Epidural or Not?? What to do... - Page 2 - Mothering Forums

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#31 of 41 Old 05-26-2009, 06:53 PM
 
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Originally Posted by AmyC View Post
I do believe, and perhaps moms of multiples here can tell you from experience, that having an epidural in place "just in case a c-section becomes necessary" (so you won't have to have general anesthesia) won't always prevent you from ending up with general anesthesia for a crash section, anyway.

But if you are considering it "just in case," then weigh very carefully how likely it seems that it would serve in that way, and how you might feel about having had it if in the end it didn't prevent the main thing that had prompted you to get it. (i.e., having general anesthesia for an emergency c-section) And also how you might feel if having the epidural may even have led to the circumstances that made the c-section necessary (that of course is harder to know for sure, but you might have thoughts/feelings/suspicions about it after the fact.)

I know general anesthesia isn't the only "just in case" reason.
Good stuff, Amy!

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Originally Posted by Novella View Post
My twins were a hospital birth with double-footing Twin B. We researched and deliberated our birthing choices intensely. I refused constant monitoring, IV, pain meds including the epidural cart they had pre-emptively arranged bedside. I also refused a c-sectin ordered upon me by the attending doc and refused to move to the operating room for delivery. It couldn't have gone more smoothly.
You go girl! I hope I'll have the strength to fight/refuse/whatever if that becomes necessary. I'm just such a good durned "patient." Grrrr!

I talked to my OB today: no induction (VBAC), no augmentation (VBAC), no epidural.

Related question: why do some hospitals insist on helplock? (That's in the arm, correct.)

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#32 of 41 Old 05-26-2009, 07:02 PM
 
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Originally Posted by magstphil View Post
lisa_nc~ that is interesting as I have a friend who had an epi for a vag birth and was rushed in for a emergency section and it was preformed on just that epidural.

Yeah, but then you have to define "emergency", you know? Even in a lot of obstetrical "emergencies" there is still time to up the dosage, prep for surgery, etc. A lot of these so called emergency cesareans still take 30-45 minutes to first cut. Not saying this is at ALL the case for your friend as I have no idea of what happened in her situation. Just sort of addressing the question about hospital policy. The normal dosage for your standard epidural is nowhere near what it needs to be to cut into someone for abdominal surgery. I believe when I was deep into researching the whole issue, I read that it takes 20 minutes to get the full dosing effect necessary for a cesarean once the epidural is in place.

In my case, I have had two sets of twins as a surrogate. The first set was an "emergency" cesarean but we still had time to place the spinal, etc. The second set was a VBAC so the sort of emergency we were talking about was mainly based around uterine rupture. If I had had a uterine rupture, I most likely would have been put under general anesthesia, even had I had an epidural in place because there wouldn't have been time for the higher dose of medicine to take effect. I don't know if this makes sense or not...

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#33 of 41 Old 05-26-2009, 07:07 PM
 
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Originally Posted by labortrials View Post
Related question: why do some hospitals insist on helplock? (That's in the arm, correct.)
If you're referring to what I think you're referring to, yes, it's usually in the back of the hand, where your IV would be. Where I am, they call it a saline lock. The reason is this: in setting this up, an IV catheter is inserted into your vein, and the lock is "plugged" into it instead of the IV tubing. That way, if something happens, such as an emergency situation, they already have access to your vein and don't have to waste valuable time trying to get an IV started. An especially good idea for patients who have hard-to-find veins.

ETA: The IV would simply be "plugged" into the end of the lock if something happened that it was needed.
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#34 of 41 Old 05-26-2009, 07:32 PM
 
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In my case it really didn't make a difference which form of anesthesia I had because of the type of c-section I had. The recovery from the surgery itself far outlasted the recovery from the anesthesia.
Thanks so much for sharing your experience! I really appreciate it.

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This may sound somewhat cold, and I really don't intend it to, but in the long run what form of anesthesia you have for the birth won't make any difference. It won't affect how you raise your children: your decisions about circumcision (if applicable) or vaccination, about the values you teach them, about the spiritual principles you teach them, etc. Yes, birth is vital and important, but it's the parenting that matters in the end. The birth experience is for the mother... the baby will never remember it, at least not first-hand. Do what you can to make this the birth experience you want. My case was not the "norm." Just because I ended up with a rather vicious c-section definitely doesn't mean it'll happen to you. The odds are in your favor that you'll have a perfectly normal vaginal birth for both twins, and be able to smile all the way home, rubbing it in the faces of the "traditional" medical staff who didn't think it could happen.
You don't sound cold at all, and I completely agree with you! I hope and pray that everything goes smoothly for us and that I am freaking out over nothing, but I'm the kind of person who stresses out about pretty much everything and has to prepare for all of the possibilities.

