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Childbirth

Share experiences and get support around labour, birth and recovery.

Experiences with a spinal

25 replies

fr4zzledmum · 29/06/2024 19:05

It's likely I'll be having a ELCS and so will be having a spinal. I never had an epidural with my first (vaginal) birth, so have no idea what to expect with the spinal.

Can I have some experiences? Is it painful?

OP posts:
Mrsttcno1 · 29/06/2024 19:13

I haven’t had a spinal but had an epidural which I think is similar, only difference being that with an epidural the tube stays in? I always thought it would hurt but I actually didn’t even feel it, although I was having strong contractions at the time so maybe was only able to focus on that pain

Lilylovetulips · 29/06/2024 19:18

You will feel the needle when they inject the local anesthetic which is the worst bit, it's fine after that.

NewtGuineaPig · 29/06/2024 19:25

I had one, very quick, the local anaesthetic first stings but I didn't feel the second injection. It worked very quickly.

merryandbrightdelight · 29/06/2024 19:27

Good luck op, I didn't feel a thing for both of my ELCS's - they gave me a pillow to squeeze and within seconds it felt like I had stepped into a warm bath and I could feel the 'heat' travelling up my legs then that was it

Tinylittleunicorn · 29/06/2024 19:27

I had a spinal for a perineal repair after giving birth vaginally. I had just given birth, which despite the tear was a really positive experience, so was possibly a bit euphoric, if sore. And I've never been apprehensive about needles. Just for context.

I felt the needle and a very sharp shooting pain down one side of my body as they inserted it, which I let them know about and they adjusted accordingly and it went away. That's about all the pain I remember. Then the anaesthetic had it's effect and it was completely magical because I did not feel sore at all. I just felt completely brilliant! I found it very strange, as could not feel anything at all, as though that half of my body simply no longer existed. I have to say I actually enjoyed the novelty / weirdness of it.

Watto1 · 29/06/2024 19:37

I’ve had two. The first was when I was already having strong contractions. I had to curl up in a ball for them to administer the spinal and it was horrible. Bending forward made the contractions worse. Then after he’d finished I was still getting stupidly painful contractions. He realised it wasn’t done properly and so hehad to do it again . After dd was born I had the worst headache of my life - I had a dural tap. Had to go back to theatre (after 4 days of faffing about with drinking strong coffee and IV fluids, trying to care for a newborn with a banging headache every time I sat up) for a blood patch.

Understandably, I was a bit reluctant when I needed a c section with DC2 but it was totally different. It was before labour had started, took seconds and no dural tap afterwards! A blissful experience!

clarepetal · 29/06/2024 20:06

I had one with my emergency c section. I was in a bit of a state in labour and not dealing with the pain very well but was so relieved when I had the spinal. Didn't feel a thing, and recovery was fine. If I were to have another baby, I'd totally ask for an elective c section and a spinal.

Dyra · 29/06/2024 23:12

I had an epidural for labour, which was then subsequently topped up for labour. I also work in obstetric theatres, so see spinals inserted all the time. Heard the spiel, and recited it myself a few times. What I experienced while having my epidural inserted was very similar. As a PP stated they're very similar, except the epidural leaves a tube in situ. It's also inserted into a slightly different space, so it acts much quicker than an epidural.

Basically you'll have a cannula inserted first. Ask for emla cream ahead of time if you want, but it's not too bad.

As for the spinal itself it starts off with the anaesthetist greeting you then going off to get themselves sterile and their drugs and equipment ready. Then the anesthetic assistant (usually a nurse/ODP) will have you sat in the edge of the bed (if you aren't already) who will check your identity (hope you know your own name and date of birth!) and ask you a variety of questions (allergies? loose teeth? metal in your body?) while hooking you up to the BP machine, and exposing your back.

Next it's time to clean your back. My trust uses a cleaning solution spray to sterilise your back. It's very cold! Other trusts have the anaesthetist paint your back with a similar solution.

