A VERY hypothetical question about c-sections and anesthesia... - Mothering Forums
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#1 of 50 Old 04-05-2008, 08:16 PM - Thread Starter
 
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... ok... Just so you know ... I have NO plans whatsoever to have more kids... I have my tubes tied, and the idea of having more kids is like, insanely far out there, other-side-of-the-milky-way Out There. But I'm curious...

I always told all my care providers, in the event I need an emergency c-s (which, thank God, I never did) I wanted to be completely knocked-out, NOT awake... and I always without fail got the response, "Well you'll feel differently at the time..."

I didn't think much about this until just now, this very moment. Would they have followed my wishes to be completely anesthetized?? Or is it just standard protocol everywhere now to keep the mothers awake??

Someone answer this, I'm nervous just thinking about it! :
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#2 of 50 Old 04-05-2008, 08:19 PM
 
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I have no clue, so of course I am answering! I thought that one of the reasons they liked to have the IV or maybe even the epidural in place was because of the chance of having to do an emergency C-section. With the IV there, would they knock you out quickly? My very limited understanding is the whole unconscious thing is if they don't have time to give you the anesthesia locally. I'm not sure they would knock you out just because you requested it, but I'm not sure.
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#3 of 50 Old 04-05-2008, 08:33 PM
 
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Seriously, for me, they would either have to knock me completely the heck out or dope me up beyond comprehension because I CANNOT imagine lying there awake knowing I was being cut open. NO way! That's me and my issues, but it is major surgery, and how many other MAJOR surgeries do they expect you to stay awake through? On the other hand, I would hate to miss the birth of my child....hearing the first cry and seeing him at the same time as everyone else.....but I really don't think I could get past just KNOWING what was being done to me.
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#4 of 50 Old 04-05-2008, 08:47 PM
 
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I unfortunately had a c-section with my son, so here's my limited 2 cents...

I'm a chicken. A HUGE chicken. I am terrified of the dentist. I am investigating a "twilight dentist" (one who knocks you out totally) for everything. Cavities, cleaning, the whole nine yards. If I could be knocked out for the x-ray part too, I'd do it! LOL

I'd never had *any* kind of surgery except for wisdom teeth extraction. I'd never been hospitalized, never had a broken bone. For the c-section I was given an epidural and whatever else they give you for the surgery and stayed awake. As they were giving me the drugs I kept wiggling my legs and thinking if I could still wiggle about, I couldn't possibly be numb. I mean to me, numb equaled no movement. I was awake and aware, but very calm- just kind of wondering why these people didn't seem concerned that I could still move.

The idea of them cutting into me was weird, but, was not making me panic. I was so absolutely calm. Probably whatever drugs I was given. I was more annoyed by the feeling than hurting. When they started it felt like someone was piling stuff on me. I honestly wondered what they were laying across my stomach and why they were putting a bunch of things on me. The nurse who was making sure I had oxygen was telling me what they were doing, but my brain still kept thinking, "why are they piling a bunch of crap on me??" It was just pressure. Not insane/intense pressure, just kind of uncomfortable. I could feel them pulling my son out, again, not painful, just this weird, inching down feeling.

The most "pain" was when they were putting me all back together afterwards, and even that was not pain, just more intense pressure. I was getting annoyed, I kept asking "aren't they done yet??" Which seemed to be amusing the nurse to no end. Not a typical reaction maybe?

They offered me morphine after, but, I really still was not in pain and I didn't want more drugs added to my system.

The most I ever took for the pain was ibuprofen.

I know plenty of women experience a lot of pain afterwards, and I know I was pretty lucky in my experience. It's not anything I'd ever want to repeat and I'm praying for a HBAC with this one, but honestly, I've had headaches that hurt more.

~heather

heather - wife to my wonderful husband , mama to Brenten William 12/29/06, and Devin Findley 10/20/09
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#5 of 50 Old 04-05-2008, 09:35 PM
 
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Wow...I cannot IMAGINE not being awake for my babys birth! I always was and am so glad. Those first few moments are magical.

GA is what scares me!

