Your experiences of patient controlled epidurals please?

[BettyButterchops]

Hello, after a chat with my consultant, I've decided on a patient controlled epidural, sited relatively early on in in labour. What a relief. son, now 6 was meant to be a home birth but circumstances meant a transfer with epidural and forceps. The problem was my epidural wasn't topped up when i reported pain. The patient controlled has been introduced since then and will allow me to top it up in safe increments by pressing a button linked to the drip. Sounds good to me, so long as there's enough in there for the pushing etc.

I'd really like to hear of anyone who has experience this themselves, in particular at Edinburgh Royal Infirmary. I was i such bad all round shape after the horrendous labour last time that I missed out on the joy of my newborn. I am hopefully going to be in a better physical and psychological state and actually enjoy the birth and precious first weeks this time. Would love to know how others got on with this choice of pain relief. Thanks :)

I've had one of these!

Yes, you can top up yourself (by pressing a button) but it will not let you top up more than it is calculated to do so (iyswim). During my long labour, however, I learnt that from self-administering to the epidural taking effect was about 10 minutes and therefore I would re-top up 10 mins early!! I got through a lot of the epidural and they wanted to lower the dose when it came to pushing so that I could feel what I was doing - I told them "over my dead body" did I want to feel anything. They finally agreed as I became very uncooperative!!

However, please be realistic as in my three epidural deliveries, all three have ended in theatre with assisted deliveries. So your psychological state my be improved but there is no guarantee of your physical state - but at least you won't feel it!.

I had a self administered epidural for both my births. Queen Charlottes London and UCH. I rate them very highly. I think I would have been broken by the pain and exhaustion without it as I had two very long labours with very big babies. DC2 was nearly 10lbs and back to back and I am 5'1".

I did let it wear off for the pushing stage as I wanted to know myself when to push and it meant that after the birth and stitches I could get up relatively soon and walk around. It is empowering to feel in control and relaxed that you can manage your own pain. I was also lucky and requested the epidural a on the day (in my birth plan also) and they were given to me without any push back. In fact my birth plan said "I do not want you to try to talk me out of getting an epidural. If I request one, please take my request seriously"

Thank you made and chocolate. Had considered an elective too, but not quite sitting right as scared of infection... i was j hosp with sepsis 3 weeks ago, so it has given me the fear! I had epis, forceps, blood loss and infected stitches, nartowly missing theatre... but i think the baby was so distressed because of such a long drawn out labour that had stalled at one point... so I'm banking on moving it along a little faster and some better luck this time to not have all that again.
Good to know they might try and get you to use less... very sneaky... stuff that! I want a big extra helping for the last bit! I'll make sure I put that in plan. A lot of it us down to luck though, I guess, no matter what we choose.
Thank you both for replying :) x

PS Excuse my awful typos above.... cracked tablet screen, can't see what I'm doing!

Hi Betty,
If this helps at all (baring in mind my natural birth/epidural experiences above) I am having an ELCS with dc4 next month. I just want a controlled, calm experience for me and my baby. Previous three births have had hard recoveries so hopefully an CS won't be any more challenging (and I have lots of help already lined up at home). Like you, I just really want to enjoy my newborn!

Sorry to hear you have been so unwell. How awful.

Calm and controlled sounds very very good. Add a cool bag full of M&S food for hopsital and we're talking idea ;) I read excellent book called positive caesarian that was very balanced and that option is still there if I get spooked before my due date It's so good to have support in our choices, we're all so different as are our experiences. Hope it goes safely and beautifully for you x x

ideal not idea!

I had one. Was positively encouraged to press the button when the light came on and not let it wear off (was on drip and back to back ). I didn't get on with epidurals generally, but the concept was good.

