ELCS booked but option for epidural instead?(30 Posts)
Since before I got pregnant it was agreed I would need an ELCS to deliver as its unsafe for me to push during birth as it will increase my intracranial pressure. Because its already too high it would jeopardise the small amount of sight I have left if it was raised higher for any amount of time.
I'd got my head around this and although its not ideal ELCS was the only option I thought I had. On Thursday we had a meeting with the consultant anesthetist. She discussed ELCS and then told us about another option she had been discussing with a neuro (not my personal one but one she regards quite highly). They think an epidural would be another option.
She said they would do the epi from the minute I arrived at delivery suite and ensure it was strong enough so that I didn't feel any urge to push at all. Once baby had made her way down low enough they could assist her with forceps or ventouse.
I feel tempted to go via this route as recovery, in theory, should be quicker and easier meaning I'm not such a burden on DP in the very early days after the birth. And breastfeeding should be easier too.
Although I am really tempted I'm also a little worried about forceps. I've read horror stories about forcep assisted births and the damage they can cause.
So I don't see my mw again until Tuesday and I was really hoping for some opinions and/or experiences of either birth from others here.
If this was your choice which would you rather go for? Are there any risks I should worry about with either that I may not have thought of?
Thank you so much in advance if you can help btw I'm 30 weeks pg.
Although this may all be speculation as the anesthetist thinks they might have trouble placing an epidural or a spinal block and if they do then it would need to be cs under general anesthetic, which for me is the scariest option that I'd really, really like to try and avoid.
I would definitely go for the ELCS. Assisted deliveries can be brutal at the best of times, let alone if you can't actively push.
If I knew instruments were going to be involved I would go for ELCS. I'm down for an ELCS and worrying about it at the moment and the need isn't so clear cut. If someone told me I would end up with forceps or ventouse it would remove any doubt. It's a personal decision though. Good luck. X
Elcs will definetley be quicker. You'll be in and out in under an hour. Or did you mean recovery time? I think it will better than you expect. I was up and about same day with emergency cs. Not running any marathons for a few weeks but basically fine and pretty much back to normal after a week max.
I had a d'état he'd retina last July and 4 ops later still have very little useable sight and my other eye is already -14.50 my consultant told me there is increased risk from pushing if further detachment to both eyes and wound support a c section if that's what I chose.
However the obs and gobs told me there was no risk as if I didn't want to push would have forceps - as epidural can not be guaranteed. Having been induced twice and with forceps unless my baby would otherwise die I will NEVER consent to forceps again and am still trying to decide whether I will 'lucky' and not further risk what little sight I gave left or push hit a section then have the recovery with a newborn and two other young children.
Everyone I speak to usually look at me as if I am mad for not having a section but I just can't decide 32weeks
Apologies for the spelling/poor autocorrects as you can tell u can't see very well!
I'd definitely have an ELCS if it would eliminate any risk of you losing any more of your sight. yes, the recovery time is a factor, but my understanding is that the 6 week recovery is the maximum and sounds as if you have support.
As far as breastfeeding, am not sure that the mode of delivery is that much of a factor as immediate skin to skin.
Thanks, I kind of expected the ELCS would be a better choice. My DP thinks it makes more sense to go for the cs as he says at least we'll be expecting the recovery to be slow and we can pretty much know ahead of time how hard its going to be.
I'm just worried about the effect it will have at home. We live in a 3 storey house with lots of stairs. The bathroom, bedrooms and kitchen are all on different floors meaning I might find it hard to use either of them straight after I'm home. For months I've been convinced I'd be facing the post cs stuff that the epidural method sounded like a good alternative. Maybe not so .
I know everyone's experience of recovery after CS is different, but I found it quite painful on day 1 during which I was in bed in hospital anyway. Day 2 was uncomfortable. Day 3 mildly uncomfortable. Day 4 onwards fine. I took it easy but wasn't in any pain.
I had over prepared at home, thinking I would be totally incapacitated for 6 weeks but the reality was I was absolutely fine up and downstairs, standing, sitting, getting out of bed etc.
I'd take that over internal damage from forceps anyday!
Snap! We live in a townhouse too plus I'm on my own so no-one to help out or do school/preschool runs for me. If I were you it would c section no second thoughts. I still I might and just speak to the school about poss if kids being late (can't afford taxi each day for them) as think my walking will be slow. People tend to be very accommodating with this sort of thing fingers crossed!!
Forgot to say I didn't get skin to skin with dd for about half hour due to stitches/her being checked etc and she latched in straight away, bf until 16 months, day until 2 years. If you want I bf just keep going, the rest comes x
I had an ELCS and was driving in less than 2 weeks and doing pretty much every thing else within 10 days , it would most definitely be my choice .i wouldn't opt for a vaginal delivery if I knew they were going to need instruments .
Had an ELCS:
- no trouble with stairs (we also lived in a townhouse).
- no problem breastfeeding: could have supplied the whole of the SW of England...
- drove after 4 weeks: could have done it after 3 weeks I think. Tiredness more of an issue that the scar.
Watch with walking (ie distances) - build it up slowly... (Pushing pram can be the difficult bit).
