Originally Posted by wifeandmom
In an *emergency* section, which is QUITE different than an *emergent* section, if an epidural is not already in place, a general anesthetic is going to be used. Period. Unless you've got an idiot for a doctor.
Emergency sections are ones where mom and/or baby are dying, therefore taking the time to place a spinal or epidural where there is not one already in place simply is not an option. I'm talking cases where the 'decision to incision' time is 5 minutes and baby is out in under 5 minutes from incision.
1st of all, I am very
well versed in the different classifications of c-sections, but I thank you for attempting to educate me. No, three is not a difference between an emergent c-section and emergency c-section. Just a similar term for the same level of severity. (There is a difference between urgent and emergent, yes).
Second, yes, I've seen c-sections termed emergent (or emergency) where there was enough time to place a spinal. GA isn't prefered because of the increased risks not only to mom, but to baby. If you have a baby who is compromised to begin with, you don't want to risk stopping the oxygen to the baby if mom can't be intubated immediately.
Third: Are you aware that a common side effect/adverse effect of epidural is low blood pressure? (which is why they bolus you with 500-1,500mL of fluid before/during) Do you know the consequence of low maternal BP? Decreased placental perfusion. Decreased PP=less blood through umbilical cord=less oxygen for baby=slowed fetal heart rate=deceleration=poor tracing=HUGE increase for "need" of c/s.
|Life threatening complications are rare with epidurals and spinals. The end.
I never said they weren't. But it is not the end. Like I've said, I've had a spinal headache, and being laid up flat on your back for days, with morphine hardly touching the pain is nothing to sniff at--I can't imagine what that would be like while trying to establish a nursing relationship, bonding, going home, etc. The risks are there. I'd never make a general statement like "Epidurals are unsafe. Period" I'm not an idiot. I've seen epidurals do very
good. I've seen them save a mother from a c/section. I just think it's very unsafe, unwise and unethical to say what I quoted. And most women don't
know the risks to epidurals, spinals, stadol, demerol, etc. in part because people consider them rare and uncommon enough to not mention it.
Re: Risk vs. No Risk: I made the choice not to have pain meds in labor, and there is no risk in not getting pain meds, so I'm not really sure I should need to elaborate more. What else qualifies me? I refused an induction. Didn't stay on my back. No directed or purple pushing. No continuous EFM. I ate and drank in labor. Obviously laboring itself poses inherent risks, but I chose not to add to that. Is that a good enough laundry list for you?