Is It Safe to Get Pregnant After Surgery and Chronic Pain?

Fear of sequelae or complications before pregnancy?

Hello Dr.
Chen: I am considering pregnancy, but I have a history of hernia and hemorrhoids (both surgeries were performed in May of last year and April of this year).
I also have a previous back injury, which makes it difficult for me to stand up if I overexert myself.
Additionally, I experience frequent urination (at least twice a night).
I am also of a certain age...
I don't seem to have any major gynecological issues; my menstrual cycle is normal, and I had an ultrasound a few years ago that was fine.
However, given the issues mentioned above, am I still suitable for pregnancy? What potential complications might arise? Here is a brief overview of my medical history: hernia (surgery on both sides at different times), hemorrhoids, back injury approximately 15 years ago (during pain, I was unable to get up and was treated with corticosteroids for pain relief), and daytime and nighttime frequency of urination.
About 10 years ago, traditional Chinese medicine diagnosed me with "liver qi stagnation," and I took herbal medicine for about a year for treatment.

Kiss Zhang, 40~49 year old female. Ask Date: 2011/12/24

Dr. Chen Changfu reply Obstetrics and Gynecology

Your described medical history does not present any contraindications for pregnancy.
However, advanced maternal age is a concern; if you are considering having children, it is advisable to conceive as soon as possible.
During pregnancy, increased intra-abdominal pressure may lead to a recurrence of hernias; increased venous pressure may cause a recurrence of hemorrhoids; and increased abdominal weight may result in recurrent lower back pain.
You may take acetaminophen for pain relief, but please avoid using corticosteroids for pain management.
Additionally, increased renal blood flow during pregnancy can lead to frequent urination.
Even with herbal remedies, unless prescribed by a qualified traditional Chinese medicine practitioner who confirms the necessity and safety of treatment, it is not advisable to take herbal medicine during pregnancy.

Reply Date: 2011/12/24

More Info

When considering pregnancy after surgery, particularly with a history of chronic pain and multiple surgical procedures, it is essential to evaluate both the physical and emotional aspects of your health. Based on your medical history, including surgeries for hernia and hemorrhoids, as well as chronic back pain, there are several factors to consider.

Firstly, the surgeries you underwent for hernia and hemorrhoids are generally not directly linked to complications during pregnancy. These procedures typically do not affect the reproductive organs or the ability to carry a pregnancy. However, the recovery from surgery and the presence of chronic pain can influence your overall well-being during pregnancy. Chronic pain, especially in the lumbar region, can be exacerbated by the physical changes that occur during pregnancy, such as weight gain and hormonal changes that affect ligaments and joints.

Your history of back pain, particularly if it has led to difficulties in mobility, should be closely monitored. It is advisable to consult with a healthcare provider, such as an obstetrician or a maternal-fetal medicine specialist, who can assess your specific situation. They may recommend a tailored approach to managing your pain during pregnancy, which could include physical therapy, pain management strategies, and possibly modifications to your daily activities to minimize discomfort.

Regarding your urinary frequency, it is important to note that pregnancy can also affect bladder function due to hormonal changes and the growing uterus's pressure on the bladder. If you are already experiencing frequent urination, this may become more pronounced during pregnancy. Discussing this with your healthcare provider can help you develop strategies to manage these symptoms effectively.

Additionally, your age and overall health are significant factors in determining the safety of pregnancy. As women age, the risks associated with pregnancy can increase, including gestational diabetes, hypertension, and potential complications during labor. However, many women in their 30s have healthy pregnancies and deliveries, especially with proper prenatal care.

It is also crucial to consider the emotional and psychological aspects of pregnancy, particularly if you have a history of chronic pain and other health issues. Pregnancy can be a time of significant emotional change, and having a support system in place, whether through family, friends, or healthcare professionals, can be beneficial.

In summary, while your surgical history does not inherently preclude you from having a healthy pregnancy, it is essential to approach this decision with careful consideration of your chronic pain and overall health. Consulting with your healthcare provider will provide you with personalized advice and a plan to ensure a safe and healthy pregnancy. They can help you weigh the risks and benefits, considering your unique medical history, and guide you through the necessary preparations for pregnancy.

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