How many of you had an epidural after saying you wouldn't?

[katykuns]

I am not asking this to encourage people to begin a rant over the pro's and con's... but basically, I am on consultant led care (high BMI) and am having an anaesthetic review on the 26th April.
I have always been quite 'big' but had my daughter (now 5) before my weight got worse and I had a very easy pregnancy and a pretty straightforward birth (just gas & air).
I want to say to the anaesthesiologist (sp?) that I really don't want an epidural anyway, but am a bit afraid that I may get 10 mins in and be begging for one
How many of you decided against an epidural and didn't have one? and how many of you got into labour and thought 'sod this, get me an epidural!'? lol

Also any advice on what to expect from the anaesthetic review from people would be really helpful.. I am rather worried! x

I did. Swore blind I wouldn't have one - no needles going anywhere near my back! After three hours of gas and air and one long contraction that wasn't doing anything, I had to go on a drip. When the midwife pointed out it was probably going to get more painful once I was on the drip, I would have done the epidural myself with a mirror if the anaesthetist hadn't been there already.

That said, I ended up with a C-section, and I do think the whole "epidurals lead to more interventions" argument is a good one for avoiding them if possible. But it isn't always possible.

I am not sure what an anaesthetic review is - I didn't have one - but I think if you say you would prefer to avoid having one if possible but don't want to have the option closed to you in case you change your mind, that will be fine and he/she will completely understand. All labours are different and noone can be sure how you will feel once you are in labour and I think the medical staff know that.

Well I always said I wouldn't have one. But the emcs both times may have smarted a bit without it.

I learnt the hard way first time round that labour and delivery come down to the luck of the draw. My ideals went right out the window and I felt like a huge failure. But second time round I realised that if I could come through it mentally well with a healthy baby then actually I was relieved that modern medicine existed. The alternative is unthinkable.

I genuinely thought it was a simple choice. I didn't want an epidural/intervention so would manage without either. Of course neither the baby nor luck knew about my plans and the learning curve was pretty steep.

I think if you'd rather not have an epidural then there are many things you can do to improve your chances of an epidural free birth and there's a whole arsenal of techniques and other options to pursue. But I would never enter any pregnancy now saying that I would/wouldn't accept xyz during labour and delivery because I don't know what that delivery would bring iyswim.

Me too. I swore blind I was going to do it all naturally and sneeze the baby out, right up until the braxton hicks started

Clearly I am the biggest wuss on the planet!

It was a tricky birth though, and I was prepped for EMCS but the baby was stuck in an awkward position, eventually had ventouse and forceps. I do often wonder if it would have been easier without the epidural, but then, if he was going to get stuck anyway, I wouldn't have liked to go through that without it!

I never wanted one. I didn't have one, but not for the lack of begging :o

I had one for the firs two after swearing I wouldn't. However both were theater deliveries. I suspect if I hadn't succombed no2 wouldn't have ended up with the ventouse as the epidural stopped everything.

#3 I was was desperate for a waterbirth. When the midwife offered to go fill the pool I was screaming for an epidural ! Sadly it was all too late and DD arrived within an hour whilst I screamed blue murder for some effing drugs.

I did - I was so adamant I wasn't having the old needle in the back (still freaks me out that thought to be honest!) but I ended up being induced and I had quite a late epidural - best thing I ever did - I was about 6cm when i had it, slept for an hour and woke up 10 cm and ready to push - didn't even feel the crowning! bloody brilliant!

I think you just can't tell what you're going to want/need until you're in the moment so have your opinions and then keep an open mind. My current stance on this pregnancy is that i'd like to do it without, but if I want one, I'll have one! and if I can keep it until quite late in the proceedings again I'd do it that way again. I don't think we actually have a huge amount of control though - fate determines the birth you'll get and you just have to suck it up!

I also had an anaesthetist review due to high BMI.

She was lovely and kind, and told me about epidurals and spinals, then basically had a look at my back to see how easy it would be to site one. Apparently I have a thin back so it would have been fine, but I imagine she would have come up with some sort of plan if I'd carried more fat on my back.

Good luck, and try not to worry, they will see much bigger women than you.

I agree that you should be able to say that you want to keep your options open until you see how you're coping at the time. They can't force you to decide beforehand, and they can't force you to have any pain relief that you don't want (and nor should they be able to deny you an epidural if you decide at the time that you'd like one).

Personally I knew I wanted to try without an epidural, but I did end up asking for one (too late as it turned out!) as DD was back-to-back and I was having a hard time with the back pain.

I didn't want one for various medical and cowardly reasons but did ask for one with DS1 after they made me lie on my back for monitoring (OP labour, was fine when I could stand and walk about but laying down was horrible) I couldn't have one as I was too far along and instead was awkwardly insistent on getting up and moving around which I think was better for me in the end anyway.

I didn't want one. I was told I had to have one because it was convenient and so was held down for 45 minutes by 2 people whilst it was sited. All my fault for having a curve in my spine, silly me. And after all that, it didn't take away any pain, just left me immobile. Which was really handy when I was left alone with a newborn to look after in the middle of the night.

So, sticking to my original plan of not having one would have been far better

Xpost with Natasha - I think it would have been a lot harder to get DS1 out if I couldn't kneel/squat and had to push him out lying down. I don't think a lot of midwives or doctors realise how much more it hurts when you're on your back and the baby is OP.

Yes, I had one after swearing that nothing on earth would entice me to have one. Even after being told, at 8 months pregnant, that baby would be an estimated 10lbs at birth, I was resistant to the idea. (I had once seen a news item about a woman who had been left in a waking coma after an epidural went wrong so was irrationally scared).

