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Anyone had a failed spinal for their first baby?

(25 Posts)
MrsBlue4 Sat 23-May-20 17:08:57

I had to have an emergency caesarean section under general anesthesia with my first pregnancy due to baby being in distress. I'm due to have my second in a few weeks and have a planned section booked. I really don't want the spinal to fail again and have to be put asleep this time. The anaesthetist said they obviously don't know if it will work this time but I was wondering if anyone else has been in this position and went on to have a normal spinal where they were awake. I did have a spinal injury years before my first which could have been a factor but equally it may have been due to time as they needed baby to get out quickly.

Anaesthetist83 Sat 23-May-20 18:34:07

As an anaesthetist, it is uncommon for a spinal to fail. It is more common for this to happen in a time pressured, emergency situation. An elective section is a completely different experience. Have you had a debrief in an obstetric anaesthetic clinic with a plan made for this pregnancy? If not, I would ask your obstetric team to refer you.

Mummyspider27 Sat 23-May-20 18:36:45

Can I just ask the effect of a general anaesthetic on the baby? I might have to have one for my section and I wondered what normally happens to the baby? Xx

Gerdticker Sat 23-May-20 19:33:35

@Anaesthetist83

Hello - apologies for stumbling in on this thread, would it be possible to message you a very quick question regards anaesthesia? Thank you x

MrsBlue4 Sat 23-May-20 19:40:11

@Anaesthetist83 I had a chat over the phone with the anaesthetist and he did say that it is a completely different experience with a planned section. I'm just a bit anxious it will happen again but hopefully not. Thank you for replying.

Anaesthetist83 Sat 23-May-20 20:20:33

That’s ok.

@Gerdticker - I’ve just seen and replied to your message

@Mummyspider27 GA effect - the effects somewhat depend upon the need for the GA and therefore the type of drugs needed.

Most anaesthetic drugs do cross the placenta to some extent, so it is not unusual for the baby to be born a bit sleepy and may potentially need a little support from the neonatal team, but this is usually short lived. The neonatal team will be present for a GA section for this reason.

The time between GA and delivery is very quick, and as far as possible, opiates (morphine related drugs) are given after the baby is born. The exception to this is where there is a need for really careful management of blood pressure - because of extreme hypertension or because of perhaps an underlying neurological vascular problem where risk of bleed. In these cases, the opiate is given before the baby is delivered, so there is a greater risk of very short lived breathing problems. Again, the neonatal team are on standby and able to intervene should this be a problem.

GA for c section is really very safe. We deliver most babies under a spinal because that’s generally preferred by women (less nausea, vomiting, drowsiness, bonding, experience, partner presence) and there is a marginally reduced risk of very rare aspiration problems, airway problems and bleeding compared to a general anaesthetic technique - but we are still talking an extremely safe technique. For some people, regional isn’t an option and I would like to reassure you that a GA can still be a really good experience with good outcomes for both mums and babies.

Wolfgirrl Sat 23-May-20 20:50:01

Sorry to jump on your thread OP but just wanted to ask a @anaesthetist83 a similarish question - my epidural failed in first labour, as in I could feel everything. There wasnt time for another. Could this happen again? Why would they fail? Thanks very much.

Mummyspider27 Sat 23-May-20 20:58:16

@Anaesthetist83 thank you so much xx

Anaesthetist83 Sat 23-May-20 21:04:05

Hi,

The epidural catheter needs to be in a specific tissue plane in the back called the epidural space. This is located by slowly advancing the needle whilst pressing a fluid filled syringe. There is a sudden loss of resistance, which usually indicates the epidural space. The thin plastic catheter is then threaded into this space, before removing the needle. It’s a blind technique essentially.

Reasons for failure:
- epidural catheter not ending up in the epidural space therefore the local anaesthetic isn’t surrounding the nerves so doesn’t work ... generally no numbness at all
- partial blocks - the epidural space isn’t really a space. It is full of fat, fibrous tissue, vessels as well as the nerve roots. Everyone is slightly different and I think there are probably some people for whom the local anaesthetic “can’t flow” and spread throughout therefore can sometimes lead to missing patches or a block on one side only for example.

