Confused about SPD epidural advice

[HenriettaTurkey]

I am 33 weeks pregnant with dc2 and I have pretty bad SPD.

I have crutches for when I go out but spend most of my time on the sofa with legs raised.

My consultant has said I can consider being induced at 38/39 weeks and having an epidural to relieve the pain. However, I have also heard that epidurals are bad for the pain as you can't tell how much pain you're really in or something.

Does anyone know?

Has anyone had a similar experience?

The danger of epidurals is you might spread your legs too far - so I was told to measure how far I could spread my knees when labour started and get MrNC to get some string to loop round them so no staff could spread them too far.

When I ended up in theatre for ventouse deliveries, the first time MrNC and a couple staff propped my legs up, the second time they found these things like ski boots to put my feet in and fasten to the table so my knees couldn't flop outwards.

Ideally I wouldn't have had labours that required epidurals, but they were very long and the SPD pain got worse in labour (this is apparently very rare, possibly related to my hypermobility - the labour pains were a doddle in comparison)

Thanks, NC. That's very interesting. Does it seem strange to you that epidural was mentioned so early?

The conversation went something like:

Consultant: We're hoping you'll go into labour and deliver naturally.
Me: DC1 was 9 days late and induced. I can't go late with pain this severe.
Consultant: We can look at you at 38 weeks. If the baby is ready and thriving we can induce you then. If not, then 39 weeks.
Me: But I can't open my legs. How will I deal with the SPD with a natural labour?
Consultant: We can give you an early epidural, and then you won't feel the pain.

It was the FIRST thing she mentioned - I had expected her to talk about water birth etc, and appropriate birthing positions, but she didn't. She went straight to epidural. Which is fine if that's what's right, but I'm a little surprised.

I'm not sure if it's relevant that I had a very fast labour with DC1, once I'd been induced (about an hour in established labour) - but I had pre-ec - and that I had been wondering if ELCS was better with SPD, but the Consultant said it was not necessary.

You can cause damage by not knowing your limits in labour so it is something to look at. It would worry me that they're only worried about the pain. Ask them for an assessment with an anaethatist, I had one and he refused to touch it, I actually had him in tears because of how much he hurt me in the assessment and he couldn't stop apologising.

The other issue with induction and epidural is that it increases the risk of c-section which is another issue with it as it can make it harder to heal afterwards.

Thanks, confuddled. I'm not scheduled to see consultant again until NYE (when I'll be 36w) so will do some research in the meantime. I am seeing my community midwife this Friday and she's pretty good so I'll ask her advice too.

It just seems that the more I research it the more people seem to advise water births. That's not something I've ever considered as I'm a fan of pain relief, but maybe I'm ought to...

With Dc1 I had g&a, and pethidine...but no SPD!

I just wish I knew the right answer. I don't want to make it worse! You can't have an induced water birth, can you...

I've had two VBs with it and I couldn't have an epidural. All of it just g&a. I didn't really feel the pain from my pelvis apart from the first time when they put me in stirrups which is a really bad thing to do to a mum with pelvis issues. I found in general I moved instinctively in ways that worked with the pain.

Maybe they thought "how will I cope with natural labour" meant "I want major pain relief ASAP"? Wondering why you asked the question otherwise - if you're on all fours or kneeling on cushions, why would you need to open your legs further than hip width? Or even in any other position?

The pool I was in for 8 hours of my first labour was great, but I was no more dilated at the end than when I started. Was only when I had to get out that I needed more pain relief.

Hope all goes well for you.

I had SPD with DD2 this year. I was on crutches for the second and third trimesters. In labour, all the pain from my pelvis disappeared as the endorphins and oxytocin took over. I laboured for 12 hours on a ball and delivered on all fours on a birthing mat. I was planning to deliver in the pool but she arrived too quickly! My legs were only hip width apart when she popped out.

I found more issues post partum as my mobility was very compromised for 7 days after the birth. I had planned to do biological positioning for bf but I couldn't lie at that angle.

Could you ask if mobile epidurals are available - I had this with my first and it takes away the contraction pains but allowed me to move into comfortable positions and limit movement of my legs and hips.
The down side can be it wears off at the pushing stage so that is done with g&a, but was quick so fine. I was standing/crouching so def looking at diff positions and what they are willing to work with.

That's a useful tip - I'll definitely ask about it. Thanks!

Oh and post partum be prepared to need physio, and extra help from your DP (or family if he is working) as I had a couple of months before I was OK again and my SPD was much milder than yours.

I was induced at 38 weeks due to spd. I had an epidural. I was happy to have it throughout labour but the tube became detached from the machine and the anesthetic was leaking and not going into my back.

As a result it totally wore off 10 mins before pushing which was not ideal.

It did take a good few weeks for the pain in my pelvis to ease. The first time I got up after the birth, my legs went one way and my upper body went the other way. It was very odd.

Ouch ugg - that sounds uncomfortable! If you had to do it again what would you recommend?