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Childbirth

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

Original poster

Spinal block or epidural for C-Section?

26 replies

2point4pets · 04/02/2009 13:32

Hello
My C Section is booked for Friday and I thought I was quite OK about it all, but lately I have been reading about epidurals not working properly! It has also been a hot topic at NCT class...
I am paranoid that they will start and then find out I am not completely numb! Also, it seems that they could offer either a spinal block (quicker, but wears off earlier) or an epidural (can be topped up which sounds good). I am intending to BF as soon as I can. Can anyone recommend one over the other? Are they 'extra careful' with a section to make sure you are numb?
Any advice gratefully received!

OP posts:
Marthasmama · 04/02/2009 13:39

I had a spinal for both sections I've had. I had an emergency section with DS and had an epidural whilst in labour. It didn't work for me so I continued to feel the pain. I had a spinal for the actual section and was completely numb. I breast fed as soon as I was sewn up both times. I would not have opted for an epidural but that is because it didn't work for me. I had a bit of a panic attack when my legs went numb (they gave me something to sort that out though) and as I'm short is was numb up to my sholders! They spray you with cold water to test where you're numb to but you very quickly lose the feeling in your legs (which is what paniced me! Silly arse!). But I recovered from the spinal very quickly. Some people are fine with an epidural....

Good luck with the birth, bet you're excited!

Wheelybug · 04/02/2009 13:44

I think if you have a planned c-sec you';ll have a spinal block. I was induced and was trying to avoid an epidural but when I asked for one, they said it looked like I was likely to have a c-sec so if I could cope they would rather give a spinal block - because they are more effective.

As Martha'smum says - they do check quite thoroughly you can't feel anything so don't worry about that !

Good luck - enjoy meeting your little one !

hedgepig · 04/02/2009 13:59

generally they use a spinal for a planned cs, mine was fine I didn't feel a thing , the anesthetist will make the decision, I would doubt that you would be offered a choice. For a planned cs they will have the baby delivered before the spinal wears off, my legs were still numb the next morning. .
I hope it all goes well with your birth

gasman · 04/02/2009 14:04

Depends where you live and who your anaesthetist is.

My advice (and I am one) is to let the person doing your anaesthetic do whatever they are happiest with. Trying to dictate what they do especially if it means they deviate from their usual practice can lead to problems (when my family have ops I never interfere although some of my colleagues have given them what i would consider to be 'interesting' anaesthetics).

Basically for an elective LSCS most peoople would do either a spinal (+: rapid onset, generally good dense block; -: can't be topped up, more likey to make your BP drop, last bit is fixable) or a combined spinal epidural which is where they do a spinal and then put an epidural catheter in too. This means you get the rapid, dense block of the spinal but it can also be augmented if it needs to be. CSEs are more 'fashionable' in some parts of the UK (eg. QCH pioneered them so do them a lot, where I work now they are used only rarely for specific indications ie. likely complicated operation).

As it is an elective operation there will be no time pressure (ie hopefully no one will be worried about your babies heart rate etc) so there should be a very thorough check to make sure that you are properly numb before they start. You do feel pressure though during the op "washing up in your tummy" but I don't think it is overly awful (not had LSCS but have looked after several hundred women having one).

Epidurals are rarely done for elective sections as they take ages to take full effect (going from no epidural to full operative epidural block takes about 30-40 minutes - with a spinal and a quick surgeon you could have had your baby in that time).

Hope this helps and I've not been too technical.
Gasman

smallorange · 04/02/2009 14:08

I've had both and think the spinal was much easier to deal with - it wore off more quickly, catheter came out sooner etc..

HeadFairy · 04/02/2009 14:13

I had a spinal for my elcs and I didn't feel a thing, not even the washing up in the tummy sensation others have described. In fact I couldn't even feel when they hoiked my legs up to put on my delightful surgical stockings. I looked up and there were my feet, waving about in the air. And I was convinced I was still lying flat.

Mammina · 04/02/2009 14:25

I had a spinal too, wasn't given a choice. It's a weird sensation bec you can feel the pushing and shoving inside but it doesn't hurt. Don't worry they won't start until you have reassured them you can't feel anything.
To be honest I was bricking it the night before but it is over so quickly and once they give the baby to you you don't even think about the fact that they're stitching you up. You will be fine just think about the end result

Original poster
2point4pets · 04/02/2009 15:47

what fantastic messages - gasman, I can only hope you may be working on Friday morning somewhere in the South East!!!
Looks like it will be a spinal for me then. Thanks for all of your kind thoughts - I suspect the section may be the easiest thing I have planned for Friday morning!