The main reason I don't want an epidural and am considering general anesthesia in the event of a c-section is because I have some serious sensory issues and not being able to feel my body and knowing there are people touching me all over the place and I can't get away would most likely make me lose my mind. I hate to be touched in anyway, especially by people I don't know, and I hate to feel out of control of my body. Getting a filling done at the dentist and being numb completely freaks me out and I have to do a lot of relaxation/ visualization and breathing just to get through it so I can't even imagine how it would be to have half or more of my body numb.

This is certainly more of a mental thing for me and really seems kind of silly to most people but it is what it is. So I just have to weigh the side effects of having general, if it came down to it, vs. having an epidural and having all of the mental and physical side effects ontop of that, KWIM?
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#35 of 41 Old 05-27-2009, 12:59 PM
 
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I hope this thread isn't scaring you. I hestitated to post earlier (I had the epi and a version w/ twin B). I think the decision to wait and see is a good one. I had lots of conversations w/ my OBs about it before delivery and didn't make up my mind until Twin B was still breech at the end of hte pregnancy. You should watch the little video and sign the epidural papers before you go into labor. I met w/ the anesth. guy before labor and talked to him about any and all questions I had. This way ifyou do decide to go for hte epidural you already have that part done! IF you are fine without it, that's good too.

FOr my twins, I was in a regular L&D room, but the anesth. was in the room as well if something were to go wrong and I needed an emergency c-sec., I was right across the hall from the OR and it was set up for immediate transport if I had needed it. The told me if something happened I would happen, even w/ the epidural in some emergencies (babies HR dropping dramatically and not recovering) would require getting put out completely b/c they could do that in seconds and the baby(ies) would be out in 2 minutes or less. My friend is an OB nurse and has scene them do them very quickly! Some before the mother is even completely out, they are racing the clock in some cases. In other emergencies, there is time to put a different medicine in the epidural line, but I think this would take morelike 10-15 minutes or so.

And lastly, there is no way right now to tell how what kind of birth you will have. You may have transverse babies, they may both be head down, or maybe you will be like me and have one head down, one breech. You don't know if you labor will come on fast, or if it will take days. You don't know if you will develop a condition that requires induction, or if your pregnancy will end sooner than you want. Your babies could come early, or they may be big healthy babies. You just cannot know. I think the best approach is to be ready for anything and don't get obsessed w/ haaving that perfect birth. I have had two other births, and my second was by far the best! I didn't like my twin birth, but in all honesty I think it went really well for a twin birth! If I had my 'dream' birth of course it would have went differently.
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#36 of 41 Old 05-27-2009, 01:36 PM
 
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i had our twins vaginally a few months ago and did not have an epidural. i'll copy and paste the chunk of my birth story from when twin b was born (after a really easy frank breech twin a)

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i moved to the or table. they had stirrups on it and i asked if i had to use the stirrups and dr c said we'll see. i heard someone say the fetal heart rate was 90. i thought i must have misheard. then they said the fetal heartrate was 70 and i knew something was wrong. they put my legs in the stirrups and i laid back and then just blinding pain. all i can say is those stirrups are built strong because my legs were fighting against them with all their strength and i had no control over them. during pregnancy we talked about how if i did not have an epidural and he had to turn baby 'b' or go in after him it would hurt. bad. i thought about that conversation and thought there was no. way. that was what was happening. i just couldn't let my mind think that was what was happening. out came baby 'b' and i pushed a little again for his head. later dr c said that he had to go in and grab him by the feet and pull him down. he was way tangled in the cord (peter and the nurses said it was around his arms, torso, neck, and leg) and my uterus contracted down fast with him transverse and high and that's when his heartrate dropped. it was very painful, but very fast and i keep having flashbacks to it (part of the reason i haven't written it out until now).
it hurt very badly. it was so fast though and i do not regret doing it without an epidural.

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#37 of 41 Old 05-28-2009, 12:48 PM
 
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Originally Posted by bekahlily View Post
This may sound somewhat cold, and I really don't intend it to, but in the long run what form of anesthesia you have for the birth won't make any difference. It won't affect how you raise your children: your decisions about circumcision (if applicable) or vaccination, about the values you teach them, about the spiritual principles you teach them, etc. Yes, birth is vital and important, but it's the parenting that matters in the end. The birth experience is for the mother... the baby will never remember it, at least not first-hand.
Not cold, good to have this perspective offered, but I must disagree.

Birthing choices (and unchosen outcomes) can have a significant impact on parenting. . . . attachment/bonding, parenting choices made by a mother who may feel she has to "make up" for something that happened at the birth, etc. (And I think these feelings are often not something we are completely aware of).

