Decompression Surgery Before or After Pregnancy

My question is if a woman is going to need decompression surgery, is it recommended to have the surgery before or after pregnancy? I know a lot of women didn’t have the option because they weren’t diagnosed until after having children or they had surgery prior to wanting to conceive. I’m in the situation though where I know both upfront and I may have the option of deciding which comes first.

My personal dilemma is that the surgery (and dealing with my insurance AND choosing a specialist) could take many, many months at best and then I know it’s advisable to wait a considerable amount of time after surgery (I’ve read at least a year) before getting pregnant, BUT we are ready to start our family now. I’m in my mid-30’s and I just don’t want to wait the possibly 2 years it could take to coordinate the surgery and recover.

My medical dilemma is that I know a lot of women’s symptoms appear or get worse during pregnancy and childbirth and I’m wondering if I might have a better chance of long-term health if I bear the pain during pregnancy and then get the surgery afterwards. I can’t help but to think about the possibility of going through this surgery and then my symptoms end up coming back during or after a pregnancy.

I obviously want to get rid of this pain and the symptoms as quickly as possible (though I’m skeptical that surgery will make me feel ‘normal’ again anyway), but I’ve dealt with this for over 5 years and I feel I could push through during a pregnancy.

On the other hand, I don’t want to go through unnecessary pain if having the surgery beforehand would alleviate my symptoms, allow me to at least enjoy my pregnancy and if I knew my symptoms wouldn’t come back after surgery.

I know nothing is guaranteed and what I’ve taken from reading forums is that the pregnancy and CM experience are very specific to each person, but I was just hoping someone could shed light on their experience and looking back would you get the surgery before or after pregnancy?

I will definitely be talking to my doctors about this, but just wanted some firsthand advice if you have any.

Thanks!

I had two kids, then surgery and then another kid. Prior to my first pregnancy, my symptoms were minimal, a non-issue really. The awful symptoms started six months after his birth. I lived with the symptoms and went onto have a second baby a couple of years after the first. Unlike many people, my symptoms went away with pregnancy. They started again almost immediately after I gave birth. I had surgery almost two years after my second child was born. My surgery has been successful and I waited one year to get pregnant. I had no Chiari related complications during pregnancy or delivery. About a year after my third was born, I did have to have a VP shunt inserted. That was 2004 and I haven’t seen a doctor regarding my Chiari since being released from care in 2005! So that doesn’t really advise you one way or the other, but hopefully my “story” will help you. Kids were born 1997, 1999 and 2003. Surgeries were 2001 and 2003. I was aged 29.5, 32 and 36 at the time the births.

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HI Skye

Surgery is not a guarantee that your CM will heal.Yes you will not have the symptoms for a while as if you're totally healed. But after a year or two after surgery you'll start feeling the symptoms again. ACM does not go away after surgery. It progresses as the person gets older. Better have your surgery after pregnancy.Symptoms are terrible and the experience after surgery. Good you have no problem yet with coordination..Take care...



Jo said:
I had two kids, then surgery and then another kid. Prior to my first pregnancy, my symptoms were minimal, a non-issue really. The awful symptoms started six months after his birth. I lived with the symptoms and went onto have a second baby a couple of years after the first. Unlike many people, my symptoms went away with pregnancy. They started again almost immediately after I gave birth. I had surgery almost two years after my second child was born. My surgery has been successful and I waited one year to get pregnant. I had no Chiari related complications during pregnancy or delivery. About a year after my third was born, I did have to have a VP shunt inserted. That was 2004 and I haven't seen a doctor regarding my Chiari since being released from care in 2005! So that doesn't really advise you one way or the other, but hopefully my "story" will help you. Kids were born 1997, 1999 and 2003. Surgeries were 2001 and 2003. I was aged 29.5, 32 and 36 at the time the births.
Surgery was 2004, not 2003.

Hi Skye,

I had the same question as you. But after consulting with the doctors decided to go with the pregnancy. Iam 33 weeks pregnant now and from my experience past months I found my headaches actually got better during first trimester and settled at prepregnancy levels from second trimester. Pregnancy did not make symptoms any worse so far. But we are going to be on the cautious side and opting for csection as my doctors think intense labor can affect chiari.

Hi Krishna,

That's great that some of your symptoms have gotten better through pregnancy like Jo said above as well. I wonder why some symptoms would get better when your body is experiencing so much change and an increased pressure. That is encouraging though because headaches are my worst symptom and I've always assumed they would get so much worse during pregnancy.

Can I ask why you decided to go ahead with pregnancy before surgery? Were your symptoms "bad enough" to require surgery soon, but you decided to wait or were your symptoms something you felt you could deal with and put off for surgery for some time?

I think you're right, opting for a C-section is always going to be the safest bet. It's just such an adjustment as a woman to sort of reconsider things you might have always wanted or how you expected your pregnancy to go. There are so many things out of our control with CM and there's so much to think about. It's overwhelming for sure!


Krishna said:

Hi Skye,

I had the same question as you. But after consulting with the doctors decided to go with the pregnancy. Iam 33 weeks pregnant now and from my experience past months I found my headaches actually got better during first trimester and settled at prepregnancy levels from second trimester. Pregnancy did not make symptoms any worse so far. But we are going to be on the cautious side and opting for csection as my doctors think intense labor can affect chiari.

Thank you, Jo! Yes, your story includes other things I was thinking about like surgery between children. I am so happy to hear that you had a successful surgery and recovery!

Did you have a C-Section for your third child since you already had surgery?


Jo said:

I had two kids, then surgery and then another kid. Prior to my first pregnancy, my symptoms were minimal, a non-issue really. The awful symptoms started six months after his birth. I lived with the symptoms and went onto have a second baby a of years after the first. Unlike many people, my symptoms went away with pregnancy. They started again almost immediately after I gave birth. I had surgery almost two years after my second child was born. My surgery has been successful and I waited one year to get pregnant. I had no Chiari related complications during pregnancy or delivery. About a year after my third was born, I did have to have a VP shunt inserted. That was 2004 and I haven't seen a doctor regarding my Chiari since being released from care in 2005! So that doesn't really advise you one way or the other, but hopefully my "story" will help you. Kids were born 1997, 1999 and 2003. Surgeries were 2001 and 2003. I was aged 29.5, 32 and 36 at the time the births.

I had a vaginal birth with all 3. My first, the Chiari was such a non-issue that it never occurred to me to be concerned and I think my docs were clueless - it was 1994. I will say I had an epidural and I have since read that a lot of women were like me in that increased symptoms happened post epidural. My doctors with my next two kiddos were very aware and knowledgeable about Chiari. I wanted vaginal births and we went into it knowing only a minimal amount of pushing would be ok, otherwise we would be off to OR. I did have epidurals but minimal. My 2nd son was born in about 30 minutes (went from 3-10 cm in that time frame) and as the anesthesiologist was inserting the epi I was telling them I was going to push out a baby. My doc barely made it! My third was also quick, but not that quick, and the epi was in for just a couple of hours. I did have big babies (10.4, 9.9, 9.5) and I am 5 ft. 3 and petite framed. My first was my hardest and looking back, had my doctors for baby 2 and 3 been my doctor for baby 1, they may have done a c-section. But my first docs nor myself knew or were concerned. Either way, though, I personally would have approached as we did with baby 2 (pre surgery) and baby 3 (post surgery) which was a “let’s try it and see how it goes.” You have to do what is best for you, your health and baby!