Anyone been induced without an epidural?

(32 Posts)
BionicEmu Tue 25-Dec-12 22:11:00

I just have no idea what to do for the best.

I'm 35 weeks pregnant with DC2. DC1 was a very fast pre-term delivery at 34+1.

I have fairly severe spinal problems. I have kyphoscoliosis, disc degeneration and bony nodules on my vertebrae. Basically, my spine's screwed. When pregnant I can't have my usual pain relief (tramadol or morphine + epidural/trigger point injections.)

I am literally in agony. I can't do anything without crying. I'm 27 years old and feel like I'm 200. I just want the pain to stop. Saw my obstetrician this week, who is hopeful I'll go into labour very soon. But I'm going to see her at 37 weeks to discuss induction on the grounds of how much pain I'm in & how debilitating it is.

But, I can't have an epidural. Met the anaesthetist, he examined my back & said "no chance." (When I have the routine injections they use x-ray for siting.) My hospital don't do remifentanyl. I can have diamorphine, but have been warned it probably won't have much effect due to my opioid tolerance. So I'm left with gas & air. I had just that for my first labour, and it was fine, but it was all over in 2 hours!

If I end up needing a CS for whatever reason I've been told I'll be knocked out with a general anaesthetic.

Everyone I know who was induced had an epidural. So the thought of going through with this without one terrifies me. And what if I need instrumental help?

I guess I'm really just looking for any thoughts or advice on my situation. It just feels a bit like I'm damned if I do or damned if I don't.

KatyPeril Tue 25-Dec-12 22:13:11

I did it on gas and air! It flies by don't worry! xxxx

MousyMouse Tue 25-Dec-12 22:13:41

yes, it hurt but was bearable, had pethidine though which helped a tiny bit.
good luck!

Sirzy Tue 25-Dec-12 22:14:54

I only used gas and air and had no problems.

Good luck!

I was induced with both dc, both without an epidural. Very different births - dd in back to back position, long labour. Ds much quicker. Neither much fun! I asked for an epidural both times but didn't get one.

picc Tue 25-Dec-12 22:15:54

yep. 2 of them. Was fine, pain-wise. Don't worry.
And good luck.
(Sorry you've been in so much pain. You're on the home strait now...)

2 inductions, didn't have an epidural with either. Gas and air and diamorphine with dd, g&a and pethidine with ds. Needed forceps with dd, but no assistance with ds.

BionicEmu Tue 25-Dec-12 22:21:46

Just noticed how long my OP was blush sorry. Feeling a bit sorry for myself as I've just spent most of Christmas Day lying on the sofa trying not to cry - couldn't even play with toddler DS.

But these are reassuring posts, thankyou! I'm trying to think along the lines of it'll only be a day or so hopefully at most of labour-pain, and hopefully only a few hours of extreme agony, so that vs. possibly weeks more of being like this makes it sound like an obvious choice. I just want the pain to stop though (I realise that sounds incredibly whiny!)

Thumbwitch Tue 25-Dec-12 22:21:51

Induced for pg no.1 at 40+14 using just pessaries, with pethidine as pain relief just prior to transition. No problem, no intervention needed (did squawk a bit but it was ok really)
Induced for pg no. 2 at 39+1 - was a bit worse this time around as baby wasn't situated correctly, so had to have baby turned, membranes ruptured and syntocin drip - the drip --> increased need for pain relief so had gas and air. Not convinced it did anything and lots of screaming went on, but still didn't need an epidural.

You will be ok, honestly - especially if you go quickly at the end! I had about 30mins of squawking with no. 1, and about 45 mins of screaming with no. 2.

Also very sorry for your pain levels - I had mild SPD this time around and was very glad to have the baby out (although it was being managed pretty well by my osteopath) - sadly it hasn't completely gone, but at least I don't have the weight of the baby on it any more!

Had an induction with DS2, had my waters broken and then had the drip. I was fine on gas and air although because they misjudged how long I would be in labour I did have pethodine, but it was pointless because I actually gave birth before it started working (DS2 was born asleep!) If they hadn't been convinced I'd be in labour for another 4 or 5 hours (rather than the 45 minutes it actually was) I wouldn't have bothered, the gas and air was fine.

UterusUterusGhaLaLaLaLaLi Tue 25-Dec-12 22:29:32

Don't worry.

If your last labour was tgat quick this one should be easier.

I've had two inductions & delivered without an epidural. Most women do.
It is possible to have an instrumental delivery without an epidural if push comes to shove.

Good luck!

MissPricklePants Tue 25-Dec-12 22:32:43

I was induced! 41+2, had waters broken and the drip. No epidural for me and dd was born 4 hours after.

UsedToBeAPixie Tue 25-Dec-12 22:32:52

Hi Emu, I was induced and had to have the old ventouse baby hoover as the cord was round neck and arms. Had paracetamol all day, followed by gas and air once things got too much. It hurt of course, but it doesn't sound half as bad as some of my friends' stories!

