I had an emergency c-section with my first. I was put to sleep.
I am due with my second on May 20th. It will be a scheduled c-section.
Will I have the option to be put to sleep? I am very afraid of
an epidural. I was told you get "pockets" or periods of time where
you feel everything with the epidural. Is this true? I am very
scared I will feel everything.
You can always request a GA (general anesthesia) for your anesthetic
options. However, the GA is associated with more complications,
that's the reason why anesthesiologists prefer regional anesthesia.
The options of regional anesthesia are spinal, epidural or combined
spinal epidural. Most of the time epidural works without problems
and there is no reason why you should feel everything. Finally,
spinal anesthesia is very popular for cesarean section. You should
talk to you anesthesiologist about that. Good luck.
Pudendal block vs. Epidural? I was in hard labor, five weeks early,
and complete. There was no time to get an epidural, plus they
didn't want to give any narcotics to me. They did give me a pudendal
block, which was GREAT! (I think, I delivered 20 min. after I
got to the hospital) What is it? Why was it "so great" and if
I need one again, is it complete enough to have with pitocin?
Pudendal block is only effective during the second stage of labor.
Hence, there are significant differences between epidural and
pudendal. Epidural anesthesia gives you total pain control that
is both in 1st stage as well as 2nd stage of labor. Pitocin related
contraction pain during 1st stage could be helped by epidural.
I had an epidural with my last child who is now 10 months old
and got a spinal headache where I needed a blood patch. What are
the chances that this will happen again with my current pregnancy?
I am due in May.
The chances of getting another accidental dural tap causing headache
Hi, I had a baby 22 months ago, now I'm due any day now, my question
is, do you think the labor will be quicker this time? It was 10
hours the last, and I'm having an epidural. They turned it off
last time when I started to push. Can I have it on the whole time?
Labor is usually shorter in multiparous parturients (multiple
birth patients). In some hospitals it is usual to shut off the
epidural infusion during the 2nd stage of labor, so that the pregnant
women push more effectively. On the other hand, pushing without
proper pain relief can be uncomfortable. You should talk to your
obstetrician as well as anesthesiologist regarding this.
How does Pitocin work? What exactly is it and is it true that
the contractions become more painful when pitocin is used? Thank
Pitocin (Oxytocin) is a hormone secreted by posterior pituitary
gland. Sensory stimulation from uterus, cervix and vagina promote
oxytocin secretion from the posterior pituitary directly into
the circulation. Oxytocin acts mainly on the uterus and on the
lactating breast to stimulate milk ejection. Late in the pregnancy
there is an increased amount of oxytocin receptors. By the end
of the pregnancy, receptor concentrations have increased 80 fold
to 100 fold over those in the nonpregnant uterus. The highest
concentrations occur in early labor, increasing the number of
contractile units that respond, thus - augmenting the force of
contraction causing pain.
How much of pain medications reach the baby during labor and delivery?
An extremely small amount.
Why is an epidural not given in the last stages of labor? The
pushing is what scares me. Thank you for talking to us.
Epidural can be and is given in the last stage of labor. If the
pushing part worries you, talk to your obstetrician as well as
I chose an interthecal for pain relief with the birth of our daughter
this past November. With the regular interthecal meds, the hospital's
new ingredient included Marcaine.
I asked for
just a very small amount of the Marcaine, because I didn't want
my legs to be numb. Well my legs were rather numb, and I could
feel a terrible amount of back labor. I know it doesn't matter
now, but could the anesthesiologist have mixed the dosages? The
nurse saw him only put a very small amount of the Marcaine in.
Could he have done it wrong? Is that why I felt so much labor,
and had numb legs? I also had no itching this time. I had an interthecal
with my first born, and had severe itching. They didn't have the
Marcaine then. Thank you for reading my question. Lisa
If I understand you correctly, you probably had a combined spinal
epidural for your labor and delivery pain relief. With this technique,
a very small amount of local anesthetic (Marcaine) and pain killing
medication are used. Because of back labor, the anesthesiologist
had to walk in a fine line. Too much medication can cause numbness
in your leg; on the other hand, your back labor needed proper
amount of medication. Back labor is associated with more pain.
