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epidural increasing risk of having c-section?

(19 Posts)
greenandpleasant Sat 27-Sep-08 16:46:21

hello, hope you don't mind me posting - not pg but have had one baby, 17mo ago - now a friend has told me she is worried that having an epidural will increase risk of having a c-section - 7/10 epidurals leading to c-sections she thinks.

I had an epidural, it was great, but have not heard of this level of "risk" of c-section following epidural. has anyone else heard this? I want to reassure her but am out of touch with all things birth-related.
thanks

LadyOfWaffle Sat 27-Sep-08 16:47:31

I think there is a slight increase in risk as I think it can throw contractions. Not 7/10 though.

lulumama Sat 27-Sep-08 16:54:53

not got up to date stats, but an epidural does increase the chances of more intervention being needed, either due to immobility of the mother or the baby not rotating correctly due to the pelvic floor being too relaxed or a combination of those things.

also, it makes your birth automatically more medicalised..

she should check out the stats on instrumental and c.section births on birthchoice website

there are lots of pain relief options before epidural

findtheriver Sat 27-Sep-08 17:31:13

what lulumama says. The 7/10 thing sounds unlikely - way too high. But yes, and epidural makes the birth medicalised, and carries a higher risk of further interventions which include forceps/ventouse/caesarian

orangehead Sat 27-Sep-08 17:41:41

Yes heard thes at nct. I think it is more to do with the fact that with an epidural you end up on your back which is the worst way to give birth so tends to slow the labour down so you are more likely for further inventions

greenandpleasant Sat 27-Sep-08 18:07:53

ok thanks for this ladies ... all makes sense from what I remember, just the 7/10 stat is a bit hmm

Agree with all the above and would like to add that it can make effective pushing in a first labour difficult as there is no sensation. This doen't hold true if you have already pushed a baby out.

PeppermintPatty Sat 27-Sep-08 18:20:59

I read somewhere (I don't remember where but it was reliable) that an epidural DOESN'T increase the risk of CS, but DOES increase the risk of forceps/ventouse.

Pruners Sat 27-Sep-08 18:25:26

Message withdrawn

lulumama Sat 27-Sep-08 18:27:52

70 % of women having an epidural also having a c.section might not be that outrageous.

nationally, c.section rates are between 20 - 25 % anyway..

also, a proportion of those having epidurals might ahve other factors that would lead to increased likelihood of c.section anyway

so it might be correct, but a skewed figure IFYSWIM

greenandpleasant Sat 27-Sep-08 18:40:31

lulumama, that's what I thought - if you end up having an unplanned c-section then v likely that 7/10 times you will have been many other options including epidural. not the same as giving yourself a 7/10 chance of having a c-section because you've had an epidural.

thanks again.

artichokes Sat 27-Sep-08 18:42:49

I could not feel to push after my epi. I was told I would have to have a c-section as I was not pushing effectively. In fact they got DD out with forceps but MW said she sees loads of instrumental births and c-sections that are caused my poor maternal pushing thanks to epis.

PeppermintPatty Sat 27-Sep-08 19:01:43

Link to NICE guidance that suggusts an epidural doesn't increase risk of CS:

www.nice.org.uk/nicemedia/pdf/CG013fullguideline.pdf

It's a long documets but it's on page 45 (analgesia in childbirth)

greenandpleasant Sat 27-Sep-08 19:57:31

artichokes sad at "poor maternal pushing" - sounds like it's the mother's fault.

I must have been lucky as I couldn't feel to push but managed to get ds out by "pushing when it hurts" (no urge to push whatsoever!) and avoiding further interventions.

Mintpurple Sat 27-Sep-08 20:24:42

Greenandpleasant - I think you are absolutely right when you say that often a c/s is the end result of many interventions and circumstances, one of which is an epi. The lead up to this of course is often induction, malposition of the baby such as OP, not moving from the bed in labour etc.

From my own experience, I would say that having an epi does not increase the risk of a c/s but increases slightly the chance of an instrumental, but we use mobile epi in our unit, so most women can feel (and move) to push.

I do think if the epi is given later at >5cms, there is much less chance of intervention than if it is given early, so I often encourage a woman to have diamporphine early on in labour and an epi later if she really need analgesia.

About 60% of women on our labour ward have epidurals, and my c/s rate last year was less than 10%, and instrumental rate about 15%, with the vast majority of my clients having a first baby.

Tittybangbang Sat 27-Sep-08 21:46:04

Mintpurple - I get the feeling from reading your posts here that you are a fantastic midwife. Do you ever suspect that you get better outcomes than other midwives on your unit?

You don't have to be modest now! grin

Mintpurple Sun 28-Sep-08 07:20:03

blush Sorry I dont mean to come across like that, but I do get better stats than most of my colleagues because I truly believe that most women can birth a baby vaginally and my role as a midwife is to facilitate that happening, not set her up for failure or a c/s.

If I can achieve that by being passionate about midwifery and using what I believe to be good, research based practice methods, there is no excuse why all midwives cant get the same results.

There is nothing 'magic' about what I do, but Ive been helping deliver babies for nearly 25 years and you do develop good skills and a sixth sense after a while.

Often I post things (or anecdotes) to illustrate a point or to provide education about a certain topic as I enjoy teaching, and with such a long career in (mostly) labour wards, I have seen pretty much everything you can see happening, good and bad.

xx

lulumama Sun 28-Sep-08 08:26:53

no harm in honking your own horn ! i think you are amaaaazing and hear from another doula that you really are as fantastic as you come across here. smile

Tittybangbang Sun 28-Sep-08 09:36:25

No - I wasn't being sarcastic.

I wish there was a 'sincere' emoticon we could use to convey that we're not having a dig! grin

It's good to hear you say you use research based practice methods - I wish all midwives did (not saying there's no place for instinct though - oh, you know what I mean!). I was talking to my friend yesterday who's just completed her midwifery training. I get the feeling her tongue has got big holes in it from having to be bitten on a daily basis during her training. She said she saw so much poor, non-evidence based practice. She was a qualified bf counsellor before she started training and I think her experience on the postnatal wards as a trainee was particularly scorching!

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