If it was the first reason, you were possibly just unlucky, and a repeat epidural may well have worked perfectly. If it is the second, it may just unfortunately be your back - it could still work really well, or not.

I think there is also something to say about the experience of the person putting the epidural in and managing the epidural - it is certainly true that the more you do, the better they seem to be (to a certain point) overall. Early recognition of an epidural that isn’t working as expected by the anaesthetist allows more time to try and either reinsert it, tweak it, or abandon and try something else. Again, experience helps with this

FirstTimeBumps Sat 23-May-20 21:07:44

I'm awaiting a reflections type thing later in this pregnant to discuss my options. I had issues with the spinal during an EMCS although unsure if it's classes as failed. I think it worked to some extent but not as it should. I got through on gas and air with the anaesthetist asking me repeatedly if I wanted to go to sleep and declining. This is a worry for me if I end up with a repeat EMCS. I'm aiming for a VBAC hopefully but it does worry me if the same happened again and they insisted on putting me under this time. I felt like I missed out on the initial bonding experience as I was high as a kite (I'm actually convinced I had something more than G&A as I was away with the fairies) and then shaking and feeling sick, my LB ended up doing skin to skin with my partner instead because I just was not in a position to hold him. I feel like it would be even worse if I was put under GA.

Did they give you any indication as to why it failed and chances as a percentage of it failing again?

Anaesthetist83 Sat 23-May-20 21:18:16

I think there is also a difference in how people perceive the sensations that still occur despite a spinal. This isn’t necessarily a failure of the spinal, but brains interpretation of pulling and stretching which seems to vary person to person. It is good that you will have the opportunity to discuss this although hopefully you will have a successful VBAC

Someonesayroadtrip Sat 23-May-20 21:34:24

I've had "issues". I had an epidural with my first. The first one didn't work, which isn't that unusual I don't think, but they redid it and I had a weird patch that was numb. One side but not the whole side, was odd, and they didn't tell me I needed to keep pressing it so they it just didn't work anyway.

Second was a c section is spinal. Worked ok for awhile, then I got a blinding pain, like burning, it was extreme. They were stitching I think at this point so I had loads of drugs and was high as a kite and got through it.

Third time, this was explained and they Saudis it was highly unlikely it would happen again, however much sooner this time it happened again. They said about general but just kept giving me drive which helped loads, the anaesthetist told the surgeons to pick up the pace, I really didn't want a general but really it was hell. I found it quite traumatising after, back in recovery in loads of pain. They said something about metabolising the anaesthetic too quickly.

I have major issue with detail anaesthesia too. I'm just a bit weird I think. I've had anaesthetic work a couple of times too, but mostly it doesn't and it's difficult as people don't believe you. Not the anaesthetist, they were lovely and they an see my heart rate rocket obviously but the dentist will say, but you have had plenty of it, your fine.

I think it's really really unusual to be like me though, never really found out why. They did say to me it's highly unusual and is very unlikely to happen again.

Wolfgirrl Sat 23-May-20 21:42:42

@Anaesthetist83 thank you very much for taking the time to answer! Very useful to know.

Kezmum14 Sat 23-May-20 21:50:31

I had to have a GA with my third baby as they couldn’t find his heartbeat. They did put a spinal in but it wasn’t working fast enough and they needed to get the baby out. We got pregnant quite soon after ds was born and my third section was also an emergency but not due to the baby being in distress (my scar was tender according to the consultant who really pressed down on it 🙄) anyway they spinal was fine as they didn’t have to rush to get baby out. It didn’t take long at all to work and c section went smoothly smile

jinglebell123 Sat 23-May-20 21:51:32

@MrsBlue4 me! First birth was identical circumstances to yours so I had the same fears for second time. I had an elective section for my second about 2 months ago and it was a dream. There were no problems at all in getting the spinal to work.

All of the medical people I spoke to along the way reassured me that it would almost certainly be fine because they had so much more time, and it was. I don't have any spinal injuries so can't advise on that but please be assured that it is very possible that it'll work fine this time!