Yesterday I went to an "open house" at the local hospital that
claims a natural childbirth is possible. I asked the nurse if
women were allowed to eat or drink and she said "only ice chips."
I questioned her on that and said that labor takes energy and
if you are not hooked up to an IV then you need to keep hydrated
and sometimes have access to a snack to boost your energy level.
She went on to explain that in the case of an emergency c-section,
the woman's stomach needs to be empty so that the anesthesia can
be given. She went on to say that the women would have to wait
for two hours otherwise for the food to digest. This seems ridiculous
to me. What if she is an accident victim or happens to progress
very fast and has food in her stomach. I believe we were being
misinformed. Can you explain to me the real reasons nothing is
given by mouth. I ate/drank consistently through my labor and
can't imagine not being able to boost your energy in that way.
In the majority of hospitals solid food is discouraged as soon
as active labor is started. The main reason is presence of solid
food in the stomach, which may be problematic when general anesthesia
is given in a hurry. The stomach may be full, if so, the incidences
of a difficult intubation and inability to intubate are higher.
Delayed gastric emptying is one of the important physiological
changes. In my hospital, clear fluid is given during labor, Gatorade
is one of the popular drinks.
I have a ruptured disk in my lower back, if I need an epidural
for labor could I still get one?
In our hospital this problem will not be contraindicated for epidural
analgesia or anesthesia, unless there are acute and neurological
problems. It is important to consult you anesthesiologist to get
the final answer.
What is the difference between a spinal block, epidural and receiving
demerol? I am concerned about pain management during labor (I
am due in two weeks.) and I want to be informed of my options.
How is a Demerol administered?
Epidural and spinal techniques involve injection of medications
in the epidural and spinal space. For labor and delivery, epidural
is the ideal technique, as it provides complete pain relief during
the 1st and second stage of labor. Demerol is given intravenously;
the quality of pain relief is not as good as an epidural or spinal.
I am planning on having an epidural at some point during labor,
but I have really bad anxiety, which affects my breathing and
staying in control. Is there anything you can recommend that I
can take while waiting for the epidural that won't affect the
baby or cause tremendous side effects? I'm currently taking 10mg
of Paxil daily. Thanks.
You first need a good support person who will work with your bad
anxiety. You can also get some medications like nalbuphine and
Demerol If your anxiety is still significant you can ask for midazolam
which is an effective anti-anxiety medication. You should see
an anesthesiologist in your hospital for a consult.
Did they change the name of a saddle block to an epidural? And
what is an epidural called now? My mother said she had an epidural,
only all it was, was a local anesthetic. I've only heard an epidural
to be what she called a saddle block. Thank you.
block consists of pain relief in the saddle part of the perineum
(crotch). It is done by positioning the pregnant woman in the
sitting position and giving a minimal amount of local anesthetic
via the spinal route. Epidural block is associated with administering
the medication in the epidural space. Extent of the block is wider
in case of epidural. Both saddle block and epidural block are
done by using local anesthetic.
I had my son two years ago. I was given an epidural, which was
"topped up" at least two times during labour as my labour was
36 hours long and ended in C-section. Other than that the epidural
seemed unremarkable. However within a few days after the birth,
I began to experience (what I can only explain as) shocks up my
spine to the base of my neck. It would last less than a minute
but took my breath away as it progressed up the spine. I went
back to the hospital and was examined by my OB who found no reason
for concern and stated my spine healing after the epidural. I
tried to contact an anesthesiologist but they do not speak to
patients once they are released. They are referred to the OB.
agree that it was my spine healing that caused this sensation?
We are trying for our second child and have been told to expect
another c-section. I am concerned to have another epidural as
this sensation was very scary to me, as it concerned my spine.
