Repeat epidural difficulties?

[flapjack]

Not for me, but my ex's wife is 26 weeks and being threatened with an elective c-section. With her first daughter, she had an epidural and they had difficulty getting it in, which has apparently resulted in scar tissue. She's now being told that because her daughter required forceps, they might need to do an emergency c-section this time and might have to knock her out because they wouldn't have time to get the epidural sited.: My ex is a homebirth daddy and doesn't understand any of this: he is, frankly, terrified by the idea of a hospital birth (he spent most of the previous births hiding from me because I shouted at him whenever he came near. He really has absolutely NO idea how lucky he was.)

Obviously, 90% of this is crap and shroud-waving. The hospital concerned have a 15% elective c-section rate (5% emergency) BUT does anyone have any specific information on difficulties in siting an epidural the second time around? I can't figure out what I need to google.
Oh- to be clear, she doesn't want a caesarean but really does want the option of an epidural. Her husband is aware of the risks, and so there is nowt else I can do- except that because this baby shares 50% of the same genetic material as my asthmatic eczematic milk allergic 5yo and my eczematic outgrown milk allergic 7yo, anything that doesn't discourage her from breastfeeding is a good thing- so no caesarean is good.

[3daughters]

I don't know about scar tissue but I have met a few mama's who have never had a 'good' epidural. Meaning that its always hard to get in (sometimes requiring multiple tries) and doesn't always give complete pain relief. For example, my sister in law has a problem with her back right in the area where they insert the epidural. After 2 mediocre experiences with epidurals she opted to go natural with a doula for her next 2 births.

[WinterBaby]

If a cesaerean became necessary I would expect them to administer a spinal, not rely on me having had an epidural, or put me under general. Spinals are placed slightly differently than epidurals, will placement also be a problem with one of those? I'd also suggest that not having an epidural, and moving around, makes forceps OR a cesarean much less likely. ANd if they can place either one of these things during a planned c-section, why exactly are they fearing doing it during labor?! SOunds more like 99.9% crap and shroud waving to me

[Sagesgirl]

Yeah, spinal can be a hell of a problem with placement. Trust me on this. The placement of the spinal for my second section took longer than the surgery itself! There are aspects of physiology that can make needle placement difficult. But that's not to say that any problems will necessarily be recurring. I had no problems with the placement of the spinal the first time. (I also know that my personal physiology is somewhat unique; my scoliosis manifest itself not only as a curvature of the spine but a twist in the spine.) I do think a lot is dependant on the skill of the anesthesiologist; as the final success with mine the second time around came when they called someone else in!

Obviously, the answer is to try to avoid the issue altogether. There are medicinal alternatives to epidural, as far as pain relief goes. I had an intravenous narcotic given during Esther's birth because there was just no way I was letting anyone near me with a needle again!

Seriously speaking, too, she needs to consider the quality of care she was given the first time around. Chances are "needing" forceps was the result of poor labor management on the part of the hospital staff, so her first order of business should be ensuring she's not going to the same folks this time around too!

[flapjack]

That's handy to know. Thanks, there's some good information there.