First time mum at Royal Free (London): Thinking of going from gas and air to c-section (thinking of not bothering with epidural after hearing negative things).

[LOVEMYMUM]

I'm 26 weeks pregnant with no. 1, giving birth at Royal Free (London) end Feb 08 (approx).

I'm thinking about birth plan (but flexible about not sticking to plan!). Wondering if to jump straight from gas and air to c-section if in a lot of pain and not bothering with epidural as i've heard negative things about it, including losing the ability to push.

I know that a c-section is a major operation (my mum had three) but am really uneasy about epidural - the main thing being in case it doesn't work.

What do you think?

there are a lot more pain relief options between gas and air and epidural !

Hi LMM, sorry, but I'm not quite sure what you mean. You will have an epidural if you have a c-section. Do you mean that you don't want to go for a natural birth under an epidural?

(Didn't realise the title is so long!)

I need to do some more research into it. I think the problem is that i've heard that they don't always work and that they (sometimes) slow down the birth so sometimes end up having c-section anyway.

(Also first time mum .

Hi bean.

I mean 'don't want natural birth under an epi'.

I seem to be under the impression that a c-section has much better pain management before birth (after may be / is a different story!).

I had an emergency c-section last time and am likely to go for an elective this time. The pain afterwards is difficult but can be managed with support and, of course, drugs!!

I'm in NW London too, so if you fancy a coffee and a chat, let me know!

Eh, are you very very scared about the pain? Not that there's anything wrong with that but it sounds like you are thinking that if the gas and air isn't good enough you will just have to hurry into a c-section. What might be better would be to try and do things before the birth which help you cope with the pain / fear of pain. I can recommend hypnobirthing - it seems weird but it helps. I did a course but think you can get books and vids...

Sorry, by c-section, do you mean caesarean?

I would think that it would be very unusual for a c-section to be indicated as a result of pain i.e. gas and air not hitting the spot, rather than as a result of the baby needing to come out fast for your or his health.

FWIW I had an epidural with dd, and pethidine. She was born vaginally after an 8 hour labour. The epidural didn't slow down the labour. Had the pethidine before had the epidural, and that helped calm me down a bit.

Not saying that you should rule out a c-section as being something that may happen if things go wrong. But that to put in your birth plan that if gas and air not working you'd like a c-section may be a bit surgery-happy.

Have also to say that hypnobirthing great. Went from labour with dd, with all pain meds, to labour wth ds and just a bit of gas and air near the end and for the placenta.
In terms of pain though, I have friends who had long drawn out painful recoveries after c-sections. It is surgery after all. If I were you I'd try and keep an open mind re: vaginal delivery with epidural & gas and air & pethidine (if necessary).

Actually I had pethidine first time round and found it also a big help - sort of distances the pain...

There can be problems with epidurals, but opting for an emergency c/section in order to avoid them would seem to be a bit drastic! Also I very much doubt that a hospital would agree to perform a c/section without a valid medical reason.

There are other forms of pain relief available - have you had any antenatal classes at the hospital yet?

these are pain relief options:

none at all

TENS

water ( not with TENS)

massage , especially sacral pressure

mobilising and vocalising

pethidine or meptid

diamorphine

epidural

hypnobirthing ( praxctised in advance)

breathing techniques

aromatherapy , homeopathy

a combination of the above !

Wow - what a quick response.

You are all really helping me to think about what to do. I created the thread so i could make an informed decision based on not only medical knowledge (eg, effectiveness of various analgesics), but also the personal experiences of women who have been through labour before.

I'm not surgery happy at all. (Sorry if i came across like that! . It's not about the fear of pain, more to do with my fear of things going wrong and the baby being in distress. (I was born with the cord around my neck). I also have suffer from higher blood pressure when under stress and don't want this to affect the baby. I think i'm over-worrying!

Will certainly look into hypnobirthing.

(Things aren't helped by the fact that DH is a doctor and i know that things go wrong!)

My goodness, have the epidural if you can. I had to have a section and can't have more kids.

If you labour with a first baby on gas and air, you will have a lot of pain. But saying that you want a c/s because of pain is not realistic, even if you could talk the doctors into doing it, which you wont!

Having an epidural will not increase the risk of a c/s, although it will increase the chances of an instrmental delivery because it reduces your ability to push, especially if given early.

Sometimes it speeds up labour, sometimes it stops labour - wish I could figure out why!
And it is usually effective and will work well, anaesthetists do them all day, every day, so not having one in case it doesnt work is not really a good option.

I think you need to look at all pain relief options, from TENS, gas and air, Diamorphine/Pethidine, epidural, to hypnobirthing and employing a doula, who would give you massive support in your choices.

Also, Royal Free has a very good birth centre, with excellent, supportive midwives and you might find this a better option. The main labour ward is just next door, as is theatre if you need it, so this might be worth a thought. You can call them for a tour.

Good luck.

Epidurals are fab. Don't be scared. It was the last thing I wanted (apart from CS) but after having other pain relief - which wasn't helpful for me. I had an epidural and it was fantastic! They let me rest for an hour once fully dilated then gave me an hour to push - I managed to push out DD without intervention. I have to say my Mum really helped though - she squeezed my hand and helped me to push through properly.
Unfortunately the umbilical cord snapped so I had to have it topped up a lot to go to theatre - so I would have had to have one anwyay.