Do all the prep that you can (ie stock the freezer with repeatable meals etc) and get all the help you can (someone to help with the cleaning for a couple of months would be ideal). Try to do as little as possible for a couple if months.
Agree about the ELCS too! I have had both c/s and instrumental delivery and I was unable to walk properly for over 7 weeks with the latter but was up and around within the week with c/s. Good luck
I had a ventouse delivery with ds1 not because we was stuck, but to get him out quick as he was in distress. If it hadn't worked I'd have at an emergency cs.
The reason I say 'not because he was stuck' is that even with ventouse I still had to push hard when the midwife and ventouse registrar told me.
I am puzzzled as to how they think they can just 'pull' a baby out by ventouse without some pushing help - ds's head was sore enough after just a few mins of ventouse!
Regarding the townhouse, we were in a 2 storey house at the time and I didn't want to just be upstairs all the time after the elcs I had with ds2 (large transverse baby). So dp would take baby downstairs with moses basket for me in the morning, I'd have every thing there like changing stuff (I usually did all that upstairs, I am one of those who doens't like nappies changed in the living room ), and I had a little bag that I put all my bits and bobs in like pain releif pills, lip salve, phone etc and carried that about if I went into a different room. The only thing I needed to go upstairs for during the day was the loo. I had a throw for the settee if I needed a nap.
Had ventouse and forceps delivery with DS, it was brutal and because of it, I am going to elect for a c section next time. I would stick with plan A if I was you OP.
I had ventouse with DS1 (shoulder dystocia) and an ELCS with DS2. The recovery time was much faster with the ELCS than it was with the assisted delivery.
I loved my ELCS
Pretty unanimous verdict on the cs .
My DP would prefer that too and I guess at least we'll know what to expect recovery wise.
I've had quite a few operations in the past few years so I'm no stranger to post op pain and discomfort and I guess its better the devil you know.
Thank you so much for helping me out with this. It makes me feel reassured to know the cs makes more sense and I can put this across to friends and family.
I'd go ELCS, assuming you're not morbidly obese with severe reactions to anaesthetics and that the spinal anaesthetic is a safe option for you.
Epidurals have an accepted failure rate (1:10), you may arrive in such advanced labour it's too late for one, even if it takes the pain away it's not guaranteed to take the pushy/pressure sensation away. I had a fab epidural - I knew when I was fully dilated and boy could I not help pushing.
ELCS - delivery date known, you can plan in advance with freezer stocking etc, rope family members in to help if possible, DP can book time off work. You'll be in hospital at least 3 days & pain/mobility should be much improved after that.
(PS I'm a consultant anaesthetist too)
I didnt realise epi's have an accepted failure rate. V interesting.
Just to update - I spoke to my mw today and now have an extra appointment to see the obstetrician next week so I can ask her about it in more detail. Hopefully she'll be able to help me feel more secure in my decision.
But you still need to push even with ventouse, not sure about forceps.... Vbirth doesn't sound an attractive option for you based on what you have said.
As one poster above pointed out, there is no guarantee you wouldn't have a fast labour with no time for an epi. It may not work. It may wear off just as you get to transition. There are just too many unknowns I think.
Thanks for the replies.
I saw my consultant yesterday and she said that she doesn't think ventouse would be an option as it requires far too much pushing so if I did choose a normal birth it would be forceps. But she went on to say even that would need 3 big pushes from me and if the baby still wasn't out they'd swap to a cs.
The chances of a first baby being out after just 3 pushes are not very high so I'm going to opt for the ELCS. It seems rather futile to attempt a normal birth with forceps if they'll probably have to swap to a cs anyway.
I'm going to see her again at my next growth scan in a couple of weeks with my final decision, which will be ELCS, I'm sure now. And then she's going to write the birth plan in both my handheld and pink notes and book the date.
I'm not looking forward to the recovery but I can have DP here as long as I need him home so I guess I'm in a better position than some.
Thank you for all your input and advice .
I had an elcs due to intracranial hypertension 6 months ago. It was calm, quick and I can't speak highly enough of it! The anethisist wasn't happy about using a spinal block on me because of the condition and wanted me under general anaesthetic at first which I strongly didn't want, however he spoke to the anethisist above him who said it wouldn't be a problem, so I was fully awake with the spinal. It was fantastic.
Thanks gillian. My anethetist thinks the spinal will be safer on me than others as even if I get the leak it'll help more than hinder haha!
I'm glad yours went well .
Yes, that's what I thought, the first anethisist said he would be very wary about putting a needle in my spine because of it, but they are happy enough doing it when I needed the dreaded lumbar puncture!! It will all be fine, I have had an emergency section before under GA and recovery time was much slower. With a planned section, I had dd on the Friday morning, could shuffle about the bed that night, the next day got catheter out and was able to walk to bathroom and get showered and could get out of bed relatively easy enough. Got home the next day and DH had forgot to get food in so I made him drive me down to tesco and I got the shopping in lol. Was driving about 4 weeks later although felt ready much sooner.
Oh wow that sounds like a speedy recovery. Hopefully I'll recover just as quick .
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