Epidural Questions (Position and Amount?)

[planner26]

Hi,

I had a couple of questions about epidurals, at it seems DC1 is back to back and I might end up needing one...

1. Can I lie on my side with a pillow between my calves? I have SPD and this position is great for me (also not as restrictive for labouring/ birthing?)

1. Can I request that the epidural is 'turned down' or that I'm not giving as much of a dose as I get to 10cm so that I can at least have a go at 'feeling' some sort or sensation to help me push?

Thanks a lot for your help

hi,

i don't think i'm the best person to answer this - hopefully someone more knowledgeable will be along in a minute. but i did have an epidural with dc1 7 weeks ago, so maybe i can help a bit!
i don't see why you couldn't lie on your side - with my epidural i was still quite mobile and could stand, kneel and even walk a bit. you will have continuous monitoring, but i didn't find the belts restricted my movements. you do still have feeling, just no pain. i had some acupuncture when the epidural was up and i could still feel the needles in my legs.
yes, you can request that the epidural isn't topped up after the first dose starts to wear off, or you can request half a dose. i did this when i was approaching 10cm. when i was at the pushing stage the epidural had worn off. tbh i was so confused and out of it that i had no idea what was going on and wasn't sure when i was supposed to be pushing - don't know if that was the epidural, but i know i would have been in a far worse and less capable state without one. i found that the data from the monitoring really helped me - i could look at the trace on the machine, see when i was contracting and push then. and the mws were really good - putting their hands on my tummy and confirming that i was having a contraction.

good luck!!

oh and i had spd and they were great about helping me - make sure it is in your notes, on your birth plan and that everyone knows! i had a piece of ribbon with me the distance the physio said i could safely open my legs - much better than trying to find a tape measure/ruler or guessing!

Not sure about the position thing but I think as you get nearer to 10cm they can just not top it up. They let mine cool off so to speak but DD in awkward position and weren't sure if I'd need forceps or emergency section and plus it hurt like hell so they cranked it up for me. But if you want to feel when to push I think you can.

It's not giving a constant dose. It is up to you to top it up (or, in some older set ups, they top it up for you) so, yes, you can let it waer off. However, with an OP baby I found that I was in too much pain lying down to allow it to do so. I wasn't at all mobile and was in a lot of pain if I didn't have it fully cranked.

It is worth discussing this with your midwives I think.

Planner 26, there's a bit of evidence that being upright (properly upright i.e. sitting on your heels)when you actually give birth - reduces the incidence of problems delivering the baby with epidural.(There's also a big studygoing on about this). You have to be a bit careful asking for the epidural to be turned down because there is no certain way of predicting when the baby will arrive so you can end up at the most painful stage of labour (seriously ouch) without pain relief and still find the baby does not arrive for a couple of hours (not nice!). There is no evidence that turning the epi off improves your chances of a straightforward birth - it is in the NICE guideline if you look on their website.

Check with your hospital about the type they offer.

When I had DC1 I had the old style epidural which meant I could feel nothing (which was frankly the best thing ever after nothing doing for fifteen pigging hours).

DC2 was born in a different hospital and I was very unpleasantly surprised when the epidural was administered. Basically, my thoughts went: What's with this mobile shit? I can still feel people. I want the completely-imobilised-paralysed-from-the-waist-down stuff, none of this "let it wear off" bullshit, thank you.

Seriously, it's worth checking.

Had OP baby and "mobile" epidural.

They'll presumably be trying to get the baby to turn during labour. Lying on left side is supposed to be good for this - so yes, they will probably recommend that. I spent several hours lying like that. All 4s also good.

Mobile epidural - the kind where you can feel legs and move around - was brilliant. Sure I would have ended up with emcs otherwise (was v close anyway). I let it wear off once fully dilated so could feel when and how to push.

Annoyingly only full paralysing epidurals available at hospital where would be having next baby. Strongly motivated to avoid that, so planning homebirth.

You may be able to persuade baby to turn before labour eg by spending time on all fours whenever baby is active. I'm a bit paranoid about the possibility of another back to back labour, so am doing that a lot. And in early labour this time I certainly won't be letting anyone recommend me to lie on my back in a nice warm bath... It'll be hands and knees or birthball from kick off.

Check if your hospital can do a mobile epidural - then you don't need to worry about dosing. I had a mobile epidural with DS, could get up and walk around, go to loo by myself, etc, and could feel all the contractions and push with them, just couldn't feel any pain. I think I topped myself up when fully dilated and had a small nap before pushing - it didn't prevent feeling the contractions to push. Also, I lay on my left side when it came time to push, so it is possible even with epidural and if you are being monitored - someone just needs to hold your calf up in the air (I am serious) as baby won't come out if you have knees together with pillow between them... DS came out after 20 minutes of pushing, no episiotomy or any kind of intervention, very easy and relaxed birth.

Thanks for your advice - unfortunately my midwife says that 'mobile epidurals don't exist' and they are a myth in books as that was my first thought....hmmm.

pinkpeony hope I get as lucky as you!

Thinking if I end up down the epidural road and can take a bit of pain (in turn have a bit of feeling) I will just ask them to start me on low doses and see what happens.

Just need baby to hurry up now!