~Marie : Mom to DS(11), DS(10), DD(8), DD(4), DD(2), & Happily Married to DH 12 yrs.!
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#6 of 50 Old 04-05-2008, 09:38 PM
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If you have an emergency c-section (a true emergency), and you don't have an epidural in place, you are going to be knocked down, because they won't have time to do a spinal with localized anesthesia. They'll knock you out and slice you open.
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#7 of 50 Old 04-05-2008, 09:41 PM
 
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general anesthesia scares me. I have had 3 c-sections and while it is wierd to know y ou are being cut open, and wierd smelling your flesh being cauterized and very very wierd to feel all the tugging... I would be *devastated* if I were not awake for the birth of my baby. I have had enough emotional distress from the c-sections, I cant even think what it would be like if I had no recollection at all of my childrens births.
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#8 of 50 Old 04-05-2008, 09:56 PM
 
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I'm hopefully going to be doing a VBAC soon (tonight would be good :-) Anyway, the doctor told me that in the event of an emergency, like uterine rupture, there would be no chance to do a spinal or anything else. She said that it would absolutely be knock me out and cut me open in 10 minutes or less. That's fine with me. I already had the experience of being awake during it, and it wasn't fun. I got to glance at my son as they were taking him out of the room and then I got to see him an hour later once they got him breathing. Honestly, there was nothing magical for me about being aware of what was going on.

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#9 of 50 Old 04-05-2008, 10:01 PM
 
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I was so absolutely calm. Probably whatever drugs I was given.
It was.
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#10 of 50 Old 04-05-2008, 10:08 PM
 
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Originally Posted by Aura_Kitten View Post
I didn't think much about this until just now, this very moment. Would they have followed my wishes to be completely anesthetized?? Or is it just standard protocol everywhere now to keep the mothers awake??
To the best of my knowledge, if they have time to do a spinal, and no concerns about infection, they'll do a spinal. I've been told that an ethical person working anesthesia won't give GA to a pregnant woman without a compelling reason, because it's worse for the baby, and riskier for the mom (riskier than for the non-pregnant population, I mean).

As far as wanting it, I totally get you. I've been awake for two of mine, and knocked out for the other two. Except that I don't want to lose the extra time with my baby and I want dh to be there, I'd have been begging for general anesthetic. The last time, it wasn't even that bad - they've changed the mix since my first time in '93, so I wasn't completely out of it for half a day and all this time. Being awake for a c-section is, for me, the hands down worst thing that's ever happened to me, short of losing Aaron. It always astonishes me when I see women saying they were glad to be awake and such, but it reminds me that we're all different.

They gave me all the drugs, too. I wasn't calm. I was in a state of near-paralysis from fear, but that's not being calm.

Lisa, lucky mama of Kelly (3/93) ribboncesarean.gif, Emma (5/03) ribboncesarean.gif, Evan (7/05) ribboncesarean.gif, & Jenna (6/09) ribboncesarean.gif
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#11 of 50 Old 04-05-2008, 11:03 PM
 
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I don't know what they would do. I don't think they would knock you out without a medical reason though.

I had a spinal with mine, it was a bit weird knowing what they were doing but I'm interested in that sort of stuff so maybe it was just me. The excitement of meeting my baby took precedent over everything else.

I'd be very unhappy if I wasn't awake for it.

Mommy of 3 super charged kiddos
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#12 of 50 Old 04-05-2008, 11:12 PM
 
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I haven't read the other responses, but at the risk of redundancy I would say that they wouldn't want to knock you out unnecessarily as general anesthesia carries more risk than the typical c-section spinal. I was offered, but refused, drugs that would make you feel ALMOST completely knocked out. Luckily for me, I was so freakin' scared my body must have produced those drugs for me because I was wooo-oooo, out there. But I do remember my baby's first cry and that means so much to me. After that, nothing but the LC back in my room hooking my baby up to my breast! at least that went great!

Catherine and B stillheart.gif DS1 (6) biggrinbounce.gif DD (4) loveeyes.gif DS2 (1) drool.gif and expecting #4 shamrocksmile.gif on March 17, 2014.  
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#13 of 50 Old 04-05-2008, 11:32 PM
 
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The risk of having a general is that the drugs pass VERY quickly through the mother's blood stream and pass to the baby. It is my understanding that, in the case of a general, the doctor has less then five minutes to get the baby out and the cord clamped/cut. This can cause issues with the incisions...when they're working against the clock, the cuts could be less than perfect. So, unless it's an emergent situation, most practitioners prefer and strongly suggest (or even refuse) that the mother avoid a general.

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#14 of 50 Old 04-05-2008, 11:39 PM
 
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I'm an OB nurse, and no doctor I know would "knock out" a woman just because she wanted it.

It's much more dangerous for mom and baby, including a longer and more painful recovery.

I understand the fear of being awake during surgery, but they'll give you meds that can do anything from calm you down a bit to make you totally dopey, not caring what's going on.

