Can I ask for an epidural right from the start / established labour?

[cheesebubble]

Hello hello, I had a planned section with my first due to him being transverse and not wanting to turn (failed ECV).

I'm 35+4, have my 36 week scan on Monday and consultant appointment next Friday to discuss my birth plan. I do want to go for a VBAC. Even though I've read the positive birth company book and bought their online classes, I cannot help but feel anxious that something might happen and I need an emergency section, so for that I would like an epidural right from the beginning. Is that even a thing?

I know I can discuss it with the consultant next week but would like to know if anyone knows x

You could but depending on the how much you can move around into helpful positions with your epidural it might greatly effect the progress of the labour making either an instrumental birth caesarean more likely. The earlier in labour the epidural is sited the bigger likelihood of this. Is there a need to have a just in case epidural when a spinal can be given quickly if the need for a caesarean arises?

Slightly different but in my 4th labour I requested an epidural before they put the drip on to induce me. So I wasn't in labour when they did that.

@EvilEdna1 it's my anxiety that baby might need to be delivered ASAP and there is no time for a spinal and they'd have to put me out completely. Some might think it's silly but I find it very difficult to control my anxiety.

& yes, I know that just by lying down, you're 30% more likely to have an instrumental delivery.

@BurningBenches what was the outcome?

Similar to PP, when I was told I would be induced (after 2 days of labour not progressing past 3cm) I requested, and was granted, an epidural right away.

Having an epidural in an augmented labour before the hormone drip is administered is quite common. The hormone drip can cause very painful contractions quite quickly. Having an epidural early in labour just in case there is such an emergency that there is no time for spinal would be uncommon. In the unlikely event of a crash caesarean situation they might give a general rather than wait to top the epidural up so there is no sensation anyway.

But it would be up to you to weigh up the risk/benefit.

I had epidural in all my pregnancies, no intervention needed (although one was close to be fair. I asked for it straight away.

Sorry OP, I meant to say I requested and was given an epidural before they put the drip on.

It was a reasonably quick labour, drip started at 11pm ish, established labour by 2am, baby born 6am after one push.

I had an epidural with my first and needed a top up for my section. To be honest the top up took longer and didn't work half as well as the spinal for my second planned section. If that's your only reason for requesting it I would think again. A skilled anaesthetist will have a spinal in you in a flash, much quicker than waiting for epidural top up.

Unless there’s a particular medical issue that would make siting a spinal difficult (back/weight issues being the commonest) a spinal isn’t necessarily be slower than an epidural top-up. Spinals also often produce more reliable anaesthesia than top-ups (when a top-up fails plan b would be either to take the epidural out and do a spinal or convert to a GA depending on the exact situation).

Epidurals are sometimes put in in anticipation of needing theatre where it would be predicted that a spinal would be difficult but the risk of a GA is also particularly high; where the rapid onset of a spinal could be a major problem (eg in some heart conditions); or where the operation may last longer than the spinal lasts.

Might be worth asking if you could speak to/ see an anaesthetist pre-delivery as they’d be able to assess your back/medical history and advise you about how difficult anaesthesia (as opposed to an epidural for analgesia) might be. Hope that helps.

They have to ‘top up’ an epidural for an EMCS... not sure how long that takes x

When I had my spinal, it literally took effect in seconds.