I remember crying as I felt like a failure to have asked for an epidural ( what a tube in retropsect) but the only negative thing was that it affected my left side more. It meant that when it was wearing off I couldn't feel my left leg for ages and it was pins and needles for a few hours. But well worth it.

FWIW - I had homeopathic remedies. TENS (which was great to begin with), aromatherapy oils, hypnotherapy etc. But when it came to it DD was back to back. You just don't know what is going to happen so be open minded but please don't be scared of an epidural.

best of luck

Epidurals are fab. Don't be scared. It was the last thing I wanted (apart from CS) but after having other pain relief - which wasn't helpful for me. I had an epidural and it was fantastic! They let me rest for an hour once fully dilated then gave me an hour to push - I managed to push out DD without intervention. I have to say my Mum really helped though - she squeezed my hand and helped me to push through properly.
Unfortunately the umbilical cord snapped so I had to have it topped up a lot to go to theatre - so I would have had to have one anwyay.

I remember crying as I felt like a failure to have asked for an epidural ( what a tube in retropsect) but the only negative thing was that it affected my left side more. It meant that when it was wearing off I couldn't feel my left leg for ages and it was pins and needles for a few hours. But well worth it.

FWIW - I had homeopathic remedies. TENS (which was great to begin with), aromatherapy oils, hypnotherapy etc. But when it came to it DD was back to back. You just don't know what is going to happen so be open minded but please don't be scared of an epidural.

best of luck

Sorry wasn't trying to be officious - hit the return button twice by accident!

I'd second the hypnobirthing suggestion. It really can help you manage the pain. I was away with the fairies.

Epidurals are fabulous, just try to stay upright (get them to prop you up).

If you sleep (yes, you can sleep through your labour!) then get them to prop you onto your side, don't spend long periods on your back.

When it comes to pushing, try to get the m/wives (you may need to insist) to turn you around so you can kneel on the bed leaning over the headboard. Gravity will help you push the baby out. Mine were reluctant, but I managed to deliver a large baby without instruments. Would have been impossible, I believe, lying on my back. It's worth a try and could make a big difference.

I second what Brummie says re lying position - definitely on your side. And I fell asleep for an hour during my labour - after I had the epidural. Apparently I was snoring my head off. I was knackered beyond belief!

Oh my goodness. Thank you all so much for your postings (and what a quick response). I think this thread will run and run!! I honestly can't thank you all enough for sharing stories with a first time mum (me!), who is getting just a little bit nervous about birth.

Nab3 - so sorry to hear that .

Camilla - a v. helpful list.

I feel much more relaxed about things. Shame i can't show my in-laws who are totally anti- epidural. I try to ignore them but it's getting harder to do so! (Maybe ear-muffs will help!)

Who cares what your in-laws think. They are not the ones going through labour and it is YOUR body - nobody elses. Tell them to bugger off and mind their own business!

You might not even need one anyway - you might sail through labour. My SIL did and she was induced and a first timer. We are all different - do what is best for you.

incidently if you don't get on that well with your in-laws - I banned them fron visitng me in hospital. Only my parents and DH were allowed. I was in for 3 days and did what was best for me.

Santa - oops - think i gave the wrong impression. I do get on with them. I think its the old story of people only remembering bad things about birth and not the good. I've made it quite clear to them that i'm going to research the options and then decide (i said this literally word for word to them).

Mind you, i will ban them until i feel ready to see them. My MIL is one things, but i am not having hoards of vistors either in hosp or at home (my SIL visited her DIL's sister a few hours after a caesarean - totally unnecessary in my opinion - could;ve waited till the following day.).

you could have gas and air and pethadine

i just had gas and air to be quite honest the worrying about it makes it more scary

i worried myself sick couldnt watch someone on tv give birth without feeling anxious and physically sick

when i went into labour took it all in my stride was no longer afraid just did what i had to do

only had gas and air and it was painful but a wonderful experience and i found it bearable

i also had kidney infection so was in more pain than normal labour without infection

do what you think is best but maybe see how you handle it first when first in labour then decide

Hi bean - may take you up on that!

Bubbla - not worried about the birth - more a case of 'how does that come out of there'!
.

With hindsight, the thing that would have made my labour with dd better (not that it was awful, or went wrong, but you know what I mean) would have been preparation.
I honestly thought, before I had dd, "it can't be worse than having a root canal". Also, that I had a high pain threshold.
I made a conscious decision when pregnant with ds that I was going to do anything I could to feel in a more positive frame of mind. Which for me included:
planning a homebirth (was determined that would try for minimal intervention)
having 3 hypnobirthing consults (helped me sleep in pregnancy and to chill before labour kicked off)
getting a tens machine (again, used during the labour, helped enormously)
getting a homeopathic birth kit ( helped with healing afterwards)
And, most important of all IMO, attending a fantastic ante-natal yoga class.
Learning about positions for labour, breathing techniques and relaxation techniques made everything much easier (with the caveat that ds was my second, so experience and confidence helped too).
Good luck!