epidurals + other meds for delivery

[spu]

*** Just a quick update: As of 2 days ago, I was 4 cm dilated and 100% effaced. I never would have known or guessed! So.... they're inducing me tomorrow. (I'm 38+ wks pg w/twins).

They're planning on using pitocin and possibly break my water if it doesn't break today or tonight. Any thoughts on pitocin? Is it truly safe? I've read a lot of scary stuff online about how it can cause autism or decreased oxygen to the babies... eek!

Either way, they want me to get the epidural with the twins just in case they need to do an emergency csection... then they won't have to knock me out.

thanks again!
susan


__________



Hi ladies,

I'd love to hear your experiences about medication during delivery. I'm pg with twins, both head down and about 6 - 6.5 lbs, and due in about a week or two. I'd love to keep the sensation in my legs so I can walk around still + my pain threshold is pretty high... how much does labor actually hurt? Does the pain go away once the baby's head is out? I heard from other moms that our endorphins and adrenalin kick in blocking out a bunch of the pain. Also that the pain felt during labor helps the mom push and be more aware of what's going on.

My dr. says the epidural is generally recommended with twins in case they need to reach up there and grab the second baby... I've heard pros and cons about having an epidural, like it could slow down labor, or cause the use of pitocin to speed it back up again... During a recent surgery, I had a spinal and hated not being able to feel my legs. Plus my b.p. is pretty low and the spinal sent it plummeting (85/23); the anesthesiologist was quite nervous.... last thing I want to do is faint during delivery...

Any advice or techniques you have would be great!!!

Thanks for sharing!

susan

[egoldber]

Here is a synopsis of a study that came out recently (late last year I believe). It had previously been thought that receiving an epidural might increase the likelihood for a C-section delivery. The new study indicates that this is not the case, that women receiving epidurals were not more likely to have a C-section. However, on average their labors were 25 minutes longer. Here's the link:
http://health.discovery.com/centers/pregnancy/epiduralsafe.html

Most epidurals do not completely numb you like a spinal, so you will still be able to feel enough to push. When I had mine, I was still able to shift around on the bed, but I was not allowed up (hospital policy). In some places, they do what is known as a "walking" epidural, where you get enough anesthesia to relieve pain, but you are still able to walk. But the policy at the facility where you deliver will govern the type of epidural you get, so ask your OB. When it was determined I needed a C section, then they really up'ed the pain meds through the epidural catheter and I was completely numb. I also had a problem then of my blood pressure dipping low, so they had to give me oxygen. Before the increased meds for the C section, I had no problems.

I would be cautious about generalizing from others labor experience to your own. Some people have a very high tolerance for pain and have a very easy time delivering. Some don't. I would keep an open mind until it is time for your delivery. But don't kid yourself, labor is going to hurt. A lot. It is no shame to ask for pain relief when it is available. They don't give out medals for enduring pain. Also, an epidural may block pain, but not pressure. I am told (since I had a C I did not experience this first hand) that even with the epidural, the actual delivery can be quite painful.

Personally, I thought that the epidural was a gift from God. My husband says I was a totally different person after the epidural. If I had to choose between a labor that was 25 minutes longer WITH an epidural or 25 minutes shorter WITHOUT, I would definitely choose with. But that's my experience and my opinion. Others will think differently.

HTH,

[sntm]

My friend made a good point - it's not like any guy comes to the ER with a broken leg and says, "Don't give me any pain meds while you reset my leg. I want to do this the natural way." :)

Anyway, do whatever makes you feel the most comfortable. Don't be afraid to discuss at length with your doctor any questions you have or to specify under what conditions you would and would not want the epidural. At the very least, tell your doctor to warn you when it is getting to the point where they could no longer administer the epidural.

shannon
not-even-pregnant-yet-overachiever

[KathyO]

I agree with Beth - keep an open mind, because it's guaranteed that labour will not go the way you imagined it! (My OB confesses that she gets a sinking feeling when women walk in with 30-page "birth plans", as it invariably guarantees that something will go off the rails!)

For what it's worth, labour hurt more than anything else in my life ever has. But it was a different kind of hurt - at the risk of sounding weird and mystical, it was like a crucible - a transforming ordeal that turns you into a new person... it's hard to express without sounding corny or worse. But really, it was in a whole different zone than a migraine or a broken ankle.

The worst pain was before the pushing phase - once you actually get to push, that can be a huge relief. As it happened, I didn't get an epidural - a shot of Nubane got me across the rough spot. My husband massaged my back with that Body Shop peppermint lotion during contractions, and that actually made a huge difference too. The breathing patterns they taught in prenatal can also help a lot, although when you're in the thick of it, a contraction can come on you before you're quite ready, and you don't get the rhythm going, and then you panic because you think "argh, it's not working!" Just write off that contraction, tough it out, and try again next time.