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#15 of 50 Old 04-05-2008, 11:39 PM - Thread Starter
 
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Eeeegh! All these responses about dr's possibly refusing GA is making me more aware I don't want to take the risk of have a tubal reversal, and then possibly needing an emergency c-s... because that is how strongly I feel about it. Having been violated in many times before, both by individuals and authorities in the medical industry, there is NO way I'd take the chance.

It bothers me that other women are being denied this choice.
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#16 of 50 Old 04-05-2008, 11:42 PM
 
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As PP's have said regional anestheisa (epidural, spinal) carries less risk than general anesthesia and would be the preferred anesthesia if time and situation would allow.

I've had both. My first was an emergency c-section under general anesthesia. I woke up puking in recovery to be told I had a son who was in the NICU and I was wheeled through the NICU to take a peek and touch his foot. It was very strange and disconnected to be told you had a son but not being awake/aware for the birth.

Second was a c-section with a spinal. MUCH better experience being awake and alert to hear and see my baby as she was born. Again, she was whisked off to the NICU, but I will carry fond memories of the early moments of her birth with her that I don't have with my son.
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#17 of 50 Old 04-05-2008, 11:48 PM
 
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Originally Posted by Aura_Kitten View Post
It bothers me that other women are being denied this choice.
From a medical standpoint, I'm not sure it should be considered a choice, any more than an elective c-section "because I want it" should be a choice.

Sorry if that sounds insensitive.

Kelly, mama (12yoDS), doula, RN, and writer.
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#18 of 50 Old 04-06-2008, 01:55 AM
 
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I understand the fear of being awake during surgery, but they'll give you meds that can do anything from calm you down a bit to make you totally dopey, not caring what's going on.
I have an even bigger aversion to the idea of knowing I had been conscious, but still being unable to remember what happened than I do to the horror show that is being conscious in OR. Is it possible to be "totally dopey, not caring what's going on", without losing your memory of things? That might work. Unfortunately, the reality is that losing my memory of things that I was conscious of at the time terrifies me - but memories of OR terrify me just as much.

It seems very strange to me that doctors won't give a woman GA "just because she wants it", but people can choose to have totally elective cosmetic surgeries done - just because they want them - under GA. There's something there that doesn't quite add up, yk? Or...maybe there just isn't as much money in providing GA for terror as there is in providing facelifts for vanity?

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#19 of 50 Old 04-06-2008, 02:02 AM - Thread Starter
 
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I have an even bigger aversion to the idea of knowing I had been conscious, but still being unable to remember what happened than I do to the horror show that is being conscious in OR. Is it possible to be "totally dopey, not caring what's going on", without losing your memory of things? That might work. Unfortunately, the reality is that losing my memory of things that I was conscious of at the time terrifies me - but memories of OR terrify me just as much.

It seems very strange to me that doctors won't give a woman GA "just because she wants it", but people can choose to have totally elective cosmetic surgeries done - just because they want them - under GA. There's something there that doesn't quite add up, yk? Or...maybe there just isn't as much money in providing GA for terror as there is in providing facelifts for vanity?
Yeah not to mention, when you add up all of the meds you would need to give, say, someone with a phobia of hospitals... someone with an abusive past... for them to be calm during this kind of extremely invasive surgery ~ is that really going to be safer for the baby than knocking the mother out ~ ??


I don't think this is a frivolous option, and I think women should have this choice available to them.
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#20 of 50 Old 04-06-2008, 02:03 AM
 
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Well, the GA is bad for the baby as well. If you're getting your boobs lifted, or your brows lifted, that's only one person to worry about. You don't have to worry that if the woman goes into cardiac arrest, that two lives will be lost...or that a mother will wake up to discussion of funeral arrangements...or that a baby will be severely brain damaged due to lack of oxygen.

Also, being pregnant poses different physiologic issues in and of itself (diversion of blood to the placenta, lowered immune system, lowered red blood cells and platelets, for example) that would not be a factor when getting GA for cosmetic procedures.

As I said, they could give you medication to make you just feel relaxed, so that you're not as anxious, but should have no memory loss whatsoever. I gave both ends of the scale...many anesthesiologists wouldn't have a problem giving enough IV meds to someone (such as the OP) who wouldn't mind not remembering or experiencing the birth of her child, because the risks involved there are still much lower than with GA.

Yes. The meds to calm someone down really are safer than GA. By far.

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#21 of 50 Old 04-06-2008, 02:26 AM
 
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I had one spinal and one general, and to be completely honest, I preferred the general.

