c-section general or epidural???

[Ali Jayne]

Hiya there,

I am still trying to decide if I should try a vbac or go with an elective ceaser and would love to know if anyone has a phobia as I do of epidurals/spinal blocks.
I had an epidural last labor which ended in an emergency ceaser and it was awful, ceaser itself and recovery was fine though. I have since had a friend who's leg kept jumping each time the doc was trying to put it in. Another lady in Dubbo had an epidural and it caused an infection which travelled to her brain and killed her!!
I know its nice to see your bub straight away but I honestly dont think I can do a needle in the spine again. Has anyone been knocked out for their ceaser??
In the case of the vbac the midwives at our base are notorious for doing things their way!! They tell you its all your choice but easily refuse intervention when requested and lately this has caused problems with the births here now too. I am totally scared and dont know what the hell to do??? I am frightened if I do try a vbac that they will let me go too long before doing a ceaser as before...Some hospitals and midwives make me sick:barf:
Unfortunately I really only have the one hospital here to go to. I tried the local private hospitals and they have all closed their maternity sections down. Last stay in hospital was dreadfull, blood still all over the irthing mat in the labor room, all over the floor in the bathroom which stayed for the entire week I stayed, I could go on and I am sure you guys are falling asleep so will stop. Kind of needed to vent a little too as am getting quite cranky and dont know what to do!!:ecomcity:

Any advice would be greatfully appreciated!!

[SassyMummy]

Spinals and epis aren't the same... it sounds like the stories you've heard are more about Epis than spinals...

I had a spinal, and nothing freaky happened. I haven't had any sort of ongoing backpain (like some women complain of after an epi) or anything... it was just one quick needle and that's it.

I never want to have a caesarean ever again, but if I did, I'd prefer another spinal. I wouldn't want to be knocked out completely (if for no other reason than it's more dangerous), and the spinal had no ill effects.

I'd definately at least ATTEMPT a spinal before electing a general...

In regards to a VBAC.... have you considered a home birth? It's not my ideal situation, not at all... but if my choice is successful HomeBirth VBAC or Repeat Caesarean, I'd prefer to do it at home. You can always go into hospital AFTER you've had your homebirth if you wish... which, at hte moment, is what I'd like to do (I enjoy having people make my dinner/breakfast/lunch etc... while I lay around all day in my PJs...lol).

It obviously depends on how much you'd like a VBAC... I want it so badly that I'm happy to give up the hospital (which I like) if it means I'm more likely to avoid another caesarean... you might be different though.

[Ali Jayne]

Hmmm, not sure I would have the guts for a home birth haha. See the doctor has told me that if I want a vbac that they limit the time you are in labor to prevent any injury to your scar or the baby so that to me sounds ideal however I know these midwives are well known for making women wait. My sister was put through over 30hrs for both her first two before emergency ceasers due to failure to progress, in all these hours she never got any further than 3cm. 3rd baby obviously a ceaser and for her this was much easier.
What also makes me angry is that women dont get to choose a doctor to have present at the birth, you just get who ever is on call on that day! Even private patients. You go into labor not knowing who will be there, and the awfull midwives tend to stick around and all the nice ones leave..
May I ask you why your ceaser was so bad?:(

[SassyMummy]

Nothing was really wrong with my caesarean... I just didn't want it, and feel it wasn't necessary. I never went into labour, was induced 3 times, and then given a caesarean because I was overdue. There wasn't any evidence that DD or I were in danger... it was just about dates.

I REALLY wanted a vaginal birth... just for the experience really... so am peeved that I didn't get that experience.

I think the reason a lot of women look into homebirth for VBACs is because nobody will prematurely rush you into a caesarean. The hospitals tend to have strict rules which need to be adhered to... strict monitoring which often limits positioning (which can be bad - since positioning can play a big part in whether you successfully VB or not), have a "time plan" in which you have to fit into... etc etc. Even then, you have different middies coming in and out... every so often... in between checking on other birthing women... etc etc.

At home you have 1 woman who is there for YOU, and you alone (oh, and of course your baby too...lol). They have such a keen eye on you that if something SHOULD go wrong, they'll be right there to witness is ASAP and make sure you get to a hospital. They won't make premature decisions for you to have a caesarean, and so long as everything is progressing well, they'll be happy to let you labour for as long as you need.

