Anyone have successful VBAC while using epidural?

[JFTB1177]

I am planning a second VBAC in the hospital (last birth was a successful HBAC), and I am due in 2 weeks. I know epi's can have neg effects on labor, but one of the reasons I am not having another home birth is the horrific pain I endured last time. I am convinced my labor/pushing (6 hours of pushing!) was so long because I was sooooo exhausted after enduring such horrible pain. Even my doula says she is pretty sure my exhaustion made everything so difficult and drawn-out.

I want the option of pain relief. I know the risks of epi's and interventions, as my first was a c/s after failed induction. But part of me has this gut feeling that if I had something to take the edge off, I would not have been so exhausted last time. My doula doesn't like the idea and has told me she has only had one VBAC client that had a successful VBAC while using an epi. On the other hand, I have a good friend who had 2 successful VBACs at the same hospital with the same practice (doctors), using an epi AND being induced!! I also know many women who have had very successful vaginal births using epidurals.

But I would really like to hear some reassurance from some moms who had successful VBACs using epi's. The thought of going through the same pain again terrifies me. None of the "natural" methods worked to ease my pain during my HBAC... it was horrible (I'm just being honest here!)!! I don't trust those natural methods to help me this time again. Baby seemed to be posterior last time (even though I was doing Webster's with a chiro weekly) and appears to be posterior again this time (and believe me, I've done everything, including Spinning Babies etc... mine just seem to like this position) so I totally expect the same level of pain. I know that fear of the pain will set my labor back unless I know I have access to some kind of relief.

So please, some successful stories of VBACs using epi's, and if you could please provide some detail (when you got the epi and for how long, ex. did you turn it down before pushing, etc)?

Thank you so much!!

[DMG8]

I haven't had my VBAC yet - I'm 24 weeks pregnant.  However, have you looked into whether your hospital offers lower dose epidurals like the combined spinal epidural ("walking epidural") or the PCEA (patient controlled anagelsia epidural)?  The walking epidural often allows a woman to still move around the room instead of being stuck in bed, they may still feel their contractions but they are less painful/intense, and are able to relax a bit during labor yet still feel to push when ready.  

Any kind of epidural though will require you to be monitored and have an IV (typically) so be sure you are ok with that.  

I too had a posterior baby that resulted in a c-section and I'm terrified of the same thing happening again - especially after reading that my posterior baby was probably the reason for my one-on-top-of-the-other contractions and inability to relax between.  

I look forward to hearing what other women have to say about their VBACs and epidurals.   

[JFTB1177]

Originally Posted by DMG8 

have you looked into whether your hospital offers lower dose epidurals like the combined spinal epidural ("walking epidural") or the PCEA (patient controlled anagelsia epidural)?   

Any kind of epidural though will require you to be monitored and have an IV (typically) so be sure you are ok with that.   

I will ask about that! I will have to have a Hep-lock anyway as I am GBS+ this time and will need to get antibiotics.

GL with your VBAC too! :)

[roadfamily6now]

I had an epi with my first and it was successful.

I'd definitely give it a shot drug free but leave your options open. your 3rd birth might be nothing like your 2nd. Many 3rd timers have quick easy 3rd births.

[channelofpeace]

I had c-sections with my first two, and was induced with my third due to blood incompatibility.  I went in on Thursday morning, the Foley bulb and nip stim put me into early labor.  It really wasn't too bad.  Until it was. On Friday night, I went into active labor and I was just so tired, I was not handling the contractions well.  At all. I got the epidural around 11?ish, when I was at 4cm.  Slept for a while, woke up and had made progress to 5 or 6 cm.  While later, I was complete.  I labored down for a while- I could feel the pressure of the contractions and the baby moving down, but not the pain.  After he came down a bit, I started pushing with the pressure of the contractions.  Born at 2:50 a.m. 

I am sorry to hear that you had such a hard time last time and hope that you can have a better experience this time around!  If I may say something? I would reconsider your choice of doula.  You need someone who is supportive of your choices, especially given your history.  If you are informed, have weighed the risks and benefits, and more natural forms of pain relief aren't working for you, you should be supported in doing what is best for you. 