I had one. It was set so that regardless of how many times I pressed the button it wouldn't release the drug more frequently than every 20 minutes.
At first I watched the clock and pressed it bang on 20 mins, I didn't feel it 'wearing off' in that time, it just kept me really comfortable. After a couple of hours (during which I watched Masterchef!) I had a nice sleep, waking every now and then to press the button as the cramps got a little uncomfortable.
At one point I woke to press the button and the midwife took the opportunity to examine me. She could see the head and it was time to push! I calmly pushed for a while - the mw advised to let the epi wear off a bit, but also let me dictate how comfortable I wanted to remain, so I cold still press the button when I wanted.
Ds was born in a beautifully relaxed, calm environment with no difficulties. I had a few stitches but nothing major. I felt completely present and in control, very safe and secure at all times. As you can probably guess, I'd definitely have an epi again!

penguins thanks for commenting... if you don't mind me asking, do you mean it didn't work out in practice for you? The epidural from my son's birth kept wearing off because the blooming midwife on that shift wouldn't get anaesthetist when asked (which the anaesthetist had requested happen), so I still had no rest and excruciating back pain would seep through- pretty much this is what i hope to avoid by bring able to dose myself. I am a little worried that the patient controlled is not strong enough, though I understand they can tweak the intervals. I had full on epidural at end though that worked a treat, just as well for forceps though!

Curls that sounds just sort of experience I'm after, thanks for commenting!

Um. Well technically it worked. But after a few hours, despite availing myself of every top up, I had awful back pain. The only way I had found to ease the back pain was being upright but I was totally numb and couldn't do that. So had gas and air too. And I think my position contributed to DD1 not turning and forceps.

I just don't get on with epidurals I don't think. I had home births for the next two.

Sorry to hear that penguins I totally sympathise with the back pain aspect. Thanks for answering :)

They said my issue was unusual though. should have said that. They expected me to have full pain relief (and it didn't need topping up for forceps or stitches, so I was pretty numb).

They said my issue was unusual though. should have said that. They expected me to have full pain relief (and it didn't need topping up for forceps or stitches, so I was pretty numb).

They said my issue was unusual though. should have said that. They expected me to have full pain relief (and it didn't need topping up for forceps or stitches, so I was pretty numb).

They said my issue was unusual though. should have said that. They expected me to have full pain relief (and it didn't need topping up for forceps or stitches, so I was pretty numb).

They said my issue was unusual though. should have said that. They expected me to have full pain relief (and it didn't need topping up for forceps or stitches, so I was pretty numb).

They said my issue was unusual though. should have said that. They expected me to have full pain relief (and it didn't need topping up for forceps or stitches, so I was pretty numb).

Bloody phone. Sorry about that.

I loved mine but my labour ended in an EMCS at 9cm. I'm not sure if the epidural contributed.

My first birth was very like Curls.
My second I asked for the epidural too late and found the whole thing much more overwhelming (I won't say traumatic as that would be too far but in that direction). The "outcomes" were the same in both - unassisted delivery, 2nd degree tear, very healthy, alert baby - but the epidural took away the fear of the pain and made me feel much more "present" for the actual birth.

I had one 12 days ago with dd2, I could top it up every 30 minutes with the button.
I'd say it wasn't as immediate as the one with dd1, that one took full effect straight away but this one took 3 top ups, so 2 hours, for me to be pain free enough to not need gas and air although I was still considerably more pain free than before.

It also never felt as strong as dd1, there was an area on the right of my bump that didn't numb fully and by the time it came to pushing it was fairly painful again but perfectly manageable and by not being numb I could feel when and where to push which was much better.
I didn't feel the crowning at all or the stitches afterwards.
The anaesthetist said that they're excellent at stopping sharp pain but sometimes don't stop the cramp type pains.

Like you with my first it took ages for the anaesthetist to get back to me when it wore off so I'd say I definitely prefer the self top up method.

I could also hop off the bed for a shower with only a slightly odd feeling in my legs whereas with dd1 I had to move my leg with my hands as it was totally dead for ages afterwards.

Thank you bigcat tarka and dogsmom, it sound very positive in general, i guess there's no perfect prediction of how it will go. Think I'll make a list of questions for consultant from the comments here, just to nail down a few of the concerns and details. I'll mentally prepare myself for a bit of pain in case. When are they going to start making the men have the babies? Think we've all done our hit now, ?