I guess for me, I'm more comfortable with that idea... knowing that ONE woman who I choose, will be looking over me my entire pregnancy and birth. She will ALWAYS be there when I need her during the birth... she'll understand my exact desires BEFORE I go into labour. She'll know me as PERSON rather than a PATIENT. I'd rather that than take my chances on whomever's working at the time.

I can understand why women would want a repeat elective... I think the way VBAC has to be dealt with it pretty poor... and even I sometimes think about just electing another caesar... at least I'll know what to expect.

But like I said, spinals and epis are different. If you choose a caesarean, I would think a spinal might be safer. They ARE pretty safe and they tend to not have as many side-effects as epis do.. and going under general can be kinda dangerous.

[mum2my4]

I have had both a spinal and a general for a c-section. Personally I preferred to be awake.

[missie_mack]

I had a spinal. No real side effects or pain. Only thing was it made me cold. Not a fan of midwives myself so I appreciate where you are coming from. Have you thought about having your own OB who would call the shots or a doula??

I had no issues with my csection but given the choice I would go natural. Less recovery requried.....

Good luck

[Ali Jayne]

Wow, there is so much to think about.
It would be great to have a woman there to solely look after you and the bub. I think I have heard to much about rupturing scars, my sister included in that so to me its not that rare as they say I guess.
Sassy_ I cant beleive they did give you a c-section so easily. I wonder why!! I would be annoyed too, at least I got to try..
They put you off here for a ceasar as long as they can so I guess that is nice for some women.
Do you guys know what the dangers are for a general? Vague arent I :confused:

[SassyMummy]

Can't remember ALL of the risks involved with a general... but the few I remember are:

*Higher Risk of Blood Loss
*Higher Risk of Death of Mother (very, very rare... but sometimes a mother cannot be re-awoken after going under)

There's also the things like bonding and breastfeeding - the sooner you can hold and breastfeed your baby, the better it is for them (and for you too I believe!).

Not MAJOR MAJOR risks... but considering a caesarean is a risk in itself, it's worth considering.

I don't want to seem pushy about VBAC, but if you'd like, there's plenty of info on uterine rupture out there. There's a very slim chance it'll happen, but it can happen even IF you have a caesarean and even if it's your first pregnancy.

The risk of uterine rupture in VBAC is about 0.05%... so about 1 in 200. Of that 1 in 200, only a small percentage will die... so the risk of uterine rupture leading to death is very very small. I can understand your concern (heck, I'm worried too!), but it's a relatively tiny chance...

Hope you don't think I'm trying to push you either way... just trying to help you info-wise.

[mishlc]

Wow, there is so much to think about.
It would be great to have a woman there to solely look after you and the bub. I think I have heard to much about rupturing scars, my sister included in that so to me its not that rare as they say I guess.
Sassy_ I cant beleive they did give you a c-section so easily. I wonder why!! I would be annoyed too, at least I got to try..
They put you off here for a ceasar as long as they can so I guess that is nice for some women.
Do you guys know what the dangers are for a general? Vague arent I :confused:

Ali Jayne,

Have you considered a Doula? I only heard about Doulas when I found this website and since reading up on them I am def going to get one. My DH is very opposed to the idea, saying it is a waste of money but I don't trust the Drs or Midwives anymore so I know she will be there for me and if she says, it's time to go to theatre, you have to Caesar, I will beleive her and go, but if they want me to go to convenience them, sorry, no can do!:shame:

Def, try VBAC. Statistically you're way better off I reckon.

xxx Mish

[chameleon]

Well I think Sassy has covered everything pretty well!:yes:

I had a spinal for my c-section and no problems with it. I did ask for a general because I was so nervous, but they said it's more dangerous.

I have also been looking into a VBAC for my next pregnancy (not pregnant yet but nothing like being prepared!) and I am also leaning towards maybe a homebirth or at least having a doula. But I'm still looking into it... so much to think about isn't there?!

I hope everything goes well for you anyway, whatever you decide!

