Epidurals and VBACs

[Sandra Dee]

Hi!
I've never posted in this forum before, so I guess I should start with the Cliff's Notes for my babes:

#1 - preterm labor @ 27wks, bedrest, high bp, water broke @ home, Pitocin administered to "speed things up" simultaneously with an epidural, unable to assist, baby was vacuum-suctioned out, 7 hour labor.

#2 - induced for high bp, mega-doses of Pitocin given, screaming in pain - unbearable - unable to open eyes, (nurses unsympathetic treating me as if I was unable to cope), got epidural, upped pit b/c baby was not decending, re-dosed on epi twice, finally 10cm but not dropping...massive hemorraging, bp dropped, consciousness lost, cardiac distress for me and babe...(turns out the Pitocin was so high I had *two* placental abruptions - babe was tangled in cord and would never have dropped - no u/s given) emergency cesarean after 14 hours of excrutiating pain and labor. Babe not born breathing, intubated, and in hospital for nearly a week - in NICU for glucose problems and jaundice.

#3 - waited for natural labor - labored for 3 hours, delivered vaginally - fast - no major complications (meconium passed during birth, but after head was delivered). Went home next morning!

So - it's obvious to me that waiting for labor and having things progress at their own rate is the way to go - DUH!
Here's my big dilemma, though, and I'd like your feedback. After switching FOUR times to find an OB who would do VBACs (found a great midwife, but she was unable to deliver by our laws) I was able to go ahead with my VBAC quite successfully. However, I was so terrified after my near-death-birth-experience that we discussed what would happen if I had a rupture. My OB explained that they would go in immediately and perform an emergency cesarean - under general anesthetic. So, upon learning that I would not be conscious for the birth *nor* for the period after so crucial for bonding and breastfeeding, I opted for an epidural.

I got the epidural in transition (b/c things went so quickly) and was able to pretty much just catch my breath before I started pushing - it was a low-level epidural and I felt SOO much and was completely able to assist with pushing. I felt her head come out and the doc said "okay, you can take a break before we work on the shoulders" I said "yeah right - you try to stop pushing with a baby hanging half way out of you!" and gave one more big push before she was out! It was the most amazing feeling!!!

Anyway, for the next one, I would like to follow the same plan of action and was wondering what you did/will do??

Thanks!

[JessicaS]

I dont know..I have wondered about that before. The whole thing about refusing an epidural then facing an emergency again...

During my c-section they were in a hurry and the epidural wasn't taking fast enough so they just inected stuff right into my abdomen...(which about made dh pass out) I had been having contractions so long by that point I couldn't have cared less..

I want to go med free but I am concerned about being konked out if there is an emergency..my last csection I was awake through its entirety and bf immediately afterwards...

My chances for another emergency are slim though..my dd's cord was too short to enter the birth canal and in a true knot..

Refusing pictocin will lower your rupture chances quite a lot though..thats awful they were that irresponsible to give you so much

[dotcommama]

I've had several friends and relatives tell me I should get an epidural "just in case." However, my fear would be that the epidural leads to need for pitocin, pitocin leads to rupture - or something like that. The fact is having an epidural increases the odds that you'll need a section. (I had an epi with ds#1 and almost ended up with a section with him b/c of complication that arose from the epi - so I guess I'm biased against them).

I was awake with my section with ds#2 and yes, I would be sad that I missed the birth if I had to be knocked out, but since there is a less than 1% chance of rupture I think I'd rather take my chances of having to be knocked out. I think the odds are in my favor

The way I think about it is in any birth there is a slight risk of a major complication that would lead to an emergency section - not just in a VBAC, but I personally wouldn't consider getting an epi "just in case" in a regular birth - so I wouldn't for a VBAC either.

I'm not saying this to put down the choices of people that do decide to get the epi - just giving my .02 on the issue.

[JessicaS]

I don't feel I am being put down. You're right of course, an epi can slow down labor resulting in the evil drug pictocin. (ugh hate pictocin)

I am just going to keep telling myself that..epi=pictocin=c-section!! ARG!

I will take my chances.. I would rather have a minute chance of being knocked out than going through a c-section again. I have already had one surgery for adhesions and still having scarring pain two years after my c-section.