Labour before planned C-Section & Spinal fusions

[Number3cometome]

Hi ladies, two separate questions here.

I am only 9+2 so this is a theoretical question for next year!

I have had 2 C-Sections already and currently pregnant with DC3

DC1 was an emergency section under general anaesthetic, DC2 was a planned section with a spinal block (at the time had back issues and couldn't have an epidural).

I was almost certain that I was going to go in to labour very soon with DC2 - I had my section at 38 weeks and was already experiencing very strong Braxton hicks the day of my C-section.

I am worrying this time because I will be booked in for a C-Section - but what if baby comes early? What will happen?

Also as I now have a full lumbar spinal fusion, will they even be able to do the section under a spinal block (defo cannot have epidural?) or will this be a general anaesthetic again? (I hope not!)

Any advice would be greatly appreciated.

VBAC is not an option here.

[Number3cometome]

Bump

[smogsville]

Watching with interest as I'm also booked for a (second) planned section (neurological condition) and while hospital isn't miles away, it's not the local one either. Apparently ambulance (which can obviously get you there quicker than a taxi) will only take you to the nearest maternity unit rather than the one you want to go to.

My plan is to start mat leave early and basically lie very still with my legs crossed for a few weeks( with a 3yo - hmm).

I asked obstetrician and she said if you feel something happening just come and in and we'll do you straightaway.

[ladybunnikins]

Obstetric anaesthetist here, your midwife or obstetrician should refer you to see an anaesthetist during the pregnancy due to the spinal fusion. A spinal might still be possible but they might not be able to get it in or it might not work so there would always be the back up plan available to do a general anaesthetic.

[Foxeym]

Hi my daughter has has spinal fusion and was told at the time any babies she had in future would need to be CS under general as a spinal/epidural would be too chancey but it might depend on each persons situation

[Number3cometome]

Oh fuck, I really don't want a general again.

I am the only person I know who has missed my own child's birth!
Don't want to have that again, and you feel so groggy and shit after.

Wondering if they can hypnotise me or something

[Number3cometome]

(Obviously the hypnoses bit was a joke) baby's safety comes first of course x

[Number3cometome]

Mine is an L2-S1 fusion with a total disc replacement.

It is a mess to be fair, this will be C-section 3 so VBAC out the window (don't want one anyway as I had seizures in labour with DC1)

What will happen if I go in to labour early?

DD was a planned section at 38 weeks so assuming this will be the same.

Why do I have to be so confusing haha

[ladybunnikins]

If you go into labour early you will probably have a caesarean, unless the baby's head is so low it's almost out.

[pocketsized]

I am currently 25 weeks and have had lots of back surgery etc. At my 12 week scan I was seen by the consultant (refered by the midwife at booking appt) who refered me on to the anaesthetist, they requested all my x-rats, scan, surgical notes etc and then had me back again. They have decided for me (slightly different situation to you) that epidural is a no go, spinal is worth a try as long as it's not a mega emergency, but that I should be prepared for a GA if a) the spinal doesn't work or b) they have concerns about the amount of time it might take as it's likely to be more difficult on me. But - I am getting distracted, my main point was that the hospital have been fab, the consultant anaesthetist spent a lot of time answering my questions (even 'silly' ones) and I feel a lot less anxious now than I did. I am sure with your history the midwife will refer you on. Good luck!

[Number3cometome]

Thank you ladies! I have an appointment on the 3rd of February to see a consultant so hoping they will refer. Wasn't sure if it was worth seeing my ortho surgeon as my fusion is only 2 years old x

[TallGiraffes]

Hi number3

I asked my consultant last time what happened if I went into labour early, before my CS. She said that our hospital had a whiteboard of names for the "tricky patients" for who needed to be called in that circumstance. For me it was because I needed two different teams to be present so they were going to have to be called in from another hospital. She said the whiteboard was non-negotiable so no-one would try and say "go on give labour a go" when it could have killed me.

[SilverStars]

Hi for medical reasons I ended up needing a general for my EMCS. I knew if needed a section it would have to be general so that helped me accept it, but not mean like it. They took photos for me in recovery room.

[smogsville]

OP I had a general and will be again. It was marvellous. They put you to sleep and then you're presented with your baby. No mess, no fuss, professionals in charge the whole time. Provided I can get to my booked date without baby making an early break for it of course!

[Number3cometome]

TallGiraffes hello!! Nice to see you.

Oh thank goodness for that, I was having a worry. I had seizures in labour before, have high blood pressure, have had 2 c-sections already and a spinal fusion, so labour is not ideal for me haha!
I was worrying they would say go and do it!
Considering my last labour was 30 hours, I am not too concerned I will go into labour and give birth at home and hospital is only 10 mins away!