Have a great birth- hope everything goes well :)

[Lisoula]

I had two successful VBAC's - both with epidurals.  I was NOT induced either time.  Neither baby was posterior, but with my first VBAC my son did have his hand up by his little head...lol.  I will mention that with my first birth, my water broke at home, contractions started on the way to the hospital (20 minute drive) and when I got there I was 3cm.  They felt what they thought might be a foot.  By the time they did a bedside ultrasound to confirm that he was indeed breech, I was 7 centimeters and his foot had prolapsed out of my vagina!  This was all within an hour of me getting to the hospital.  Needless to say, I dilate pretty quick.

With the first VBAC, my water broke at home at 37.2 weeks and contractions started soon after.  I was 5 centimeters about 4 hours later, got the epi, and complete one hour after that.  I remember pushing with a total of 6 contractions, and out he came! 

With the second VBAC, I was in "early" labor, but unfortunately already at the hospital.  I was attempting an un-medicated birth, and foolishly let them break my water at 3 centimeters even though I was not having regular contractions yet. I was 38.3 weeks.  It took me 8 hours to get from 3 centimeters to 6 centimeters.  That's when I got the epidural, and my daughter was born less than an hour later after about 1/2 of a push.  Basically I barely beared down and had to stop because the doc didn't have his gloves on yet :)

Best of luck to you. The best advice I can offer you is if you do decide to get the epi, please wait until you "really" need it.....much less chance of your labor stalling.  Some studies show that the risk of uterine rupture increases when you're at a particular dilation for a looooong time. I would suggest waiting at least until you're 5 centimeters.  If you get an epi and you are "too numb" you can always ask them to turn it down.  I'm a L&D nurse, and we do that all the time.  Like a PP said, though, the 3rd birth could be very different and go fast enough that you don't even need any of this advice!

[Monkey Keeper]

I DID!!!!  Here's the short version of my birth story: http://www.mothering.com/community/forum/thread/1264157/my-natural-birth-with-an-epidural-vbac-success

I took the same outlook roadfamily suggested.  I did it until I couldn't any more.  Labor started on its own and progressed with encouragement from acupuncture.  Baby was badly asynclitic, and I had atypical labor pain for which Hypnobabies did nothing.  My epidural was perfect--so light that it just took away the worst of the pain but allowed me to use a bedpan and try a variety of positions (all in bed) to cope.  It also worked well enough for the first 3 hours or so to allow me to sleep which was important since I'd been awake for about 24 hours at that point.  I also felt the urge to push and had zero coached pushing.  (I actually didn't have the epidural IN when he was born but still had some residual pain relief.)

I was stretchy to 7cm by the time the epi was administered, so I'm sure that had *something* to do with my success.

[sparkle&shine]

I labored at home until I felt the need to go to the hospital.  I was already 8 cms by the time I got there and got the epidural about an hour later.  It did stall my labor and even with a 'low dose' I couldn't walk around the room.  Looking back I realize that I was in transition and probably could have avoided it if I had been better mentally prepared/aware instead of loosing myself to the pain. I was able to successfully have my VBAC though!

[JFTB1177]

Thank you so much ladies!! :) I love hearing the positive stories!

I had planned on staying at home as long as possible but I am GBS+ this time... I know there is a lot of controversy around being GBS+ but I am scared to take any chances and want the antibiotics (they did a special culture so the "right" antibiotics will be used, that and I am allergic to pennicilin). Were any of you GBS+?

[Lisoula]

I was only GBS+ with the first one....my cesarean baby....and ironically the only one I didn't have time to get antibiotics with.  He was fine, though.

[sparkle&shine]

I posted above and I was GBS+.  My water didn't break until I was pushing and they did start the antibiotics as soon as I was in the hospital.  Like I mentioned the epidural really slowed my labor down so my DS wasn't born for another 8 hours (I think) after getting to the hospital even though I was so far dilated.  I think he was also needed to get in a better position.