One last note... I had to have a cervical cerclage in my 14th
week and they gave me a "spinal" shot for this and I did experience
severe headaches after this experience. Is it possible that I
have some sort of sensitivity to the spinal/epidural procedure?
I understand you don't have all my history to answer and I will
of course revisit this topic with my OB. Thank you in advance.
The cause of the shocks up your spine is not well understood.
Spine healing could be one of the causes. Spinal anesthesia given
for the cerclage was associated post dural puncture headache.
This is also not common. I do not think you have any sensitivity
towards spinal, epidural procedure. For you next cesarean section
spinal anesthesia may be an ideal option.
Why do women have to wait until they are 4 cm dilated before they
can get an epidural? I go very fast from 4 to 10, so I was unable
to get the epidural in previous pregnancies. However, getting
to 4 is very painful. When I had my last baby, I talked the Dr.
into giving me the epidural before he even started the induction.
It went perfectly. What are your thoughts on this?
This came from one study that showed that if epidural is provided
before 5 cm the incidences of cesarean section was higher. Although
other studies did not agree with the first study's results. I
believe if the pregnant woman is in severe pain the epidural should
be provided independent of the cervical dilation.
I had a spinal tap about five months ago and now I am having a
baby in July. I say I want any epidural, but will it be as painful
as my spinal tap was?
Providing a fair amount of local anesthetic in the area of epidural
needle placement, it should not be that painful.
I've heard that epidurals can slow down my labor and increase
my risk for a C-section. In your experience, have you found this
to be true?
Several studies have been done regarding these questions. They
showed that the epidural analgesia minimally affect the length
of labor and did not increase incidences of cesarean section.
Is it true that an epidural can leave you paralyzed? What is the
difference between a spinal and an epidural?
The chances of this major complication are extremely rare. Spinal
anesthesia is the technique where the needle is inserted inside
the spinal space, full of spinal fluid, whereas in the epidural
technique the needle remains superficial to the spinal space.
The area of the block will depend upon the amount of local anesthetic
used. The amount of local anesthetic used is smaller in case of
spinal compared to epidural. Epidural block is ideal for labor
and delivery analgesia, whereas spinal anesthesia may be preferable
for cesarean section.
I have a bad back, am I still allowed to have an epidural? And
if so, can an epidural make my back pain worse? Also, do epidurals
cause back pain?
In case of chronic back problem, we do not feel epidural should
be contraindicated. There are several studies which show that
during pregnancy there are no differences in back pain between
epidural and non-epidural groups. The hormone relaxin is a major
factor of back pain during pregnancy.
Will the epidural effect my being able to nurse my baby immediately
after delivery? Will there be drugs in my system that I have to
Absolutely not! The amount of medication is extremely small and
the amount in the breast milk will be a very small amount if any
Our hospital offers a "paradise" epidural. How does this differ
from a regular epidural?
I never heard
of "paradise" epidural. I am eager to learn from you.
I am having a planned C-section. Will I be offered a spinal or
an epidural? Will I be allowed to choose?
In most of the places spinal anesthesia has become the popular
technique for cesarean section unless contraindicated where epidural
anesthesia will be used. You can talk to the anesthesiologist
before a final decision is made.
My hospital does not offer epidurals. What alternatives are available?
The next best alternative would be patient controlled intravenous
anesthesia, where you can inject pain control medication via a
button depending upon your needs.
During my last delivery, the nurses told me I couldn't have an
epidural because I was too far into my labor. Is that true? If
this happens again, what are some alternatives to help me through
the final stages of labor?
It is true, because epidural works slowly, it might not be a proper
technique if you have advanced too far. In such a situation combined
spinal epidural or one-shot spinal will be ideal techniques.
When would they knock me out for a C Section? If I were to be
put under general anesthesia, could my husband come in the delivery
room with me? How long after getting general anesthesia can I
breastfeed my baby?
In general anesthesia they will put you to sleep once everybody
is ready for the surgery. We only allow the husband to come in
when the baby is delivered and if the baby does not have any problem
he can take care of the baby outside.
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