With the spinal, it took FOREVER (7 hours) for me to get the feeling back in my lower half of my body, and I felt dopey and out of it for at least 4 of those hours...which means I dont really remember holding DS the first time. I took one hit of morphine off the pump, and then half a perc every 8 hours for the next day, and then nothing afer that.

With the general, aside from my throat being sore from being intubated, I felt totally fine within about 30 min of getting to my room from recovery. I remember holding my daughter, and I didn't feel loopy. I needed more pain relief the second time around because the incision hurt more (go figure, chasing a toddler around in addition to caring for a newborn will do that to you), but I was off the prescription strength stuff after a couple weeks.

I actually just had emergency sinus surgery for a mass in my sinus, and was under general again, and was feeling fine within about 20 minutes of being in the recovery room. : They gave me a prescription for Lortab, but I didn't even need Tylenol....

I think my body metabolizes stuff weirdly. Big pain I can handle. Small pain makes me want to cry. I did 6 hours of Pitocin labor with no pain meds, then had a shot of Nubain to take the edge off, then got to complete within the hour....but I was in tears when the nurse put my IV in for my sinus surgery 2 weeks ago. :

Sorry if that strayed off topic a bit.

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#22 of 50 Old 04-06-2008, 02:28 AM
 
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i had a really crappy birth. it was a c/s. in the middle of it (it took over an hour just to get into my abdomen and get my baby out, never mind the prep or the sewing up after), the ansethesiologist asked me if i wanted to be knocked out because i was wailing, thinking my DD might be dead, since it was taking so long and we knew she was stressed.

he asked repeatedly if i wanted to go to sleep, and i finally yelled, "no! i want to be awake when she comes out. i want to see if she's dead or alive. i want to see her either way! don't you dare put me under!"

so i'd definitely fall squarely in the "you will WANT to be awake no matter how bad it is" camp. i thought my DD was going to come out dead (really truly thought so), and i still 100% wanted to be awake for it. and believe me, they were giving me PLENTY of calm down meds, and i still felt PLENTY upset. i don't feel robbed of my emotions whatsoever.

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#23 of 50 Old 04-06-2008, 02:33 AM - Thread Starter
 
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i had a really crappy birth. it was a c/s. in the middle of it (it took over an hour just to get into my abdomen and get my baby out, never mind the prep or the sewing up after), the ansethesiologist asked me if i wanted to be knocked out because i was wailing, thinking my DD might be dead, since it was taking so long and we knew she was stressed.

he asked repeatedly if i wanted to go to sleep, and i finally yelled, "no! i want to be awake when she comes out. i want to see if she's dead or alive. i want to see her either way! don't you dare put me under!"

so i'd definitely fall squarely in the "you will WANT to be awake no matter how bad it is" camp. i thought my DD was going to come out dead (really truly thought so), and i still 100% wanted to be awake for it. and believe me, they were giving me PLENTY of calm down meds, and i still felt PLENTY upset. i don't feel robbed of my emotions whatsoever.
See... things like this make me believe it really should be a CHOICE. And, that everyone really does respond to medication differently!!
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#24 of 50 Old 04-06-2008, 02:34 AM
 
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wanted to add, i would have to agree that i had no memory loss whatsoever. i remember everything about the birth. sometimes wish i didn't, but in the moment i wanted to be in the moment, so there you go.

dissertating wife of Boo, mama of one "mookie" lovin' 2 year old girl! intactlact:: CTA until 7/10 FF 1501dc
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#25 of 50 Old 04-06-2008, 02:35 AM - Thread Starter
 
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Completely off topic but, Heather I just noticed your sigline, and the ribbon ...

My bf's mom just had a double mastectomy... and my good friend also had a mastectomy... my friend isn't doing nearly as well ... she already had it years ago but it came back and now isn't responding to chemo. It's an issue that is very close to my heart right now.
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#26 of 50 Old 04-06-2008, 02:42 AM
 
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I had said after our first experience that, if I needed a repeat c/s, I'd want a general. My body doesn't react predictably to Lidocaine, and I FELT PAIN during my son's birth. I've had several other surgeries under GA, and aside from one of them, recovered quickly from the drugs with no adverse side effects.

There was a thread on here a few months back about the topic, and one poster had her DP "guest post" as an anesthetist, I think. He explained *exactly* what the issues are with GA for pregnant women and during birth. After that, I decided that it would be really irresponsible for me to *choose* GA if it wasn't absolutely necessary. The risks are just too great for mom and baby (and are different from the risks for a non-pregnant person).

