Not getting an epidural - someone give a grip quick

[LouisaJF]

I've only got a few days left and have just been told the midwives are unlikely to give me an epidural due to my SPD.

After a 45 hour labour with DS1 the epidural was the only thing that got me to the end. In all my plans for this labour I was focused on the epidural and how much help it had been the first time. The fact I now can't have one is scaring me to death I don't want pethadin again as I really didn't feel in control, so is my only option seriously just gas and air?

The SPD has exhausted me, I'm not getting any sleep, and I really don't think I have the strength to get through a hard labour. Someone pass me a grip and tell me it'll be ok, please!

It'll be ok! :)

Your second labour might be entirely different to your first, and you might not want pain relief half so much. It was that way for me.

Either way, the midwives will look after you. You'll be fine. All the best.

I want drugs! All of them!

Have you asked them if they can measure how far apart you can get your knees without been in pain pre-epidural and then as long as you don't exceed that measurement you should be fine? They just need to keep remeasuring on any position changes.

No one has mentioned that yet, I will make sure I ask. I've seen 5 different midwives this pregnancy so every bit of information has seemed a bit disjointed.

Hi, why may they not give you an epidural? I know hospitals differ, but this seems extreme. I also suffer from terrible SPD during pregnancies and an epidural has never been an issue. Have you spoken to a consultant about it?

They really should refuse you an epidural unless for instance the anaesthetist is busy, the ward is too busy to provide one on one care.

They should inform you of any risks (ie, more long term pain if your hips are abducted too wide) and let you make an informed choice. Like I say measuring is a sensible precaution to minimise that risk.

I've read about using string to make sure you don't open your legs too wide?

Possibly on the pelvic partnership site?www.pelvicpartnership.org.uk/pregnancy-and-birth-with-pgp/how-will-i-get-my-baby-out.html

"I want all the drugs"

Fair play

I'm no expert, but surely there are other pain relief options? Diamorphine? And as pps have said, explore the epidural situation fully and searchingly if you think that is what will suit you best. Try and discuss with an anaesthetist rather than just the midwives? (not to be dismissive of midwives, but because it is the anaesthetist's speciality).

Eh? Why on earth not?? I've put plenty of epidurals into women with spd. Yes you have to be careful not to unconsciously over stress your joints, but that's not a reason for not having one.
Can you ask for a rapid referral to an obstetric anaesthetic clinic and talk it over then get something written in your notes to the effect that it's fine for you to have one if you want with whatever caveats arise during the discussion depending on your specific circumstances?
Please try not to stress. An anaesthetist should be able to talk it through with you (even if it's on the day itself) and come to a sensible plan.

I was just told that if I have one I won't know my limits and could so myself more damage. I'm hoping the midwives on the ward know a bit more about it than the ones I've seen so far. I guess the anaesthetist is the one to make the call.

Thank you for letting me know about the options, at least I can be a bit better informed going into this.

Sorry, my last post should read that they should not refuse you an epidural.....

I've had severe SPD 3 times (4th now what am I thinking? hehe) and I got epidurals in all the births and certainly intend to get one now too! SPD makes labour hard for me, difficult to move around and deal with the pain. To top if off I have GD and aren't allowed in the tub because I need IV's with insulin :/ Do you have a maternity slide sheet for the pain at night?

Hi,

I am not allowed an epidural because of a medical condition I have. The anaesthetist has offered me an IV drip with remifentanil instead. I have no experience whatsoever, and I'm only just 19 weeks, but I have to have a very specific birth plan due to my health.

There are obviously plus sides and downsides to all pain relief options, but I've been advised this is the best alternative to an epidural, and is most commonly used if an epidural is not appropriate.

If they won't give an epidural, it's worth seeing the anaesthetist to discuss other options.

HTH

Thanks for all the replies.

For those of you who have given birth whilst suffering from SPD, how did it compare to your other labours? DS1 was a 45 hour back-to-back labour, so not exactly a walk in the park. How much worse can I expect it to get? (Can you tell the reality of this is finally hitting home?)

I hope you get an epidural if you want it. Either way I highly recommend a book called birth skills by Ju Ju Sundin. Really helped me with pain management.

I didnt think spd massively affects birth (although mine was not that severe, I suspect yours is)

I had an 18 hour b2b labour with dd1 omg ! Very close to having epidural (even though very scared of them) and if it had gone on for 45 hours deffo would have.

DD2 wasn't b2b and it only hurt for the final 40 minutes before she was born. Honestly . Your first labour experience was very extreme you would be very unlucky to have that again.

And in terms of the epidural get some proper advice, don't write off the possibility from something said by one midwife.

If you can't have an epidural for whatever reason due to your health, a pca is a good idea. They aren't used very commonly though, and it's not always remifentanil, sometimes it's fentanyl. So don't be too surprised! A chat with the anaesthetist should help (in advance or on the day) go through the pros and cons. The obstetric anaesthetics' association website has some good stuff under their 'information for mothers' section (google homepage, tab is on the left hand column).

In the end it was irrelevant, he came so quickly that an epidural was not an option anyway. I now have my gorgeous boy in my arms.

congratulations. hope all is well with you both.

congratulations. And I'm glad it wasn't another 45 hour b2b job again.

Yay, congratulations! Glad to hear it all went well

Many congrats