is located on a modern, renowned, academic medical school campus, at Rutgers New Jersey Medical School.

For an appointment, call 973-972-2802.
Patrick Foye, M.D.
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