Next a sterile drape is stuck to your back. Don't touch! And you'll be asked to assume "the position". Basically you relax and drop your shoulders, and curl over your bump, pushing your lower back out. This position opens up the spaces between your vertebrae. The anaesthetist will feel the bones of your back to identify the area they're going to inject.

Next is the local anaesthetic. It's a sharp prick, then a stinging sensation for a few seconds then the area goes numb. This is, imo, the most painful part of the entire procedure. Once that's done, it's time for the spinal needle itself. Try to hold still as you can. It shouldn't hurt, but you might feel some pressure. If it is too uncomfortable, tell the anaesthetist and they can give some more local to help numb the area further. You might be asked if you feel the needle more on one side or in the middle. Sometimes you can get an electric shock sensation. Once the needle is in the right place, the medicine is injected. You might feel a warm sensation trickling down your back and legs. The needle is removed, and that's it!

You'll be encouraged to lie down straight away as it's pretty fast acting. You might feel pins and needles as your legs gradually go numb. You'll lose the ability to move them too. Your BP will be measured every minute from now until baby is out. You'll also get your heart rate and oxygen saturation monitoring attached at this point too. The bed will also be tilted to the left as well, since you shouldn't be laid directly on your back. After a few minutes, the anaesthetist will measure the progress of the block. Usually this is done with a cold spray. The nerves that carry pain carry cold. If you can't feel cold, you won't feel pain. They'll spray it on your arm to demonstrate how cold it is, then spray it up your body from your pelvis towards your boobs. They'll want to know 1) if you feel anything, 2) if it feels cold, and 3) when it starts feeling cold.

After this first check, you're usually numb enough to have your catheter inserted. Once that's done, another cold spray check is done, and usually you're numb enough to proceed. Sometimes you need a little longer, or it's not quite high enough on one side. A bit more time, or tilting the table often remedies the situation. Your anaesthetist will be in constant communication with you the whole time, and will discuss options with you should the spinal not have worked, or isn't working completely.

Once the anaesthetist is satisfied, and all the hullabaloo of the WHO and draping is over, one final check is done by the surgeons prior to incision. You should be so numb you'll have no idea it's happening. Assuming all is well, it's the actual C-section itself, and this post has gone on long enough. You'll feel movement and pressure, but no pain. Your legs will be completely numb for a few hours, but sensation will gradually return.

Hope this essay helps!

PrincipalCharlotte · 29/06/2024 23:29

It was lovely 🤣🤩 a little nippy going in and then a feeling of total warmth and relaxation, like I'd had 3/4 of a bottle of wine. Much nicer than what I remember of my epidural before my emergency section the time before. I've had fillings that hurt more!

Milkand2sugarsplease · 29/06/2024 23:35

I've had 2 - one for CS which was an emcs so was bloody glad I'd had it in labour prior to it becoming an emcs. Then one for knee surgery last year.

Both very uneventful (the spinal part, not the emcs part!!).
Sat on the side of the bed hunched over while the anaesthetist did their thing, lots of checks in theater to make sure it was working and away they went.

Wore off well afterwards. The one last year took longer to wear off and I didn't like the half numb half ok part while it was wearing off but otherwise, nothing to put me off it.

In fact, it was me that opted for a spinal for my knee op instead of general so can't have been too bad the first time round for me to do that.

Ihaveayellowhat · 29/06/2024 23:40

It hurt a bit but not too bad. I had a weird reaction though with my temperature dropping dramatically until it wore off (the nurse tried 3 thermometers because she was sure the reading was wrong). I felt fine though just a bit cold and needed some blankets. And my blood pressure dropped a lot so I needed anti sickness meds in theatre but I was expecting that after my first emcs where the same thing happened

User235648 · 29/06/2024 23:52

Barely felt it! You have to bend over so your spine is rounded. They give you an intial injection to numb the area first and that feels like a little pinch. Then you feel nothing at all. To be honest, the baby is so active that the hardest part is trying to hold still while you feel all that wriggling inside. I was so distracted that the injection itself was a non-event. In case you got a catheter before the spinal, that will also feel more irritating than the injection. The uterus pushes down on the catheter so you are constantly aware of it. The best part is that as soon as the anesthesia takes hold, you feel absolutely nothing anymore and it's bliss.