OP posts:
HeadFairy · 04/02/2009 16:57

Good luck. It's a breeze You're only on the table for 5 mins before they hand you your baby, the next 30 odd mins fly by cos you just stare googly eyed at your little dc while they stitch you up. I even fed ds in recovery 10 mins after leaving theatre.

violethill · 04/02/2009 18:23

If you've experienced a natural labour previously it'll seem very quick and easy... as headfairy says, no sooner are you on the table than they're lifting the baby out. Stitching up takes a while though. You won't feel any pain, but you will feel a lot of pulling and tugging - I was virtually lifted off the table at one point. But don't worry about pain - they will spray cold water and pinch you to check that there's no pain. I found it all a weird sensation, because I hadn't had an epidural for previous VB, but it doesn't hurt at all.

bunsen · 05/02/2009 10:33

Marthasmama and Gasman, I am to have a planned CS and suffer panic attacks. Do you think they will give me something for it so I can stay awake? Had an em cs last time and they knocked me out because I said I'd need something to calm me down.

McDreamy · 05/02/2009 10:36

I had a spinal for both my sections. Have 3rd section booked for next Tuesday and have been told I will have a spinal epidural combination (local policy). Both my spinals were great although I did drop my BP with the first one. I wonder if I will even notice the difference!

mumoverseas · 05/02/2009 10:46

really useful thread and in particular the message from gasman.
I'm booked in for a CS in 69 hours (yes, I'm counting hours now as I'm starting to panic a bit) but can feel me getting a little calmer having read the messages on here.

gasman, ignore 2point4's request to work friday morning in the SE or else fit her and in and then fly to Saudi to fit me in on Sunday morning!

I'm having my 3rd CS under spinal but since the first one (12 years ago) I've had a spinal fusion (L4/5) and when I had DD 2 years ago I was pretty scared that the spinal wouldn't work due to my fusion. I was terrified that it wouldn't work and got very panicky and felt very sick and dizzy but from what you said in your post maybe that is normal to do with my blood pressure and not just me being a woos? I remember last time the anaest(sp?)/nice drugs man kept wanting me to have a GA which I didn't want and have been terrified the last few days about the thought of the spinal not working (don't worry OP, I know it works for normal people, just worried about my crap back)
Am seeing the anaesth/drugs man on Saturday night so am hoping for a bit of reassurance then but your views would be fab if you come back on here. (so sorry for hijak op

gasman · 05/02/2009 18:36

Ok.
don't think I'll see either of you - sorry!

Erm in order of poster...

bunsen
Tell your anaesthetist you are prone to panic attacks. They wouldn't want you to lose the plot on the table mid operation as that is pretty unpleasant (and possibly dangerous) for you and the rest of the theatre staff.

I wouldn't usually give people sedatives but other anaesthetists might. Definitely worth speaking to them about. Tbh I find that reassuring/inane chat is noramlly enough (can only think of one or two cases where it really wasn't enough). Brief your birth partner too about being super reassuring. We will look after you, honest!

mumoverseas
Yes -too rapid a drop in BP = sick and dizzy. Prev spinal surgery (as you know) is often a reaons for a spinal/ epidural not to work so you are right to be anxious -the fact that you've had a spinal which did work is very reassuring though. Hopefully it'll all be fine on Sunday.

I'll be thinking of you both over the weekend.

hairygodmother · 05/02/2009 18:52

Haven't got time to read all posts but just saw this in passing - don't worry about them starting if you're not numb. I had exactly this happen to me with no 1 - elective cs, they actually did a spinal and as they started I asked them if I was supposed to feel anything. They all kind of took their hands off me and stepped back so don't worry, they will be paying attention and won't carry on if you tell them you can feel it! I think a couple of the other posters are right - just trust them to do the right thing, they do it all the time! Had an emergency cs for no 2 with epidural and it all went absolutely fine and was bfing within the hour!
GOOD LUCK!

madmouse · 05/02/2009 20:22

gasman seconding you on the importance of reassuring chat. I ende up giving birth in theatre after rotational forceps, but number ready for section.