Cue 46 hours of labour, v v v v v slow dilation and utter, utter exhaustion by the time they said I could push. I pushed as much as I could until white lights started to go off in my head (at least that's the only way I can describe it) and then demanded pain relief. I just couldn't get him out. His head was wedged and then his heartbeat started to dip.

In the end I had to have an emergency c-section as he did a poo and he wasn't moving any further. I was thankful that I had an epidural as it enabled me to have a c-section and stay awake. DS still has a groove in his skull where he was wedged into the birth canal but wasn't moving further along.

Thanks for all your responses!

Debka, I heard that if you have troubles, they can put the drip in ready just in case you will need one. I really would also like to avoid that! Hopefully I have a thin back as well lol

I think you really do lull yourself into thinking it will be like the first labour, and I shouldn't be so naive lol. Maybe I will get lucky and it will happen so quickly I don't have the chance to decide :P

BigHairyFlowers - I doubt very much you are a wuss lol. I think one of the biggest reasons I don't want an epidural is the idea of them fiddling about with needles near my spine! I think that makes me a bit of a wuss! lol

I definitely think if I had a very long labour, I wouldn't give a crap about the pros and cons of the epidural and just be there consuming all the drugs within reach just to get rid of the pain! lol

I had an anaesthetic review as BMI was 57 . Took my mum with me and glad I did, it was quite upsetting as they were very blunt (told me they wouldn't do a GA as I could die as it'd be hard to start me breathing again if I stopped). They wanted me to have an epi early in labour as it'd harder to site them when you're bigger. Long story short as I'm typing one handed whilst BFing, I said no as I wanted no drugs due to my size, ended up with one anyway as waters went but labour didn't start quickly enough so induced by drip, ended up with section as stuck at 4cm for 8hrs and got infection from waters being gone for so long. Ironically I was all set for a hypnobirth but waters going and labour not starting scuppered it.

I haven't had my first child yet, though I am planning to have my baby in a midwife-led unit as long as there aren't complications between now and then and I know I can't have an epidural there. So I'm hoping to be someone who has a straight-forward birth and don't end up screaming for an epidural.

Anyway, I had my anesthetic review fairly early on with my 20week scan. The anaesthetist was surprised to see me there that early but it was just planned that way so I wouldn't have to go to the hospital twice.

She was understanding and talked me through the risks associated with a raised BMI and about how sometimes its difficult to site an epidural so if I want one then its best to ask for it sooner - as it'll be easier to place when I have longer between contractions.

I can't remember if she even asked what I was planning for the birth, it was more about her giving me the information (about increased risks, lowered effectiveness, if they can't get a local in earlier they may need to put a general in in an emergency etc) rather than her laughing at my plans to not have an epidural IYSWIM? She felt my back and looked in my mouth. Didn't seem to see anything that would prevent me from having pain relief if I wanted it.

I was ready to be sarcastic if I had been told off for my high BMI (well, thanks I'll bear that in mind when I'm planning the next one, but as I'm already pregnant and have been told not to lose weight...) but didn't need to be so defensive. Most folk have been understanding really, to my surprise.

The only irksome thing is she gave me a leaflet about obesity in pregnancy and why I needed the anesthetic review. It said:

^When will I see the anaesthetist?

If you are otherwise well and your BMI is between 35 and 40, then the anaesthetist will see you as early as possible when you are admitted in labour. If your BMI is greater than 40 you will be given the opportunity to meet an anaesthetist at one of your antenatal clinic visits. This will allow us to see you, examine you and discuss pain relief and anaesthetic choices in relaxed surroundings. This is easier than trying to explain things when you are having labour pains.^

I suppose it could mean that there is more discuss if your BMI is >40 maybe the risks are greater and the chances of them finding a problem when they examine you is greater. But I read it as... if your BMI is greater than 40 then you are clearly more likely to be hysterical and stupid during labour, so we need to have this conversation with you before you have a contraction and lose all reason.

I may be a bit sensitive - mainly because my booking in BMI was 41 (just after christmas day and my wii had measured me that morning at just over 40). But at the time of the anaesthetic review my wii gave me a BMI of 38 (even if you assume that it was a little generous, it would still be closer to 39 than 40). And the hospital gave out my notes to another patient that day not sure I'd trust 'em with my baby tbh...

(prays for straight-forward birth in local MLU)

Wii still measuring my BMI (marginally) under 40 at 25 weeks +6

My entire NCT group

I was the only one openly adamant from the outset that I would want one. That said, I was warned by the midwife that it would slow proceedings down - and it did - but I was in a lot of pain as DC1 was in a dodgy position and as it turned out even without the slowing effects of the epidural I would have had problems.

Do try and keep your options open. You don't want to spend your pregnancy wondering whether you made the right decision.

I am/was a size 20 when I had DD. I didn't want an epidural and in fact gave birth with absolutely no pain relief whatsoever. I was 12 days "overdue", went into labour at about midnight and was back home by midday.

Anecdotal I know but being big doesn't have to mean difficult birth :)

I was going for the full on whale music and low lights natural birth, but caved about 12 hours in to what turned out to b a 36 hour labour ending in c-section. Thank fuck I did.

You cannot know in advance what your labour will be like and how you will handle the pain. I have a very high pain threshold, but after 12 hours of it, I was like a wounded animal. I couldnt have gone on.

Me
I thought I wanted a natural birth but I had a 5 day starty stoppy labour before they would even let me in hospital so by then I was knackard and needed a rest so opted for diamorphine. I then got induced as I didnt progress as had hoped. Opted for more diamorphine and 20 mins later demanded and epidural! it was too much and I was too tired.

As others have said, you can't predict what will happen or how you will feel/cope but being informed is the best thing you can do so you make a choice at the time.
I hope this labour will be quicker and I can have a water birth but we will see what happens in about 7 months time!