[chameleon]

Have you considered a Doula? I only heard about Doulas when I found this website and since reading up on them I am def going to get one. My DH is very opposed to the idea, saying it is a waste of money but I don't trust the Drs or Midwives anymore so I know she will be there for me and if she says, it's time to go to theatre, you have to Caesar, I will beleive her and go, but if they want me to go to convenience them, sorry, no can do!:shame:

My DH is the same! I was telling him that I was thinking about having a doula there next time and he was not fussed at all! He thought I was telling him he wasn't a good support person and took it personally... they just don't understand!:no:

[Ali Jayne]

Thanks guys,

I am seeing the specialist today so will also see what he has to say..

Hopefully either way I will have made my mind up which way I am going to go coz I dont like being confused..

Thanks everyone :smiliedance:

[unhindered]

There will always be less risk with a vaginal birth no matter how many c-sects you have. Rupture of the uterus is very rare. Again it comes down to choosing your care provider if you go to a surgeon, someone who does not specialise in normal natural birth then surgery is most likely the outcome. Have you looked into independent midwives? Birthing at home does not require you to be someone special if you have a vagina you can birth at home. IM's specialise in one to one care in normal natural everyday birth. No scaremongering and fear tactics to fit into the system iykwim. Less stress all round for you and your baby.

[Melbz]

I have had both a spinal and a general for a c-section. Personally I preferred to be awake.

I've also had both and I agree, much better to be awake.

[Ali Jayne]

Well ladies I have been to see the specialist and I am affraid I am no better off. He did say he wanted me to try a VBAC but in asking about my scar tearing he made me feel like I would rather a ceasar again. He said he has seen tearing quite a lot and that they have to move very quickly in this instance as its highly dangerous for both mother and baby and that I would be rushed down with little explanation and would just need to deal with it afterwards.

So I then asked if there was someone there all the time to do surgery if this was to happen and he then said no, that I would be taken to another hospital 45min away if there was no-one available. He also said I would be hooked upto a drip and all the necessary equipment ready for surgery during the labor just in case. Having tried a natural birth with twins and being hooked up constantly its so hard to move and get around.

Another thing that concerned me is I asked him how would they know if my scar was tearing? as we know, contractions are that severe that it would be hard to distinguish another type of pain and the ob agreed that they need to watch for other signs which is the baby usually goes into distress and the heart rate slows and the labor stops. Now if I have a baby in distress and then have to travel almost an hour to another hospital I feel I would rather a ceasar any day. I had no problems with my last ceasar, I had no problems breast feeding my twins or bonding with them either so I have no fear of ceasars. Not sure where the link between ceasars and not being able to breast feed ever come from!

So I guess that is that unless any of you guys have any other ideas. HBAC is deff out of the question. As much as some people dont like intervention I believe that intervention has saved many a baby and mother in these modern days especially when you are in a high risk category so I havent the guts to do something like that. Overall I wouldnt forgive myself if something happened to the baby due to me trying to have a VBAC.
Sometime its better the devil you know maybe?

Just to let you know, our local hospital, GP's and midwives all have a shocking reputation here so that doesnt help either, I wouldnt trust their judgement. Our one decent ob I can book into for the ceasar and that is my most comfortable choice I think.

Sorry to gabble :ecomcity:

[SassyMummy]

There'd have to be something going wrong for him to have seen lots of ruptures recently... the statistics don't back that up, so you'd have to be living in a very unlucky area!

Perhaps what you should do is talk to women who have experienced VBACs... a lot of the time, they are very well researched in the area, and can offer plenty of advice.

Also do your own research.

http://www.vbac.com/uterine.html

Also found THIS on uterine rupture for you:


What is the added likelihood that the scar will give way (uterine rupture) during a VBAC labor?
Best research suggests that an extra 27 women experience a ruptured uterus in every 10,000 VBAC labors, compared with planned c-section deliveries. Thus, nearly 400 women would need to experience surgical birth to prevent one instance of uterine rupture during VBAC labors. While the scar giving way usually requires an urgent cesarean, loss of the baby is much less common (see next paragraph).

Added likelihood for a woman with a known low-transverse (horizontal) scar: MODERATE for scar rupture compared with planned repeat c-section.