It would *also* be incredibly irresponsible for a practitioner to accommodate my request for GA without attempting to educate me on the issue... just as it IS really irresponsible for practitioners to accommodate requests for elective c-sections or convenience inductions without attempting to educate women on just what the risks and issues are.

We're not the same person, and what is just way too risky for me might be appropriate for you... but physicians are *supposed* to advise their patients on what the risks of a particular option are, and yes, they will likely attempt to convince patients to accept the much-less-riskier option. They will also sometimes draw the line at not prescribing medications that will put a patient at risk without any tangible benefit. If, in your case, you see GA as having a benefit that outweighs the much greater risks, then it would be up to *you* to convince your provider of that.

Glad it's all just a hypothetical question for you... if it's got you THIS worked up, when it's not even in the offing, eek. I may actually have to MAKE this decision in the next couple of weeks, if things don't go well for our birth.
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#27 of 50 Old 04-06-2008, 02:58 AM - Thread Starter
 
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Many, many many times though women in labor / birth situations are pressured to accept medication because the practitioner thinks it's best... ie drugs to calm her... I was forced into accepting at least three different medications that I did NOT want, that I reacted badly to, and was given MORE of them when I told them I didn't like how I was reacting, during my ds's birth... and also after a surgery I had a couple of years ago ~ again, didn't want a certain medication, and again was administered it anyway despite my speaking out against it.

For this to go on, and then for a dr to open up a woman's abdomen and be cutting around her insides ~ ?!! I stand by my previous analogy, although I have since edited it out since it is so obviously offensive. I think though that it is just as offensive ~ in my opinion ~ to suggest a woman just get meds to calm her down when she doesn't want to go through the experience to begin with. A woman who already has a traumatic past... who already knows where she "doesn't want to go" psychologically... to be coerced into just accepting medication so it can be done the doctor's way seems nothing short of a violation of her body, heart, and mind.

Ironica ~ yes it has me "worked up" ... and yes I am very glad it's not a decision I'll actually have to make ever. But I think that it's something women need to be talking more about, because I had never considered that a woman's wishes regarding her state of sedation (or non-sedation) during a massive surgery would be ignored... until today.
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#28 of 50 Old 04-06-2008, 03:11 AM
 
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You know, I think I'd rather be awake, so long as they gave me whatever "relaxation drugs" everyone's talking about (not a big fan of drugs in labour at all, but obviously with a c/s that's out the window). Without them I'd probably be a nervous wreck. I've had surgeries before though, and I know from experience any nervousness I once had goes away once the drugs are in my system!
I know if I were knocked out I'd regret not seeing my baby's first moments. It's very important to me to get comfortable with the idea of c/s (not that I'm more likely than normal to have one) because if I don't face that fear now and it does happen for whatever reason I want to be able to come to terms with it as soon as possible, for my baby's sake.

I'm a modifiedartist.gif DH is a reading.gif we have 2 angel.gifs, and DS is a rainbow1284.gif baby.gif
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#29 of 50 Old 04-06-2008, 03:34 AM
 
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I was given a choice, and when I said I wnated the spinal, the dr.'s were very happy. I was shocked the GA was even an option, short of an emrgency.

I've had to friend's that needed GA. One, they had touble getting the psinal in, and she finally said "enopugh! Just knock me out!". The other was an emergency, so no time for a spinal.


I was so scared during my c-section. I tohught they would check to see if the spinal worked, and they didn't check, and I was just so scared it would hurt. Then I heard the dr. tell the nurse they'd already made the 1st incision, and that the nurse could go get my mom. So I didn't worry about pain after that.

GA scares me, though.
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#30 of 50 Old 04-06-2008, 11:26 AM
 
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I would have LOVED to have been awake for DS's birth. I'd had an epidural in place, so they tried to give me the spinal drugs. Thinking it had worked, they then made the first cut and it HURT! Not just pressure, but burning, searing pain. My right side was completely numb, but the left was pretty much unaffected and it was all I could do not to scream. They had to stop, kick DH out of the OR, and knock me out because they couldn't get the spinal to work. My first sight of my son was an hour later, when I woke up enough to understand what was going on around me. All I have of my DS's first moments is the two pictures a wonderful nurse snapped for us and a small piece of paper with his stats written on it (she wrote them on one of the wrappings for something from the surgery!)

Assuming I end up requiring another CS in future births, you can guarantee I will NOT go for GA unless there's no other choice.
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