Q: I am 28 years old, I had a fall 5 years back and was diagnosed to have disc prolapse at L4-5. Had backache with pain radiating to my left leg. Took bed rest for 6-8 weeks, did exercise and was absolutely pain free till I conceived this year. I had relapse of pain, radiating to my left leg but was cured after taking bed rest for 8 weeks. I am 8 months pregnant now, but I fear that my backpain would reappear after normal labour What do you recommend about the mode of delivery? How far is LSCS safe considering my history?

A:The exact relationship of back ache and normal labour is difficult to predict. Whether normal labour will make the pain worse or better is not predictable. It depends amongst other things on what is the main cause of the back ache. Disc is a common label but does not tell the whole story. You will have to decide with your doctors on the mode of delivery. Caesarean is not a guarantee that you will not get backache as the cause of weakened back muscles and ligaments is related to the pregnancy hormones and not the event of labour. The decision to operate or not will depend on obstetric reasons and caesarean will not ensure no backache. Needless to say caesarean if required for medical reasons and done properly is safe these days. So please get an orthopaedic opinion and make a decision with your obstetrician. It will not be easy to make a decision. But one cannot make a blanket statement that caesarean will ensure that backache will not come back or normal labour will essentially make the backache worse.