Human beings are too sensitive and complex, and the mother-child gestational interplay too significant to say that the birth experience is for the mother only. While a child may not be able to verbalize emotional or physical effects of the pregnancy and birth, it seems a bit dismissive to presume that they simply don't exist.

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#38 of 41 Old 05-28-2009, 03:02 PM
 
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Not cold, good to have this perspective offered, but I must disagree.

Birthing choices (and unchosen outcomes) can have a significant impact on parenting. . . . attachment/bonding, parenting choices made by a mother who may feel she has to "make up" for something that happened at the birth, etc. (And I think these feelings are often not something we are completely aware of).
:

Without writing a dissertation on this myself, because a lot of it is in transition right now and very emotional, suffice to say that I have BTDT. It matters. It doesn't ALWAYS make a difference, but it definitely can in ways you least expect.

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#39 of 41 Old 05-28-2009, 03:18 PM
 
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:

Without writing a dissertation on this myself, because a lot of it is in transition right now and very emotional, suffice to say that I have BTDT. It matters. It doesn't ALWAYS make a difference, but it definitely can in ways you least expect.


I always looked at this on the reverse meaning epidurals/c-sections hinder bonding but after my traumatic birth I have realized that there is no real one way only. Sometimes it works differently than you expect. I think we all need to be prepared for the many different circumstances that can arise and be open to taking a different path if needs be. Not having an epidural doesn't automatically mean easier bonding and neither does having one. It really does depend on the situation.

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#40 of 41 Old 07-04-2009, 02:22 AM
 
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I'm mostly subbing here. Thank you to all who have shared your stories! This has been a great thread.

I did want to add a little to the discussion about whether or not birth experiences matter, personally, I believe they do very much. First, from a biological standpoint, we know that babies are "meant" to experience vaginal birth. It gets them properly wired for life outside the womb and when drugs are part of the birth experience those have the potential to have negative effects on the fetus and subsequently the newborn. But there is another part to it too: how the mother feels about herself and her birth experience. Birth is transformative and it has the power to really shape someone's life.

From the reading I have done, the research I have looked at, and the work I am doing now, what really matters to most women is how they were treated and supported (or not supported) during their births. For a mother whose birth did not unfold according to her plan, whatever that plan may have been, if she still felt loved, respected, included in decision-making, and surrounded by supportive people, ultimately she could still feel very satisfied by her birth experience and enter into motherhood in a very positive way, which of course would be beneficial to her baby and her relationship to her baby. However if a woman felt intimidated, un-worthy, ignored, abandoned, etc., she may very well have a negative outlook on her birth experience, and this could really affect her for the rest of her life. This could apply to someone with a text-book, easy homebirth or someone with a hospital birth. Again, to clarify, even if a birth was an emergency cesarean birth under GA, if this mother still felt loved and supported, she may still walk away from the birth experience feeling good about herself. At the end of the day, it really does matter how we bring our babies into the world. The memories of the experience last a lifetime and they are powerful forces in shaping our identities and our relationships.

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#41 of 41 Old 07-04-2009, 05:46 PM
 
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I think you are very wise in playing it by ear. We planned a vaginal delivery and I refused everything and had many "come to Jesus" meetings with every OB, Midwife, anestesiologist and nurse that heard what we were planning. In the end we chose to have a c-section and they did a spinal (I had worsening Pre-E). A c-section is obviously to be avoided but if you need one you need one. Personally I would choose NOT to get one placed just as I chose last time because it lessens the risks of intervention greatly. The less things you have stuck into you or stapped onto you the better. True screaming emergencies are super rare, even among twins and things like unreassuring fetal heart tones def leave time for a spinal to be placed. Even an abruption can be ok if it's not complete. My Spinal took effect in about 5 min and they were cutting almost as soon as I layed down. Another thing to consider is the fact that Epidurals don't always work and sometimes they fail or leave a window.... this means you'll need another anestesia if something happens. Seems like alot of risk and very little benefit!

As for the comment about it not mattering, I agree and disagree. If you have to have one you're not a failure or a bad mom, but on the other hand it can be harder for both you and babies to adjust and there are risks to surgery of course. For me, I took almost 6 months to begin bonding with my twins not to mention recovery was painful, I had adhesions, the twins were "wet" and kept vomitting and choking on mucus for days and the Dr of course refused to delay cord clamping. Would I do it differently, no. I think that they truely needed to be born this way and I believe I did everything I could to avoid surgery, but in the end their safety and mine depended on this life saving operation. On the other hand if I had NOT had breech/vertex twins and if the Pre-E never happened I wouldn't have let the hospital near me with an epi/iv/scalpel etc. Circumstances are everything.

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