Pregnancy After Coccygectomy: Vaginal Delivery Versus Cesarean Section

  • I was recently contacted by a  woman who had undergone a  coccygectomy (which is surgical amputation/removal of the coccyx/tailbone).
  • Her question was whether, after having undergone coccygectomy, it would or would not be advisable for her to undergo a cesarean section rather than a vaginal delivery for any subsequent pregnancy.
  • Perhaps you, the reader, are in a similar situation and have this same question.
  • This is an excellent question and one that I do not think I have ever seen explicitly addressed within the published medical literature.
  • On the one hand, if the coccyx is no longer present, then it should no longer be presenting any obstruction to the baby passing through the birth canal, and therefore a vaginal delivery may indeed be possible.
  • However, if the patient is still having significant pain at the coccygectomy surgical site (such as from scar tissue, etc. at the surgery site), or if that area is currently symptom-free but still more prone to being exacerbated, then it is possible that a vaginal delivery could cause a flareup/worsening or return of your pain in the coccyx region.
  • So, I do not have a hard and fast rule by which to advise my patients on this.
  • In general, if the patient has little or no pain at the coccyx region and the pregnancy overall seems normal (e.g., just one baby rather than twins or triplets, for example, and the baby is of normal body weight rather than being significantly enlarged), it is possible that the patient could deliver vaginally without substantial flareup at the tailbone.
  • Conversely, if the coccygectomy site is still very painful, or if the pregnancy is complicated by twins/triplets or a larger than usual baby, then delivery by a cesarean section may be more advisable.
  • But again, these would be general topics for how to consider this decision rather than firm advice on which choice to make.
  • All of this should be topics that the patient should discuss in person with their treating obstetrician/gynecologist.
  • Lastly, if the patient does end up having a vaginal delivery, or even a C-section, they would generally want to make sure that while they are at the hospital they do not flare up the coccyx region just from the sitting in a reclined position that is common on the typical delivery table.
Tailbone Pain Tip 7, PREGNANCY and CHILDBIRTH Can Cause or Worsen COCCYX PAIN, Tailbone Pain, Coccydynia
Tailbone Pain Tip 7, PREGNANCY and CHILDBIRTH Can Cause or Worsen COCCYX PAIN, Tailbone Pain, Coccydynia

COME FOR RELIEF: For more information on coccyx pain, or to be evaluated in-person by Dr. Foye’s Coccyx Pain Center in the United States, go to:

– Patrick Foye, M.D., Director of the Tailbone Pain Center, New Jersey, United States.

Patrick Foye, M.D.
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