does anyone have any experience of giving birth when you have chronic asthma?

[makipuppy]

I'm 41 and nearly 30 weeks.

My asthma is chronic but usually perfectly controllable with two inhalers - I was able to do spin classes at the gym with no problem before getting pregnant! I still use my inhalers but am very out of breath up and down stairs and can sometimes need a puff on my reliever if I'm just walking around, or if I laugh a lot, etc.

Otherwise, I'm very healthy and not overweight. Pregnancy is all fine .

I'm overseas at the moment, returning in a couple of weeks to start discussing birth plans. Will the doc definitely want me to have a planned c-section?

Thanks Leningrad. I'll have to see what my doctor says about my meds when I'm back in the UK. I suppose I could get a higher concentration reliever, but my GP (here in Germany) has said it's OK so long as I only need it once or twice a day. I had a chest infection last week and she gave me an inhaler machine (not ventolin, just a saline solution) and some herbal remedies I didn't take.

It's not helped by living 100 steps up (believe me, I've counted).

Congratulations on being 33 weeks!

Thanks Leningrad. I'll have to see what my doctor says about my meds when I'm back in the UK. I suppose I could get a higher concentration reliever, but my GP (here in Germany) has said it's OK so long as I only need it once or twice a day. I had a chest infection last week and she gave me an inhaler machine (not ventolin, just a saline solution) and some herbal remedies I didn't take.

It's not helped by living 100 steps up (believe me, I've counted).

Congratulations on being 33 weeks!

Interesting what you say about the pain killers, I'll definitely look into that.

Oh, you mean the brown one? Yes, I've upped it a little bit, used to just do one puff night and morning now do 2, on dr's instruction.

Some drs might push me towards a c-section anyway because of my age which makes me a bit cross because I'm perfectly strong and healthy. I'm hoping there aren't contraindications with epidurals and asthma though. That would be a real problem for me..

Ok.

Analgesia in labour - epidural is OK as is Gas and air (have met several pts who have told me that midwives said they couldn't have it. I don't understand this rationale. If they had to have a general anaesthetic (for any reason) they would get gas and air).

Post Op analgesia (assuming you need operative intervention) Paracetemol, Codeine etc. are OK. NSAIDS (Ibuprofen, Diclofenac, Neurofen etc) are Ok provided that you are not one of the 10% of asthmatics known to react badly (wheeze) when given them ore Aspirin.

Traditionally the risk of wheeze with NSAIDS was overstated so many asthmatics have spent their life avoiding them. I usually prescribe them in this situation but other doctors vary in their enthusiasm for them.

Provided that you are generally well there is absolutely no reason why having asthma would lead you to need an elective LSCS.

Sounds like your control at the moment is supoptimal and you need to see someone about incrasing your medication. IMHO the risk of poorly controlled asthma is greater than the risk of the increased doses of medication you are likely to need to control it.

HTH.

Thanks Gasman. I'm out of the UK now but when I'm back in a couple of weeks I'm going to look into further with my doctor. I did think I was going to get referred to a specialist when I got pg but the appointment never happened.

My asthma was much better when I was PG. About 6 weeks after each birth I had an attack and was hospitalised for a few hours.
Now GP has changed brown preventor (Becotide) for a purple one (Serotide) and I've never felt better.
I have heard that Serotide is not recommended during pregnancy and breastfeeding, but my GP reasoned that being able to breath outweighed any tiny risks.

I have chronic asthma and have 2 dc. I always find my asthma worse in pregnancy and have def had to use my reliever more. I am on flixotide and it has really sorted out my asthma. My gp upped my dose during pregnancy and it made it better.

Both labours I used gas and air with no problem. They never suggested a planned c-section for either. I had a huge asthma attack 4 days before dc1 was born and had to use my nebuliser a couple of times but it didn't have any impact on my labour.

Hth

Thanks luckywinner. I'm glad to hear your asthma attacks didn't have any impact on your labour.

So it sounds like my asthma shouldn't affect my choice of birth.

I do agree with gasman about the avoidance of nsadis though. We had IVF and they refused to give me nsaids because of my asthma which I thought was weird because I've never had any problem taking them.

Thanks for your replies!

your hospital should have a specialist respiratory nurse who would check meds and make sure that midwives etc are prepared for you.

Thanks Jenhden, I'll make sure I ask about that. We've moved countries twice this pregnancy so I've not had the continuity of treatment that would have reassured me on this, but I'll be back in the UK next week and will be on the case with the hospital.