Nat6999 · 30/06/2024 01:32

I had an epidural with ds in labour before my induction failed & had to have an emcs. The only thing I felt was a massive twitch down one leg when the needle went in. Exh said my face changed the moment it took effect & I stopped swearing. It's weird feeling when you can't feel anything below your boobs, I tried to move my legs but nothing worked. They give you a button to press to top up the epidural, it can sometimes make you feel shivery & cold.

Nat6999 · 30/06/2024 01:35

During the section it feels like someone is rummaging inside you, no pain but strange, they have no sooner got you on the table & arranged than they have the baby out. Putting you back together takes longer than getting the baby out.

Rummikub · 30/06/2024 03:14

I had a spinal with dc1. It was for an EMCS. I'd already had an epidural but I felt shivery with it and it didnt feel like a total block. So for the emcs I got a spinal.
I didn't feel a thing. It was awkward getting into position on the edge of the bed. I was wobbly (from epidural) so put my arms around the poor guy in front of me to get steady!

After that I lay down and thought they were massaging my tummy. Then dd was there! Painless.

fr4zzledmum · 30/06/2024 08:21

Thank you @Dyra that was really informative!

OP posts:
meganna · 30/06/2024 08:26

I've had 2 spinals and they were fine! The most uncomfortable bit is having to bend over a pillow when you have a massive bump 😅

I don't remember feeling pain, just a lot of pressure while the needle went in, and once the injection is in your legs start feeling very heavy.

No issues with it wearing off either, I could move my legs again when I was back in recovery.

It's a weird feeling being numb but also being able to feel a bit of pulling and tugging (not painful though). DS was quite high up and I remember the anaesthetist saying that I would feel a lot of pressure while they pressed down on my rib cage to get him out. Wasn't sore, but for 10 seconds it felt like something heavy was sitting on my chest.

Greybeardy · 30/06/2024 09:00

OP you might find the labourpains.org website useful if you've not seen it already - the site's run by the Obstetric Anaesthetists Association and has loads of info about spinals etc.

@Watto1 not sure if they explained this about your spinals/headache... a spinal injection is supposed to be a 'dural tap'. The incidence of a post-dural puncture headache after a spinal in obstetrics is about 1 in 250 (probably a little higher if you've had to have two passes of the needle to get the block to come high enough). The rationale behind waiting at least a couple of days after the headache developing before doing the blood patch is not just faffing around, its that a) occasionally the symptoms do get better with conservative management and if that happens it avoids the risks associated with a blood patch (the headache after a spinal is a bit more likely to improve with conservative treatment than one after an epidural is) and b) if the headache doesn't get better the blood patch is more likely to work after a couple of days than if it's done immediately.

Lunamoon23 · 01/07/2024 20:42

@Dyra isn't my post but stumbled across as am having a ELCS with my first due to tokophobia and found your post so helpful and informative. I do have a follow up question though if you don't mind - the injection first to numb the area. Where is that put? Is that put into the spine or into the surrounding skin around the spine? And are they able to numb this with Elma cream too or would that not be effective? X

Dyra · 01/07/2024 23:54

Hi @Lunamoon23 Glad my post helped! The local anaesthetic is given in the surrounding skin, and TBH no-one has ever asked for EMLA in that area, so I genuinely wouldn't know. My post may have inadvertently made it sound worse than it is. I can honestly assure you it really is a very quick pinch, a couple seconds of mild stinging and then it all goes very rapidly numb. It's a very small ouch for hardly any time at all.