ChipsAreLife Sat 23-May-20 21:52:30

My experience may reassure you. It took three attempts for my epidural to work with my first.

Second I had an ELCS and the spinal worked straight away. The only trouble I had was it made me really sick.

Currently expecting third and will have the spinal again and just make sure DH has the basin ready 😅 good luck!

MrsBlue4 Sat 23-May-20 21:58:24

@jinglebell123 Thank you for sharing. I'm sure you'll understand my anxiety around this. Waking up groggy and seeing baby with daddy before you realise what planet you're on isn't what you imagine for your first birth 😅 Hopefully as you say it will work this time.

MrsBlue4 Sat 23-May-20 22:01:13

@ChipsAreLife Thank you for sharing. That is reassuring. I think I'll have to give my DH the same advice if he is in the room this time 😅

MrsBlue4 Sat 23-May-20 22:04:16

@FirstTimeBumps I did feel with the GA I did miss out on that initial bonding etc. But ultimately all that mattered was that baby was delivered safely. In saying that I would like to be conscious this time and here then saying it's a....

No indication of the percentage of it happening again this time. I had a car accident and broke my spine about 5 years before this but again they couldn't say whether this was definitely the reason it didn't work. It was all rather rushed at the time though due to concern with baby so hopeful with time and a more relaxed atmosphere it will work.

MrsBlue4 Sat 23-May-20 22:05:05

* hear them

FirstTimeBumps Sat 23-May-20 22:07:24

@Anaesthetist83 thank you for replying. I assume if it was down to the way my brain perceived the sensation that it would almost certainly be the same if I was to require a repeat section? Kind of hoping it was down to it not working properly now 🤣😭

SinkGirl Sat 23-May-20 22:10:37

My spinal didn’t fail but it was very difficult for them to get it sited. I have tokophobia so pushed for an elective CS but then needed an emergency one - I am also utterly terrified of needles but as I was having twins they would have wanted me to have an epidural anyway.

They could not get the spinal in - it took 7 goes and I was absolutely hysterical by the end. They offered me a GA but I didn’t want DH to miss the birth. A few of the attempts went wrong somehow where it felt like my leg was being torn off.

I think the problem is that they rarely tell you what happened and why. All they told me is the needles kept bending, and asked if I did Pilates (ha, no).

I want to ttc again but I can’t do it - I couldn’t go through that again and stlll terrified of vaginal birth so out of options really since I don’t know why it happened or whether it would happen again.

I know people have experienced far worse so it sounds silly but it really traumatised me - I’ve seen people say they don’t hurt at all but even the multiple locals were awful.

I hope things go really well for you this time - I think you’re really brave flowers

Anaesthetist83 Sat 23-May-20 22:11:37

It’s hard to know to be honest - but a discussion with the anaesthetist (particularly if they have access to your notes from last time) should be able to provide more info. Emergency sections are always different to elective which are almost always a positive experience so I wouldn’t worry too much about this.

ScrimpshawTheSecond Sat 23-May-20 22:12:03

I had an emergency c-section for my first baby. It was the weekend, and the anaesthetist seemed fairly inexperienced. I was labouring away and getting the needle in was so difficult. He took - as far as I recall - eight goes to try and give me an epidural. They all failed until the last one. Horrible experience.

Anyway, my second was called an elective c-section, so although I was in labour it wasn't advanced and the contrations were mild. It was SO much easier to get the anaesthetic in, first time, a spinal block. smooth as anything. A female anaesthetist, too, she was amazing. So it was an utterly different experience, night and day. The team were very much more respectful, partly as they knew I'd had a hard time with the first. It was actually a lovely birth, although not what I'd planned!

I also had music playing and immediate skin to skin - they were as accommodating as they coudl be considering it was a surgical procedure - have a wee look at 'gentle c-s' if you like.

Wishing you all the best with your pregnancy and delivery, OP.

MrsBlue4 Sat 23-May-20 22:30:48

Thank you all for sharing your experiences and your well wishes flowers

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