Hi, I am terrified to be in my third trimester of pregnancy with a pilonidal cyst, and I would be grateful to hear your experiences with childbirth. Do you recommend vaginal or cesarean delivery? Were you able to have an epidural? Did a vaginal birth exacerbate your cyst? Was labor and delivery more painful? Did you have back labor and if so, was it on the cyst? Did you have episiotomy and tearing and how did that affect the cyst, or the cyst affect that? In my case, I had 3 pilonidal cyst surgeries back between 2000-2004—the first closing the wound and the second two leaving it open with packing. I also had all the lancing, silver nitrate, etc…tried everything..but it reoccurred. I’ve been living with that 4th pilonidal cyst for about a decade now—would rather live with it than go through another surgery. It’s still an open wound that drains itself. It doesn’t hurt unless I lean back at a certain angle like in a movie theater—and then there is shooting pain. Antiobiotics clear it up when it gets painful and infected from time to time (about once a year--which happened again this weekend). I am terrified of childbirth with it. My hospital anesthesiologist said I should be able to get epidural unless it is very infected at the time—but I know sometimes they don’t work well or only on half of body. Also, with all the pressure on a tailbone from possible back labor, I wonder if the cyst will be aggravated to a point where I will have to have a pilonidal surgery after childbirth—or if it will burst. (And also big babies run in my family—I was 9 lbs 10 ounces myself) which would seem to mean even more pressure. My OB will give me a cesarean if I want one due to my situation which is why I'm trying to find out if vaginal vs. cesarean is better in this case. Thank you in advance everyone for your advice.