Good luck, you'll be fine
Xxxx

MustafaCake Tue 25-Dec-12 22:36:17

DS2 was an induction at 35/36 wks. Had the pessary and a sweep, read hello magazine, waters broke and 1st contraction at 2pm, DS2 born at 3pm. Just a paracetamol and gas and air. Needed stitching afterwards and that was done on just a local injection (which didn't work) and gas and air (which made me giggle through the pain!).

I won't lie, labour was painful but it was manageable and mercifully quick. Far far easier then the 12 hour epidural/ventouse/forceps debacle that was DS1.

If you had a previous quick labour chances are you'll have another.

BionicEmu Tue 25-Dec-12 22:42:05

Oh god, thankyou all so much! You're making me feel lots more positive about this smile

Last labour was fairly easy really, had no idea I was in labour until a doc thought he may as well check and discovered I was 7cm dilated. Was just a bit uncomfortable up to that point, certainly wasn't asking for any pain relief. Doc accidentally broke my waters, then it hurt a lot more, but DS born less than 2 hours later.

shellyf Tue 25-Dec-12 22:54:17

Gas and air after pessary and water being broken after pessary didn't work.

inadreamworld Tue 25-Dec-12 23:41:13

I was induced on drip and had epidural. BUT I am a wimp when it comes to pain and I know three women at local Mums group who were induced just on Gas & Air. Good luck and hope you go into labour very very soon - horrible to be in so much pain.

aufaniae Wed 26-Dec-12 00:28:54

Would you take remifentanyl if it was available? i wonder if it will work on you given your opiate resistance? If you think it will I'd seriously consider changing hospital in yolur shoes (i may do this myself).

I was induced using syntocinon drip. I wanted to avoid an epidural if possible but quickly reaised I'd need one. They tried 5 times and it didn't work, not one bit. So I had 12 hours of labour with only G&A. Personally I didn't find it manageable. It was pain like I never knew existed. I really wouldn't wish it on anyone. I don't want to scare you, but as you seem to be making a decision based on what's being posted here I think it'd be unfair for you to make that decision in the absence of any negative experiences IYSWIM.

My baby was big (9lb 4oz) and i expect this made it more painful. Also the MW was awful IMO. She seemed to have never heard of active labour, and just wanted me on my back. I suspect this is because she had me on continuous monitoring because of the drip, and wasn't experienced enough to deal with monitoring unless I was lying down on the bed. As a result I felt totally unsupported.

I'm not particularly worried about instruments as far as pain is concerned. I had an episiostomy last time, and ventouse delivery. I didn't feel the pain either, tbh the pain from labour was much worse (sorry!)

I'm now pregnant again. They couldn't explain why the epidural didn't work last time (the anaethesist actually came an apologised to me the next day!) so I have to be prepared that the same thing might happen again this time.

Here's my plan for not experiencing the same level of pain again:

1. if I need to be induced, find out what the options are. Does it have to be the syntocinon drip? I've heard that's more painful. What are the options?

2. If it is the drip, I want to ask why it hurt so much last time. I heard the anaethesist mutter "Jesus give her a chance" when checking the levels of the drip. Are there choices/different approaches here?

3. I need to find out if patient-administered remifentanyl is actually available at the hospital. They've said they do have it, but as you may know, the reason many hospitals don't do it is because your breathing needs to be monitored by a nurse/midwfe as it's an opiate. AFAIK, even if they have it in the cupboard it's no use if they are short-staffed, they won't give it to you. I want to find out if my hospital does actually use it in practice. If not, I will seriously consider moving to the larger, better staffed hospital in the next town. I suggest you at least consider the same if feasible.

4. My birth plan is very short. If i have to have continuous monitoring & drip, the most important point, is that I want to be able to move about, even if hooked up to a drip (not on my back basically). I will ask the MW when I meet her if she's happy to support active labour while I'm on a drip / being monitored. If she's not, I will insist on another midwife - it is our right to do this. (Didn't work last time however as it was Christmas and they were very short staffed. But I'm hoping if I insist from the outset we might have a chance!).

If all that fails, and I have to go through the pain again, so be it.
It was awful, sure, but it's not forever - eventually the pain stopped, and in the end we got our baby.

I hope that helps. i'm not trying to scare you honest! It must be so difficult to be in so much pain, i really feel for you. I felt i had to post though as I was totally unprepared for the pain i experienced last time, and think you should make an informed choice. It would be unrealistic to think it is always managable, although it's certaily encouraging to hear it can be!

It's also hopeful for both you and me that we're having our second babies, it should hopefully be an easier / shorter labour (fingers crossed!)

aufaniae - my experience of the drip makes me think it hurts more simply because your body hasn't had time to naturally work itself up to that level of contractions, you don't get a chance to 'warm up' iyswim, or gradually get accustomed to your contractions increasing.

Thumbwitch Wed 26-Dec-12 11:29:57

aufaniae - to add my experience of the drip, I would say that the worst thing about it in terms of difference to not having it is that I got no respite between contractions with the drip, they all just seemed to roll together like waves - the new one was starting as the previous one receded. Without the drip, I got a couple of minutes' break from the contraction pains. I think that made it a lot harder to deal with; plus my DS2 was a bit stuck, so I wasn't managing to push him out like I had with DS1 until I was rolled onto my back, when his head dropped clear of the anterior lip and I got him out in 2 pushes and 1 minute, surprising everyone.

ghoulelocks Wed 26-Dec-12 12:07:21

Well at the weekend I was induced, straight to drip, contractions huge. Half an hour of active labour, pph with removal of clots as an emergency straight after with no time for pain relief... not pleasant but it's amazing how you forget!