[heather_c]

I had a VBAC with a epi with my second.  I had labored for 24 hours prior to receiving the epidural.  I also knew my baby was in an optimal position (LOA, 6 cm, and at 0 station).  It is hard to say if my labor slowed down as it was incredibly slow the entire labor.  I delivered 12 hours after receiving the epi.  I only pushed for 45 min with a 9+lb baby.  BTW - My first birth was an induction and I pushed for 3 hours and he never moved down.  DS1 was 7lbs 5 oz.

[TiffanyToo]

A few thoughts.

Do not let anyone do internal exams, this to avoid infection, prom and the possibility of baby getting into a bad position.

Develop a pain management list. That might be getting the hypno scripts, relaxation exercises like Bradley Birth uses, walking being verticle, learn the emotional stages/signposts of labor,

use water shower, bath as comfort methods, etc do this and use this list before you get medicine give yourself and your bodythe opportunity to let nature do its thing.

The OB is had when we transferred care from home, AROM'ed me got dd stuck, I got a epidural as prep in my mind for surgery. A nurse helped me get into this crazy position of right knee up around left shoulder while laying down, this to try and turn dd and get her unstuck. To my AMAZEMENT it worked. DD spun and moved off wham baby!

VBAC vibes!

[Maggieluciasmom]

I did.  It made all the difference in the world.  I was days into labor and looking at a real possibility of being cut again, but the epi relaxed me enough to open me up so I was ready to push.  I only pushed for 30 minutes (my first labor too!).

There are a lot of women who are more comfortable in a hospital setting because of the risks during VBAC, I'm one of them, but in my case the hospital setting HELPED me get my VBAC.  I'm no super woman, the pain sucked, I don't think I could've done it without the epi.  I'm SO glad that I got my VBAC, and even now, 5 months later, I'm so proud of myself for doing it and proving my bonehead doctors wrong.

Best of luck! 

[Ivy53]

I was afraid to get an epi during my VBAC because I feel that that was part of why I had my c/s (induction 10 days past due, basically stuck in bed on pit, epi at 4 cm, maternal fever, fetal heartrate increase, I couldn't get to 10 cm in their timeframe so c/s - I didn't know much back then), because I didn't learn until after he was born that epi's can cause a fever. With my VBAC, I was walking and doing okay, but he kept moving off the monitor - the hospital was very encouraging of VBAC but required continuous monitoring, luckily they had mobile monitors - and so I ended up laboring for a while on the toilet, but STILL he wouldn't stop. I was literally trying to get through contractions with my hand pressing the monitor onto my belly!  So they wanted me to lie down to get checked, I guess, I think I was around 5 cm and they gave me something to take the edge off for a little while and while I was laying down I felt this almost uncontrollable urge to push. I knew it wasn't time and having to fight the urge was totally destroying the concentration I needed to get through the contractions. I was so panicked I said, that's it, epidural, NOW. I was having a lot of back labor - they told me after he was born he was "sunny side up" but I have still never actually found out what that means in medical terms. I also found out later that sometimes when they're in that position you can get the urge to push before it's time. Anyway, after the epi I got to 8-9 very fast, in just a couple of hours (I had gotten to the hospital at around 9am, I don't know what time exactly I had the epi but it was afternoon), but 9-10 took some time. I had been told this was because in my previous labor I had never gotten to 10, only to 9, and so that it would take more time. Then because I wasn't in pain I tried to nap some while the baby moved down. When it was time to push I had the epi turned down. I could feel things but I never got back the urge to push. It took me an hour and a half, about, to get him out, but I did. 10 lbs, 8 oz.

But I was so terrified all the time after the epi. I wish I had been better able to communicate to my doula and my husband what my problem was, with the urge to push. Maybe there was something I could have done to quiet it, or maybe not. I know I remember asking the nurse, when I had gotten to 9 or so, how the baby's heartrate was and they said he was doing perfectly fine, no issues...I just kept crying. I was so relieved it wasn't happening all over again.

I'm intrigued by the stories of the other women in this thread have who had epidurals so light they could walk, that they could still feel the urge to push. That's a very useful thing.