Epidurals

[RayeB]

Hi

I had a bad first labour with my DD, and this time I have decided I'd like an epidural early on before trying pethedine etc (which didn't do anything for me). Does anyone know how far dilated you need to be before you can have it, and what happens when you can't feel that you are ready to push - do the midwives just keep checking you and then tell you when to push?

Thanks.

I cant tell you when you get one I will guess I was about 6 to 8cm?! Sorry I was on a lot of drugs by then! But the epidural I had was one that enabled you to still feel pushing. I had it on the "lowest setting" and the nice man came and turned it up a bit I think that was right same as I said I had drugs! But I could still feel everything just not pain and yes the midwife tells you when to push mine was great she was so supportive I also had a trainee as well she was fab.

You can have it quite early (I had a very traumatic birth last time and the consultant suggested I have an early epidural this time)... but from my reading/questions to docs it can slow the labour down and make intervention more likely (not wanting to scare you) although this risk goes down very significantly for a second birth.

I had an epidural last time. It was supposed to be a 'walking epidural' where you can still move about and feel contractions etc... but I couldn't walk or feel the contractions (although the midwife told me when to push so that worked fine) which I don't want to happen this time (I want to be able to feel more!).

One thing that I have learnt from that experience is to try and make the decision to have one slightly earlier rather than later in case you are waiting some time as they have lots of emergencies. In my case it would have been better if I had it the epidural late afternoon/early evening rather than waiting until late at night when they were invariably very busy (but of course I am aware that you can't plan these things most of the time!)

However, I didn't actually dilate last time until I had the epidural and relaxed (a particularly tough early induction) so for me the epidural was a godsend despite the lack of mobility etc. My recovery was super quick too and I had no aftereffects at all. It also made the actual birth as serene as possible.

I've had it written into my birth plan by the consultant midwife that i can have an epidural as soon as i am in active labour this time.

I've had to get the consultant midwife involved because last time i begged for an epidural but no aneasthatist was available and once you get to 9cm they won't give you one anyway.

I've been told that active labour is when you are at least 4cm dilated. apparently if i beg for one before then i may get one but they prefer to make sure that your labour is well established.

Can you speak to the head midwife at the hospital and get her to write in your notes about wanting the epidural asap?

I've been told i was just unlucky last time but I don't want to have to try and convince a midwife mid contraction that no i don't want to bounce on a ball/get into the birthing pool, I just want the drugs! I've been assured that because my request has been signed off by the consultant midwife(and because of a previous traumatic birth) I should be able to get the epidural as soon as i get to 4cms.

As far as i know you are told when to push which will be a little odd! But nice because it will be pain free!

As far as making interventions more likey, well I laboured last time on just gas and air and still had to have a ventouse to get him out, then a retained placenta, syntocinon drip which put me back into agonising labour even though ds had been born (hmm) massive pph and manual removal of placenta in theatre where i finally got a spinal block!

So I think I'll take my chances with the epidural this time

Sympathy to IThinkNot - I also had an episiotomy and ventouse on just gas and air!!!

After chat with MW on tour of labour ward last night 4cm + is the norm, up to 3cm you can stop contracting (false labour). In some case they do give them early but if your contractions slow down then, you have to have the drip to speed it up and if that fails a whole host of interventions is unveiled.

I'm on baby No3, I had two straight forward, gas and air births no stitches, in 7 and 6 hours (this maybe quick but it's still 6/7 hours of pain, which is knackering). However that was 15 & 16 years ago and now my feeling is if I have a headache I take a pill so when labour starts this time, it's no endurance test, it's water birth if I can manage and if it starts to get too much give me the the hard stuff, no half measures, the end result will be the same just without the pain, happy mum = happy baby IMHO

I told them very early on that I wanted an epidural so no one was in any doubt about what I wanted! Every time a new midwife came on shift I reiterated what I wanted!

When it comes to pushing they talk you through it. They told me when to push and how to push and when to stop and when to take a deep breathe etc.

Don't know how far dilated I was - roughly 6 or 7 cms.

First time I think I was about 6cm I could still feel when to push and was only fully numb on one side, this time I was failing to dilate after leaking hind waters and broken front waters so had it at 1cm just before they gave me the syntocinon drip (I was clear I wanted the epi before the drip having done it the other way around last time!) They put me on the lowest dose and I could feel when I went through transition and my contractions changed and felt when to push, my epi actually ran out during pushing but was still partilally numbing me, although I needed a local for my episiotomy (ds had a big head!)I'd recommend them though, they worked well for me!

Thanks for all your messages - really really helpful. I'll get it put in my birthplan and speak to my MW next week when I'm due to see her. Feel much more positive about it all now.

you are allowed it from 3cm at the v earliest. i had one @ 3cm for my first as it had taken ages to get to 3cm and they were putting synto drip in at that point so got it at the same time

I wanted one but didn't get- arrived at hospital at 8cm and had a high temperature. All they would give me was gas and air, which they took away for the pushing bit . Thankfully they gave it back for the stitches which I could still feel after 3 locals (one before episiotomy and 2 after). It was pretty rough at the time. Next time I won't fanny about at home so long- was scared of being turned away if I wasn't far enough on.

I think its normal from active labour (4cm and regular contractions) however it depends on individual circumstances, for example if you are being induced with the drip they may give it earlier.