Childbirth after a previous post dural puncture headache.

[dramajustfollowsme]

I'm not pregnant yet but are trying. When I had dd, I ended up with a post dural puncture headache. It was VERY debilitating. I couldn't even sit up for a couple of weeks without throwing up. I was scared to walk and carry dd as I got so dizzy and had double vision. I ended up being readmitted for a second blood patch.
I'm worrying about my options if and when we have another. I'd like to just birth normally but worry that if things didn't progress they would want to give me a section. I never want another epidural because it was so awful afterwards. Would I therefore have to be put under general anaesthetic if it came to a section?

You'll have an aneasthetic consultation during pregnancy - good time to discuss other pain relief eg remifentanil PCA for labour. I think the risks of a PDPH are likely to be lower with the one off spinal block that could be used for an EMCS. But, thinking positively, if you laboured and birthed normally the first time, even with an epidural, chances are you'll be pretty quick this time. Hypnobirthing techniques may be a good idea?

I don't know how widely available this is but one of my friends here in Stockholm had pain relief injected in through her lower abdomen. It took the edge off the contractions. It's something I'm going to look into some more myself. Acupuncture is also popular here.

Dural puncture headache is generally caused by epidural rather than spinal anaesthetic. This is because the epidural needle is much wider bore so if it accidentally goes through the epidural space into the spinal space it causes CSF to leak into epidural space causing the headache. If you needed a section this time & didn't have an epidural they would do a spinal anaesthetic, which is supposed to go into the spinal space & uses a much finer needle so leaking much much less likely to cause headache. Hope that helps.

Yy to what SoYo said. I had an epidural and the dreaded headache first time round, then dc2 was breech, and I had an elcs. I talked through my previous experience with the anaesthetist and he was excellent. Used an extra thin needle and no headache :)

If I had had a natural birth I would have avoided an epidural at all costs, but spinals carry a low risk and they can lower it even more if they know your history. Good luck and feel free to pm me if you'd like more info.

Thanks everyone. It really was bothering me, at the back of my mind.
I am glad there will be other options. Now just the small matter of conceiving again first!