What are your options when you can't have an epi but need a cs?

[StormySar]

Is general anesthetic the only way to have a cesarean when you have had back surgery and have not been cleared for an epidural or spinal? Are there other options?

What is typical hospital protocol for something like this? How long before the mother can nurse her baby? See her baby? Will the hospital be feeding the baby and do they often offer a choice as to what the baby is fed (donated breastmilk vs formula, if a breastmilk source has been provided). is the baby required to stay in NICU for 'observation' or can a family member hold the baby? What kind of effect does this have on the mothers ability to bond with her baby, or the baby with her?

Is there any 'routine' care the baby is subject to after being born from a surgery where mom is completely knocked out?

A family member is likely going to be going through this next spring and I'm trying to gether information for her.

[Rivka5]

Has she been *ruled out* for an epi or spinal, or just not cleared?

I had back surgery (for scoliosis), and I got horrible advice from an orthopedist I saw for unusual back pain during pregnancy, who told me that I could absolutely not have a spinal or epidural and no anesthesiologist would be willing to try it.

Closer to my due date, I spoke to an anesthesiologist at my hospital on the phone, and then brought my back X-rays in to be examined by a different anesthesiologist. Both said that, even though I had had back surgery, they saw no problem with doing a spinal in my particular case. So I'd spent months worrying about maybe needing a C-section under general anesthesia for NO REASON.

Also: an epidural and a spinal are very different. A spinal is less dependent on perfect placement and everything being put together as they expect it to be. So she might be able to get a spinal even if she can't get an epi.

[mommabear207]

i had to have an emergency c-section last minute and since i was doing it without pain meds and didn't already have an epi i had to have general anesthesia. I think it took me about an hour to come out of it but once i woke up in recovery i was immediately brought to my room and they brought my baby to me and i nursed right away. while i was in recovery dh held ds and did give him a bottle as they were concerned about dehydration (not typical but because of my medical situation) and dh and i hadn't talked about it as we thought i would have a vaginal birth and we had no breast milk to give etc. On the downside i feel the bottle did cause initial trouble with nursing as the bottle flowed into his mouth so ds din't want to do the work of nursing but we stuck with it and he turned into a champion nurser.
unless you specify otherwise the hospital will do they're routine protocol-cleaning weight suction if needed eye ointment, vit k... but you can tell them before hand not to. also unless thereis medical reason for NICU theres no reason to go there. the most likey one would be to get help regulate body temp under lights. i believe they try to give the baby to dp as soon as possible.
i don't think it had any effect on our ability to bond. i don't feel ds was aware of our initial separation. i know it helped dh to bond.... i think the only way it would affect bonding is if the mother felt resentful towards the baby / situation. it was abit harder to nurse as you have a big sore spot and even the baby's weight is an issue but pillows and practice make a difference . i also am a big support of side nursing - restful, no pressure on the stomach, no shoulder hunching....

[OceansEve]

The most important thing is to speak to the hospital she will be giving birth at. Everyone on here can have completely different experiences and it depends on where they give birth. I was loopy for hours after being knocked out with DD1 and didn't get to see her for 5-6 hours. They gave her formula and pacifiers dispite my instructions not to. I don't know what that hospital's protocol would be if she had been on time. In my situation she was early and had lost a lot of blood. Just talk to the hospital and she can make a plan from there.

[bobandjess99]

ya, asking won't really help, she needs to work with the people who will actually be helping her...I know in my local hospital, the BIG difference between a c/s under general vs. epi or spinal is that under general, NOONE, not even the father, is allowed to be in the OR. The reason given for this is because the support person is there for the mother, and since she is out, she doesn't newed anyone. Apparently, the father wanting to watch his child be "born" doesn't count for anything. DH weNT around and around with them on this one, and they absolutely would not budge. So, he had to wait down the hall in a waiting room while his ex wife had her sections...he got to meet his children later, after the docs and nurses had already done all their stuff to them and decided to come out and inform him. Once he was informed, he stayed with the baby the entire time, waiting for exwife to come out of it...no...he isn't bitter about it....not at all...have I mentioned he was thrilled that we UC'ed?

[infraread]

Have her speak to anesthesiology to find which options will work best for her. I was put under for cosmo's birth, because 2 spinals didn't take. My hubby was not allowed in and was a nervous wreck because the GA was not discussed beforehand, it was a split second decision. He was born right before 2 p.m., I woke up around 6-ish, but wasn't truly coherent until around 8-ish.

Keep in mind, everyone handles meds differently!

DH stayed with the baby from as soon as they brought him out of the OR. He had a say in everything that was done to him, and was given him right away. It is my understanding that he was fed nothing (no sugar water, formula, or paci) and I was encouraged to BF as soon as I was ready. So, every hospital is different, too. (on a side note, my first birth was also a c-section, and I was loopy from the epidural + narcotics the midwife slipped to me-- I'm allergic. anyway, I was out of it and my hubby & a nurse literally held my first son to my breast to get him to eat, in recovery. Some hospitals really are baby friendly )

[Ceinwen]

I'm surprised at how long it takes for pp's to wake up post-GA.

I work in a PACU (post anaesthetic recovery) and people come to immediately. As soon as the 'gas' is removed, it starts to circulate out of your system - and you wake up.

Absolutely people are groggy (often nauseated too) but people don't sleep for hours after a GA.

As for the op's question - definitely ask for a pre-anaesthetic consult (well, your family member) to better assess whether a spinal or epidural will be possible.

Epidural is typically used during labour because it has a catheter, and the anesthesiologist can 'top up' the medication as needed. A spinal is typically used for a c-section as it is a MUCH better block. However, it's a one shot deal and they usually won't try more than four or five times to place it.

HTH!

[OceansEve]

Mine wasn't gas, mine was a shot. Spinal didn't take (two tries) and they needed me out immediately. They kicked DH out too, he said they let him see DD shortly and he looked over his shoulder into the OR to see her hollowing me out. He said I looked dead.

[infraread]

Originally Posted by nursemummy

I'm surprised at how long it takes for pp's to wake up post-GA.

I work in a PACU (post anaesthetic recovery) and people come to immediately. As soon as the 'gas' is removed, it starts to circulate out of your system - and you wake up.

Absolutely people are groggy (often nauseated too) but people don't sleep for hours after a GA.

I did. Medicine is not one size fits all, everyone reacts differently.