Tailbone Injury During Birth: Who Is at Risk?

3 min read

Woman in Labor

Tailbone injury is a potential complication of giving birth. It is often caused by pressure from the baby’s head while passing through the birth canal, especially during the later stages of active labor.

The coccyx — or tailbone — is located at the base of the birth canal. The baby comes in direct contact with the coccyx when coming out of the birth canal. The pressure that builds when the baby passes through the birth canal can cause bruising, dislocation, or even fracture to the tailbone.

How Common Is Tailbone Injury During Childbirth?

Tailbone injury during childbirth is more common in a long or difficult labor, especially when forceps or vacuum delivery are needed to remove the baby from the birth canal. These complications are also known to be some of the more common causes of birth injuries.

Women are 5 times more likely to experience tailbone pain than men, according to a medical study in the Ochsner Journal.

Like other birth injuries, a tailbone injury can be avoided if proper steps are taken by labor and delivery staff. However, if doctors and other health care providers are negligent, they can put the mother and child at risk of serious complications.

Learn more about birth injury causes and treatment in our free downloadable guide.

Causes of Tailbone Injury During Childbirth

Tailbone injury during birth occurs when the baby passes through the birth canal and comes in contact with the coccyx. If the mother’s tailbone is aligned correctly, it extends backward so the baby can pass through safely.

However, some women have tailbones that are stuck forward, which causes the baby to pass through with force. This pressure can even dislocate the tailbone, which can lead to muscle spasms and pain in the pelvic floor.

Several different situations can lead to a tailbone injury during birth, including:

  • Face-up presentation at birth, which causes the back of the baby’s skull to push against the mother’s tailbone
  • Birth weight of more than 8 pounds and 13 ounces
  • Difficult or complicated labor
  • Medical negligence
  • Small or narrow pelvis
  • Use of forceps or vacuum extractors

In a study of 57 women with tailbone pain after childbirth, 50.8% of cases were caused by forceps delivery complications.

Additionally, if a woman has broken her tailbone in the past, she has a greater risk of another tailbone injury during birth or other serious birth injuries.

“It’s important to let your healthcare team know if you have had any pain or injury to your tailbone before going into labor because there are things you can do to minimize the pressure.”

— Deena Blumenfeld, Lamaze Certified Childbirth Educator (LCCE) and Fellow of the American College of Childbirth Educators (FACCE)

Symptoms and Treatment for Tailbone Injury During Birth

Most women who experience tailbone injury during birth hear a crack or a popping sound during childbirth. If the tailbone is injured, there is usually tenderness and pain that feels worse when seated.

Additional symptoms of tailbone injury during birth include:

  • Achy tailbone
  • Anxiety
  • Back pain
  • Depression
  • Pain after sitting for a long time
  • Pain while straining for bowel movements
  • Pain during sex
  • Piercing pain in the tailbone
  • Poor sleep

If a tailbone injury during birth is suspected, your doctor will perform a visual exam of the area to check for any obvious fracture, deformity, mass, or infection. They will then conduct an internal and external rectal exam and may order X-rays to confirm the injury.

According to Cleveland Clinic, common home remedies for tailbone pain include:

  • Applying hot or cold packs to your lower back
  • Decreasing time spent seated
  • Leaning forward while seated
  • Stretching and strengthening the pelvic and lower back muscles
  • Taking a hot bath to relax your muscles
  • Taking non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, to reduce pain and swelling
  • Taking stool softeners to decrease painful bowel movements
  • Using a wedge-shaped gel cushion or donut-shaped pillow
  • Wearing loose-fitting clothing

About 90% of patients who require treatment for a tailbone injury recover with at-home remedies.

Chronic tension in pelvic muscles may cause pain. Long-lasting pain may be treated with physical therapy or steroid and local anesthetic injections.

In severe cases, surgery may be required for chronic pain. However, this option carries a far greater risk to the surrounding bones and muscles.

Doctor-recommended surgical options include:

  • Partial coccygectomy (removal of part of the coccyx)
  • Total coccygectomy (removal of the entire coccyx)

A bruised tailbone can usually heal itself in a few weeks. Fractures can take up to 8 weeks to heal, but pain may last even longer if there is inflammation of the muscles or ligaments.

Nurse Beth Carter

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Finding Help After Tailbone Injury During Birth

Unfortunately, too many mothers face serious complications during childbirth. Women who have experienced tailbone injuries may be victims of medical negligence if their doctor used excessive force during delivery.

Additionally, these types of difficult deliveries may put babies at an increased risk of serious birth injuries such as hypoxic-ischemic encephalopathy.

You do not have to navigate this situation alone. If you believe you suffered a preventable tailbone injury during birth that may have also injured your child, contact our team of registered labor and delivery nurses today at (800) 914-1562.

Birth Injury Support Team

The Birth Injury Justice Center was founded in 2003 by a team of legal professionals to educate and empower victims and families affected by birth injuries. Our team is devoted to providing you with the best resources and legal information for all types of birth injuries.

View Sources
  1. Cleveland Clinic. Coccydynia (Tailbone Pain). (n.d.) Retrieved April 18, 2023, from https://my.clevelandclinic.org/health/diseases/10436-coccydynia-tailbone-pain
  2. HealthLinkBC. (2019). After Childbirth: Pelvic Bone Problems. Retrieved April 18, 2023, from https://www.healthlinkbc.ca/pregnancy-parenting/labour-and-birth/after-labour-and-care-new-moms/after-childbirth-pelvic-bone
  3. Kaushal, R., Bhanot, A., Luthra, S., et al. (2005). Intrapartum coccygeal fracture, a cause for postpartum coccydynia: a case report. Journal of surgical orthopaedic advances, 14(3), 136–137. Retrieved April 18, 2023, from https://pubmed.ncbi.nlm.nih.gov/16216182/
  4. Lirette, L. S., Chaiban, G., & Tolba, R. (2014). "Coccydynia: An Overview of the Anatomy, Etiology, and Treatment of Coccyx Pain.” The Ochsner Journal. Retrieved April 18, 2023, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3963058/.
  5. Marple, K. (n.d.). Bruised or Broken Tailbone. BabyCenter, LLC. Retrieved April 18, 2023, from https://www.babycenter.com/baby/postpartum-health/bruised-or-broken-tailbone_1152322
  6. Posl, L. Coccyx. (2019). Injuries from Childbirth. Soul Medic. Retrieved April 18, 2023, from https://www.midwesttailbone.com/coccyx-injuries-from-childbirth/
  7. Zafar, M.A. (2017). Yes, You Can *Break* Your Tailbone During Labor, & Here's What Experts Say About It. Romper. Retrieved April 18, 2023, from https://www.romper.com/p/yes-you-can-break-your-tailbone-during-labor-heres-what-experts-say-about-it-2989340