Silver With my general they didn't take any pictures, I was in Intensive care and had no recollection of anything, it was almost like it wasn't me who gave birth. I want my partner to be present but don't think it is allowed with a general? I also worry about the risks to baby.

smogs I wish it was like that last time, maybe because it was an emergency? I do actually love the feeling of being put to sleep (i know, weirdo right?) but it worries me that something will happen or I will miss something.

[noitsachicken]

Hi,
I have spinal damage, fracture to L1, various surgeries and fusion, but no metalwork in there now.
First baby ended up with EMCS under GA, section was due to fetal distress, but had GA because they didn't think epidural would work and no time to muck about.
I am pg again and having a ELCS booked for 39 weeks (two weeks time!)
I saw an anaesthetist who looked at my scans/records etc and is confident a spinal would work, but if not then a GA is still a possibility. I have said I would rather try for a VBAC then have a GA. But fingers crossed the spinal works!
Good luck, the baby has to come out some how! I know a GA is not ideal, but still safe for both of you.

[Number3cometome]

Chicken

Ooh not long!! You must let me know how you get on.

So they are allowing you to have VBAC after 2 sections?

My spinal fusion was anterior / posterior so I have scar tissue in my stomach and back, the c-section scar joins the anterior scar so it's a mess really. I guess it needs a good looking at.
Here's a pic - metalwork all still in x

[ladybunnikins]

An elective GA caesarean would be very different to your last one, presumably the intensive care unit was because of the seizures or maybe a haemorrhage.
Partner can't usually be in theatre once you're asleep but they might let them stay until you go to sleep.
Ask about TAP blocks - local anaesthetic nerve blocks into the muscles of your abdominal wall which are done while you are asleep and can reduce the amount of morphine you need.
Re: risks of GA: this leaflet gives the risks of general anaesthesia to you. For the baby, the anaesthetic does cross the placenta so they can be a bit sleepy initially, especially if it takes a while to get the baby out (due to scar tissue from previous operations), so they will have a paediatric doctor in theatre.

[SilverStars]

Hi, no dh not allowed in the theatre with a GA. but he was allowed to it very near outside, baby was checked and given to him ASAP for short skin to skin ( a midwife took photo) and that was first photo we got. Then the anaesthetist kindly took pictures of baby on me ( he got skin to skin even though I was not aware) etc.

[Number3cometome]

It makes me feel teary thinking about it. But as I sit here typing my nearly 12 year old son who I very nearly lost is making me see that safety comes first!

It's was due to seizures, it was horrid.

[noitsachicken]

No I have only had one section so far!
I will try to remember to come back and update you!

I have pics like that somewhere, I also have a bag of nuts and bolts they removed from me!

[Number3cometome]

I think I'm keeping mine inside haha

[smogsville]

Number3 I too love that feeling! Thought I was the only weird one.

DH had DD for about an hour by himself in a special little room next to theatre as she came out pronto and then they had to sort me out, give me time to come around. Tbh I thought that was quite special for him really as she'd been in my tummy for 9 months. My mum was virtually banging the door down trying to get at DD but not allowed as a sterile environment! Then DH didn't let anyone hold DD before me.

Getting quite emosh just thinking about it (get a grip woman...).

[smogsville]

There are some lovely pics of him holding her too he looks slightly bewildered and overwhelmed which is as it should be really.

Oh and I EBF her for nearly a year, so none of the bonding problems people talk about with sections.

[Number3cometome]

Smog thanks for the reassurance - I agree it is good for baby to bond with Daddy. This is OH's first so it will be nice for him.

I did B/f my other two, DC1 was pretty tough but once we got established it was fine, no problem with DC2, I had her straight to my skin.

Hopefully will be the same this time!

I really appreciate all of your advice, I will of course see a consultant soon so we can discuss al this.

[GreatJoanUmber]

Hi Number3,

My number 3 is now almost a year (in January!) and he too was a scheduled caesarean.
I can't advise on your spinal issue - the standard procedure with ELCS is to do a spinal block, not epidural. I had a crash caesarean with my second, under general, and I really hated not "being there" and only seeing him an hour later and being too weak to hold him etc, so I can see why you'd want to avoid that!
As for going into labour earlier, they will probably just ask you to come in straight away and perform a caesarean, only it would then be classed "emergency" rather than "elective", purely because it wasn't booked in in advance.
The standard these days is to perform ELCS at 39weeks unless there is a medical reason to take baby early, due to the risk of respiratory illnesses in earlier babies. So you might need to fight if you want the ELCS at 38 weeks.
Best make a list of questions to take to your consultant appointment, so you won't forget anything!