Failed epidural during C section - how rare is this and has it happened to any of you?

obs anaesth PoV... it's not that common, but not unheard of either. Epidurals can be a bit more unpredictable than spinals, but if one's worked well during labour then that usually means it should top-up well. The block should be well tested before starting surgery and obviously they shouldn't proceed until the testing looks good, however, just occasionally epidural don't behave quite like we'd expect. It can happen with spinals too, although is a bit less likely. It sounds like they did the right things by pausing, topping-up further, offering a GA. There is a limit to how much you can top-up an epidural without causing increased risk (of local anaesthetic toxicity, or the block getting too high, but still not dense enough where you need it). Doing a spinal on-top of an epidural that's worked well in labour/has already been topped-up a bit can also be a bit hairier, but can be an option. For most women, doing a GA is higher risk than both epidural and spinal so it's sensible to try and avoid that where possible, but if the alternative(s) have failed then it's the only remaining option. The anaesthetic decision making isn't always super-straightforward in obstetrics!

If someone's experiencing pain intraoperatively then the management depends a bit on where the surgeons are up to in the operation - if it's right at the start/baby's not out yet and an epidural's been topped-up as far as safely possible the GA is the only option really. If it's right towards the end, then sometimes a bit of IV pain relief +/- local anaesthetic by the surgeons and a bit of gas and air to breathe will do the trick, but GA remains the back-up plan. Sedation is not usually an appropriate option in obstetrics.

OP if you have questions/ want to chat to an anaesthetist then most units should be able to arrange an anaesthetic debrief appointment/planning for a next delivery (if/when you're ready). Having had one disappointing top-up doesn't necessarily mean it would be a problem again, but they'd be able to give you a better idea based on the exact details of what happened this time/ what the best plan of action might be for different scenarios in the future.

I had an epidural for my first for ventouse with possible c section and it only took on one side. I have since been diagnosed with Ehlers-Danlos which means risk of local anaesthetic not working is much higher.

I have had many things done on the NHS recently and am now at the stage they will agree to use deep sedation as the jabs on their own are often not enough. It's also common in people who are hypermobile and redheads too apparently.

Sorry you didn't get to meet your LO, if it's any consolation I'd been in labour for 38 hours by the time DS was born and was so unwell I turned over and left DH to him so they could work on me and I could try and rest. I came to terms with that quite quickly.

Hope you recover well

Hi, I had a similar experience (in my case I started experiencing pain after my baby was out, while they were trying to sort out a haemorrhage). They offered to put me under general anaesthetic but I declined so they paused the surgery while they upped the medication. They were able to get me up to the right dose and finish off. However due to these issues I didn't feel comfortable to hold my baby as I was in pain and shaking/panicking so I was only given her when being taken to recovery which was tough.

It was awful and unexpected. My understanding is that it is more common in C-sections done under topped up epidural rather than a spinal block. If I was to have another C-section I would specifically request a spinal block as I wouldn't feel comfortable to have it under epidural again.

I will say when you feel ready, you may benefit from a birth debrief (ask your midwife) to help you to make sense of it a little.

It happened to me but I don’t know how common it is, sorry! From others in a similar boat I’ve spoken to, the pain of not seeing them enter the world doesn’t go completely but it fades slightly. I’m still in the raw phase and we ended up in the NICU as well and not knowing which baby was mine still haunts me but I hope one day I can do it again. Sorry if that’s not what you want to hear but I found there aren’t many of us in this boat. Wishing you luck 💐