I mention this because you've suggested that you might like to avoid an epidural. I don't want anyone thinking that I am down on them in any way, or on anyone who chooses one. You'll know what's right when the time comes!

Cheers,

KathyO

P.S. - that being said, if you DO get one, and they apply it while you're leaning over your husband's shoulder, make sure he looks away. My male colleague was in this situation, and didn't, and FAINTED, and missed the whole event!! His wife was cheesed!

[trumansmom]

I had an epidural, and I'd do it again in a heartbeat! I went in after laboring for 14 hours at home. During this time I took a bath and 2 showers to try and get through it. The showers helped alot. The bath, not so much. I finally went in when the pain made it difficult to walk.

When I got the hospital I was 3 cm. They gave me an epidural after a couple of hours, and I stalled out at 4 cm for about 4 hours. But during these 4 hours, I got a GREAT and desperately needed nap in! Then they gave me pitocin and I went from 4 to 9.5 in 2 hours. Because of the epidural, I didn't feel this at all. In fact, my husband and I sent out a bunch of "baby alert" emails. I knew when it was time to push because I felt a very strong pressure. Actually, I thought I had soiled myself! I was so embarrassed and made my husband leave the room before I asked the nurse to check! She laughed at me because apparently this isn't an uncommon sensation. It just meant it was time to push.

I only pushed for 45 minutes, and while I felt NO pain, I always knew when the contractions were starting before the nurse or doctor sain anything, and was very much able to push.

It's a personal decision and I agonized over it a good deal, but I've never regretted for a minute getting the epidural. The pain of labor wasn't nearly as bad as I expected it to be, but I wasn't able to rest or sleep until I got the epidural. Those few hours of napping were a lifesaver.

Good luck!

[schums]

I second all the above comments about epidurals. Do what you feel is best for you when you go into labor.

Just a couple of additional comments:

I was induced, and was only at 1 cm with no contractions when we started pitocin. Pitocin starts contractions very hard and heavy, and without your body having time to get used to them. I waited 6 hours before getting an epidural (still at 1 cm after all that time) and I'm sorry I waited.

Point two: If you don't have an epidural, and they need to do an emergency or semi-emergency c-section, they often will simply knock you out, so you miss seeing your babies, etc. until you come to.

Just my 2 cents.

Sarah

[suzska]

Well, for me there was no choice. Or the choice was taken away. I shall explain....I'm sure some of you have seen some of this before.

My water broke at 7:30am. Talked to the doctor around 8:30am (after getting a shower and waiting fot DH to get home from the grocery store). I got to the hospital just before 9:00am. When they checked me I was at ~1cm and nothing. By the time my actual doctor got there, she said she could stretch me to 2cm. They started the Pitocin around 12:25pm. The Pitocin did make the contractions pretty intense, and quick once they got going. At some point they sent for the anesthesiologist (sp?). I have scoliosis and had spinal surgery when I was 14. I have a 7" metal rod attached somewhere to my spine. Problem is, don't remember exactly where and certainly don't have the x-rays from almost 20 years ago handy. Never gave the surgical records to my OB/GYN (note to self: make sure they have them for next time if possible--still haven't done that). They don't want to give me an epidural because of scar tissue, etc., so none for me! They did give me a shot of a two drug mix to take the edge off. Guess that helped. The nurses changed shifts around 3:00pm and so they checked me. I was still at 3cm! I wanted to just give up! They were sure I was going to be delivering well into the night or the next morning. Ugh! Well, about 4:30pm (1.5 hours later) I felt like I wanted to push. This happened two contractions in a row, but I didn't push. The nurse came in, and DH told her I felt like pushing. Okay, chase my parents out of the room, etc. They check me--I'm at 10cm!!! Find the doctor! And pushing was definitely a relief! Not a great relief, but it felt better to push. As I said, the Pitocin made the contractions pretty quick. I wasn't getting much rest in between. It still took me ~1.5 hours of pushing until Evan was born at 6:24pm. I don't remember much of what happened after Evan was born--you're just so relieved to have a healthy baby. I don't remember delivering the placenta. I do remember the doctor had to stitch me up a little. This was all going on while they were checking Evan and weighing him, etc.

Of course now, here I sit, thinking, "ah, well, I did it once without an epidural, I can do it again!" I'm sure I wouldn't feel the same if I was in labor.

How much does it hurt? It HURTS!!! Does the pain go away? I think you have different pains--depending on whether you tear or not, and I seem to remember still having cramp-like pains. But all I took were very large Motrin's. And there was the whole blood loss and chills thing I had. My iron levels went done, so they gave me iron pills--yuck! My blood pressure was fine during labor as far as I can remember.

Just discuss with DH what you might want before hand. Because you may not be rational enough to make a decision. :-) The nurses kept asking my to describe my level of discomfort, from 1 to 10. It's hard to give them an answer, because you aren't sure what 10 might be yet.