OhMaria2 · 02/07/2024 00:08

fr4zzledmum · 29/06/2024 19:05

It's likely I'll be having a ELCS and so will be having a spinal. I never had an epidural with my first (vaginal) birth, so have no idea what to expect with the spinal.

Can I have some experiences? Is it painful?

My anesthetist couldn't find a cavity and ended up doing me about 14 holes ( 7 pairs) which sounds horrific but, although not fun, wasn't as terrible as it sounds so please don't stress about it. I'm a massive baby and I've got a low pain threshold too so you think I would've been really upset about it, but it just sucked a bit , it wasn't excruciating.

I will say, if you are nil by mouth, and emergency c sections keep going in ahead of you, DEMAND fluids. I was a weeping dehydrated mess from waiting 5 extra hours on top of overnight fasting. I was eventually given fluids and a glass of water but my consultant thinks dehydration was a factor in me having a blood pressure drop. Be assertive.

Also, the anesthetic went too high up and my hands went numb. Whilst I've been told that your chest can feel somewhat heavy with a spinal, if you feel you can't breathe don't be shy about telling them. Dont be fobbed off.I was told oh you're fine, but I wasn't. then I had my blood pressure drop . Again be assertive.

OhMaria2 · 02/07/2024 00:11

Ihaveayellowhat · 29/06/2024 23:40

It hurt a bit but not too bad. I had a weird reaction though with my temperature dropping dramatically until it wore off (the nurse tried 3 thermometers because she was sure the reading was wrong). I felt fine though just a bit cold and needed some blankets. And my blood pressure dropped a lot so I needed anti sickness meds in theatre but I was expecting that after my first emcs where the same thing happened

Did you feel like you couldn't breathe when your blood pressure dropped too?

Greybeardy · 02/07/2024 08:18

@Lunamoon23 It would be pretty hard to get EMLA in the exact place for a spinal. We never really know exactly where the needle’s going to go until you’re sat in front of us, prepped and in the slouchy position and it takes about 40mins or so for the cream to work so it’s just not that practical. The initial local anaesthetic injection goes into the skin & subcutaneous tissues.

Re block heights/breathing difficulty/BP drops…
there’s a surprising degree of variability in how high blocks come up with spinals. You need a dense block to mid-chest level to get all the abdo/pelvic bits numb enough for surgery, but 0.1ml of anaesthetic can make the difference between just enough/not enough/too much. If a spinal gets as far as numbing hands, that is unusually high but aside from feeling disconcerting isn’t usually a massive problem (doesn’t mean anyone’s done anything wrong/daft…it’s just part of the witchcraft of anaesthesia). If it starts to get up to upper arm/shoulders/neck then that can be more of a problem and often we’d switch to a GA at that point but it depends on the exact scenario.

As well as numbing sensation the spinal block numbs the nerves that control blood vessels so they all relax and that’s what can make BP drop (bit like when someone gets very hot/has an infection). Usually that’s anticipated and can be managed pretty quickly with fluids/medication but sometimes it takes a bit longer to manage and that’s when people can feel nauseated/dizzy. The usual anti-sickness drugs don’t work well for managing this (but they may help if nausea related more to some of the other drugs we have to use for c-sections). When the spinal’s working well enough to numb someone to mid-chest level it makes the intercostal muscles (between the ribs) numb and weak and this is partly what causes some people to feel chest heaviness/like breathing’s really hard work (the other obvious thing that can cause that is lying flat with a pregnant uterus squashing everything). The diaphragm isn’t affected by a spinal and so breathing is usually completely safe and pretty normal but just feels like hard work. HTH.

DinnaeFashYersel · 02/07/2024 08:19

It's quite ouchy as it's administered but then instantly effective and you have no feeling below your chest.

Lunamoon23 · 02/07/2024 16:10

@Greybeardy ah okay that's makes sense. Thank you, that was really informative. Xxx

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