The most reassuring person in theatre was the anaesthesist. He taked me through all the faces,, all the procedures and he made me laugh! In fact I am likely to need a section when next pregnant, plan to return to the same hospital and will pray and cross fingers, toes and tail that I have him again.

madmouse · 05/02/2009 20:23

ahem numbed ready for section

banjaxed · 05/02/2009 20:34

Interesting thread! I had an emcs with a spinal and remembered feeling very woozy at one point whilst all the stitching was going on. I had assumed it was blood loss (800ml) - I hadn't realised that spinals can drop your BP.

FWIW my spinal was so effective I was numb almost up to my neck - made 1st BF interesting when I couldn't feel a thing...... Had DD around 4am and still had numb legs most of the way through the next day.

Good luck & enjoy it! It's lovely being so numb to it all and having an excuse to lie in bed and do nothing! (not so fine when DC is screaming in the cot next to you and you can't get him/her out, but that's another chapter).

AngeChica · 06/02/2009 08:16

Sorry to hijack but would be interested to hear from Gasman. I had an EMCS but it wasn't really an emergency as my induction had totally failed so it was quite a chilled out procedure - everyone sitting around chatting in the threatre etc. However after DS was born they had to do various things inc uterine massage to stop the bleeding but I lost 1500 ml blood. I vaguely remember the anaesthatist say he was giving me something to help stop the bleeding. I'm not sure to this day what made me feel so awful on the operating table though - the one thing that really freaked me out about the op - was it the blood loss or the drugs?

I was debriefed by an anaesthatist after the CS but it wasn't the same guy adn I can't remember a thing about what he said!!

Also I was monitored very closely, first by theatre assistant then midwives for the first few hours as my oxygen levels were a bit low - was this because the spinal had affected my lungs a bit & is that quite a common occurence?

mumoverseas · 06/02/2009 08:48

thanks for the info gasman

2point4 good luck for today. I'm sure all is/was fine and look forward to your birth announcement x

EllasAunt · 01/10/2010 21:50

Hello

I have felt relief and some sadness reading these posts.
I had my beautiful son a year ago - following 10 years of trying with ivf.
A planned c-section was decided on for medical reasons.
I told the anaethetist in the consultation that I suffered panic attacks and was worried. Nobody took any notice.
As soon as I felt my legs go numb the worst panic attacks of my life followed and I ended up screaming on and off - throughout the c-section, in recovery, and back on the ward. I just spent the whole time trying to keep myself calm. I barely remember my son being born and have shed many many tears over such a ghastly experience. At no point did anybody offer me any help, or come to talk to me about it afterwards. There was just one nurse in recovery who I heard ask the others if I'd been given anything for the panic attacks.

I feel so sad that it actaully would have been possible for them to give me something and why oh why didn't they?

I have spent many times over the last year trying to find any information of others that might have also panicked when they lost the sensation, but people have just looked at me gone out.

It has prevented me from trying for baby number 2 as it was so traumatic. But maybe I should - and insist on something to calm me down.

Sorry for the ramble - feel relieved

xxxx

MollysChambers · 01/10/2010 21:54

Good grief Ellas that sounds terrible. Have you spoken to anyone about it?

TheBreastmilksOnMe · 01/10/2010 22:56

Gasman- thanks for your posts they are interesting, could you please elaborate on what you meant by 'interesting anaesthetics'? I find that fascinating that you can get different types and would like to learn more about them if you have a minute?

I had an epidural for my labour which didn't work as I could still feel the pain in my back and down one side of my body even though it had to be repositoned several times. In the end I had 2 spinals and for the length of time they lasted they were bliss! When I went down for my emergency c-sect I had another spinal and it was great. No pain just a lovely warm feeling but I did feel very dizzy at one point during the op and got awful shakes afterwards.

I'd never have another epi again though as I'd hate to be paralysed and in agony again. I'd much rather be in agony and be able to move around.

beanlet · 03/10/2010 17:18

EMCS. Spinal. Wasn't offered a choice. Even ELCS's are done quickly, so no chance of the spinal wearing off.

japhrimel · 03/10/2010 20:34

Yep, epidurals being topped up is for when you're in labour a long (and unknown) amount of time.

The plus of a spinal is that you can tell them if you can feel anything! The anaesthetist I saw to discuss all this (various health issues mean epidurals/spinals are far less likely to work for me) said that a spinal should work so fast they have plenty of time to check it has worked, even if an emergency.

If you get panic attacks, discuss it with your consultant before going in. An anaesthetist is not likely to be able to give you anything for anxiety so this needs to sorted ahead of time.