Sorry to go on and on....but you asked! ;-) :-)

[spu]

Hi everyone,

Thanks for sharing all your thoughts and experiences. I'm due any day now and it sure helps to see the wide range of what could come. With twins on the way, I'd be afraid of having no pain meds and ending up with a c-section where they would have to use a general... that would be a bummer.

Is it true that most labor starts with back pain? I've been feeling a lot of back pressure toward the end of the day, but not sure if it's just the weight of the babies pulling on my back or if it's a sign. By morning, I usually feel a bit more refreshed.

thanks again!
susan

[suzska]

I don't remember any back pain. Which for me with my back problems was pretty surprising. I know some women have terrible back labor. Like everything else, I think it's different for everyone and every pregnancy. I would say with two in there, I would be surprised if you didn't have back pain! :-) I hope you don't have too much longer until you meet your little ones!

[egoldber]

My labor did start with back pain, then became more like very strong menstrual cramps (like those described by Joanne). But I was induced with Pitocin after my water broke and contractions did not start on their own.

If you think a C section is likely, an epidural may be a good thing to do. As you said, if they then decide to do an emergency C, they may may need to use general anesthesia if you do not already have an epidural started and there isn't time.

But I also had a lot of back pain in general during the last trimester. Carrying an extra 30 pounds (or more!) will do that to you. And if you have been on bedrest, your back muscles will not have had a chance to "toughen up" over the course of your pregnancy. If you feel better in the morning, it is probably not labor. In general "they" say that if the pain is relieved by anything you do, it isn't labor!

Best of luck!

[dubbogod]

Well, I've had 3 kids, 2 with epidurals and 1 without and I highly recommend an epidural. I had a wonderful labour with my epidurals, still felt a bit, but didn't have to suffer with anything too much. I still pushed fine, and had no complications. With my son, I didn't have an epidural, and it did hurt, but I'd do it again just for the result! I just think if the option is there, I don't see any need to not take it.

[jojo2324]

I would recommend the epidural as well. I wanted to go as long as possible without any medication, but by the time I was 4cm I had to ask for something. They gave me a shot of NuBane which was great. It did make me feel very woozy and not quite there mentally, but I got a nice nap in. Just so you know, NuBane stings when they administer it, and it leaves a nice bruise on your arm. Well, at 6cm that had worn off so I asked for another. It had really helped relax me and breathe through the contractions. However, I guess the intensity of the contractions had gone up, because the NuBane was not cutting it anymore. This is when I asked for the epi. Problem is, I had just gotten both within a very small amount of time and I was totally out of it. I felt like a vegetable; couldn't move, couldn't speak coherently, could barely open my mouth. I felt really bad about it, like I was completely relinquishing myself to the "evils" of technology (a la Sears) but I know now for the future. The epidural was heaven in the beginning. Couldn't really feel anything. But then the spinal part of it wore off and whatever was left really did nothing. At this point I am at 8cm and can feel every little thing. The contractions are now coming every minute, really really intense and I am screaming like a banshee! It was like I was a 13 year old being profiled on Maternity Ward or something. I am still a bit embarrassed by my behavior. DH told me that whoever was in the room above us was banging on the floor, trying to get me to quiet down. Oops! :) I know they say that you aren't able to move after the epidural, but I feel like I could have walked around no problem. Finally the nurse agreed to let me have another epidural because she said I would accomplish nothing if I was screaming and exhausting myself fighting the contractions. Of course our hospital has only one anesthesiologist (sp?) available and he was tending to an emergency (not me!), so it felt like forever before he showed up. It didn't work as well as the first one, but it took the edge off enough that I could breathe through them and try to relax and finally get to the pushing stage.

So my opinion is don't deny the possibility of drugs. I had no birth plan because I didn't know what to expect. I tried to hold off on any meds as long as possible. Now I know what to expect and next time around I'll try to do things a little differently. Good luck!!

[katzenkowz]

I like what one poster said about no man walking into the hospital with a broken leg and skipping the pain meds in the interest of "natural." My office manager gave me the best advice I think--"drugs are your friend"--she's had 3 and doesn't understand the point of suffering thru the pain if you don't have to. My OB midwife says if it's done at the right time (not too early--4-5cm) it doesn't slow things down significantly and definitely can get you the break you need for pushing. At my hospital they don't "wear off" because they give you a continuous infusion--so they can also turn it up or down as needed. My mother says she doesn't understand "these people who think you need something for the pain," but she was heavily drugged for her first 2 because that's what they did back then--no choice. She didn't go "natural" until the 3rd one, and by then there was pelnty of room. Well, he was breeched--but then my mother is still trying to prove she's superwoman. Personally, I'll probably go for the epi, so I can enjoy/appreciate the result more.