Hi OP, I too was really afraid of induction after a bad first birth but I was induced with my second who was 18 days past due date and it was really really fine smile.

I did some very basic hypno style breathing to keep me calm and managed on gas and air. I didn't need the drip so I don't know how that would have worked out pain wise, but even without it I had very close together very strong contractions and it was fine with breathing, gas and air and a strong birth partner. I do think that managing my own fear was very helpful too.

A good friend of mine was also induced with her second and had a positively blissful birth. She didn't even realise the head was out!

WizardofOs Wed 26-Dec-12 12:22:00

I would try and induce naturally which may well not work but might make your body more ready for induction this making it more likely to work without resort to syntocinon which I would not recommend without epidural. So acupuncture, eat lots of dates, reflexology, sex if you can bear it, just orgasms if not, nipple stimulation. Positive thoughts!

LineRunner Wed 26-Dec-12 12:25:15

Yes, OP. My 2nd birth was an induction at 35 weeks (pessary), and it was very fast and I just had some gas and air. smile

All very best wishes to you, you poor thing.

Yep, twice. First one was with the drip and ended in forceps had diamorphine. Second was just the pessary (was 35 weeks) and only had gas and air smile

Hooliaaa Wed 26-Dec-12 22:41:03

I was induced with both my labours. The second one I was planning to go in the pool but the baby had occasional dips in heartbeat so I ended up just on gas& air. It was fine though the last half hour was pretty intense. Moving around and bouncing on the ball helped a lot.

PinotGrigioandaMincePie Thu 27-Dec-12 01:19:34

I was induced and had mostly gas and air and one lot of diamorphine to help me to relax early on but this had worn off long before the pushing stage. I found it completely bearable.

I had the syntocin drip after my waters broke but contractions didn't start.

Good luck!

Tinselandchocolates Thu 27-Dec-12 08:09:36

Glad you're getting some positive responses.
I'm surprised you got a "no chance" on the epidural. If you've had epidural pain injections then it is technically feasible if probably difficult. They should look at any old X-rays/screening/pain notes and/or get an ultrasound expert to have a look at your back (you can use ultrasound to locate space for epidural but it's a bit of a new skill).
It may not be possible and may not work, but the procedure is no different to your pain injections, just unguided. Personally I would have given you the option of an attempt by an experienced anaesthetist. Was it a consultant anaesthetist you saw? I'd ask for a second opinion. (I'm a cons anaesth).

BionicEmu Thu 27-Dec-12 11:13:39

Thanks again everyone.

I'm finding it an odd situation to be in, I was admitted at 27 & 29 weeks with contractions and cervical changes so have spent the last couple of months willing the baby to stay in - now I just want it out!

Tinsel Yes, I saw a consultant anaesthetist. He said as he was so experienced he could probably give it a go, but it would be technically very challenge as he'd have to sort of mentally untwist everything and take into account damaged discs etc in order to get a needle in. He said in practice it just wouldn't happen - in all likelihood I'd get the oncall anaesthetist who would just say "No." Also it would be obviously more difficult if I was actually in labour as I'd struggle to stay still.

This is the same anaesthetist who, when I enquired about remifentanyl during labour, said "Oh no, we don't offer that for labour. It would be like using a sledgehammer to knock out a broken tooth." hmm

There's no other hospital to go to. The only other one is the one I had DS at, but that experience was pretty awful, and they made some big mistakes, so I don't feel safe going there.

priscilla101 Thu 27-Dec-12 16:05:09

I was induced without an epidural and it was fine. It did hurt (labour does hurt though) but the gas and air helped. The drip method was a little brutal in the sense that the contractions are forced on you as it were, and at one point I did ask what other pain relief was available, but I didn't take the pethidine offered.

Will your spine issues make labour more painful? How do you feel abou an ELCS? From what I have read on here they are generally better recommended than an EMCS...

Good luck OP x

StuntNun Thu 27-Dec-12 16:22:27

My DS2 was induced with the lowest setting of syntocin and I got by on gas and air, even with the episiotomy and venthouse. I don't think the gas and air would have been enough for me on a higher setting of syntocin or forceps were required but I have a ridiculously low pain threshold. DS1 and DS3 were both born by CS under general anaesthetic, both emergencies due to placental abruption. It's not too bad but you and baby are both very drowsy after delivery. If you are going to have a CS under general anaesthetic then opt for it sooner rather than later so it can be planned. Your birth partner won't be able to be in the room for the delivery but you will want them to be available as soon as possible to look after the baby while you are coming round from the anaesthetic.

BeaWheesht Thu 27-Dec-12 16:30:23

Yes, twice. First time was a piece of piss, second time was pretty painful but that was because she had a massive head and was back to back.

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