What is the added likelihood that the baby will die as a result of the scar giving way (uterine rupture) during a VBAC labor?Best research suggests that about 1.4 extra babies die due to problems with the scar in every 10,000 VBAC labors, compared with planned c-section deliveries. Thus, over 7,000 women would need to experience risks of surgical birth to prevent the death of 1 baby from scar problems during VBAC.

Added likelihood for a woman with a known low-transverse (horizontal) scar: LOW for death of the baby around the time of birth compared with repeat c-section.


You can find more here:http://www.childbirthconnection.org/article.asp?ck=10210&ClickedLink=293&area=27

There's a lot there about VBAC vs elective repeat caesarean.

FOR ME, it seems ridiculous to have a caesarean JUST IN CASE something goes wrong... because for all you know, something could just as easily go wrong with another caesarean.

I think that, from an OBs perspective, you having a caesarean is safer FOR HIM because he can control that - you just lay there while he control the situation. Labour is something he cannot control though, so I think that's why OBs often tend to be more pro-ERC (elective repeat caesarean) than pro-VBAC.

Obviously, it's all down to you, and what YOU think and what YOU'RE willing to put your faith in. One is putting your faith in your OB and his knowledge, skill and such, and the other is putting faith in statistics, your own body. That's what it really comes down to.

If you have faith in your own decisions, faith in your body, then go for VBAC. If you're a little skeptical, then take time to think things over. Looks at evidence-based facts for BOTH sides of it... then decide.

[Mamaduke]

I've had an epi, spinal and a general (note, I've only had 2 babies so far!)
The epi was done while I was having contractions and it was the WORST pain I'd ever felt in my life, and I'd been through 12 hours of labour by then. Left me so bruised.
The spinal was for my elective c/section and just as they were cutting that last cut I felt everything which resulted in me having to be put under (general). Afterwards I developed a spinal headache which means that spinal fluid was leaking into my brain. I had to go back to theatre and have a blood patch done - blood taken from my arm and injected into my spine to close the leak. NOT FUN!
I now have a terrible phobia of anything going in/near my back and unless I get this sorted out between now and January, I'll be having a general...which I don't really want either.
Lesser of two evils for me I think.
Edited to add...I'm now sorry that I didn't insist on a VBAC with my second pregnancy. With a VBA2C the odds of uterine rupture are just too high for me.
If I had my time again, I would have definately insisted on a VBAC with Lukey.

[Silvana]

Just out of interest, why do some have a general and some a spinal or epi? I had a spinal (they had to get through nearly 2 inches of fluid because of the pre-eclamspia :eek: ). Apart from a big bruise, no other effects.

[SassyMummy]

I think general is sometimes reserved for emergency caesareans, especially when the woman doesn't already have an epidural in.

They can also be requested.

[Ali Jayne]

Unfortunately I do live in an area where the staff are well known for being bad including the GP's. My ob is good but they don't attend the birth.

I have another appointment to see where the baby is positioned etc in 3 weeks. He is happy to have a trial of labor and told me he can tell me the odds of it being successfull as we get closer to the due date.

If I was in a decent hospital with emergency staff available I would try vbac but with limited staff etc its so scary. The ob himself lives an hour away even if he is on call to have to come in for a c-sec.
I feel if you can rule out certain risks then its ok.

Have any of you guys seen any connection between the labors your mothers had to your experience. I have been looking into it and so far it seems almost genetic with what type of labor you have. Not taking into account obviously your own preparation etc but still is interesting.

All my friends that have had shortish labor, their mothers also had this and vice verser.
The shortest actual labor my mothe had was 24hrs. My sisters labor both went over 30hrs and yes I am talking actual labor! then I tried also for 24hrs with failure to progress. I guess I amtrying to prevent trying labor and ending up in c-sec again. As much as I coped with this with my twins, I was so out of it and tired by the time the ceasar happened I cant remember a thing. DH told me it was cait they put in my arms but I wouldnt have been able to tell you.

You have all been vey helpfull girls. Much appreciated!!!!!! :hugs: :hugs:

[Lillynix]

Probably a bit late now...

But I had an emergency c-section under a general with DD.

It was not my choice to have the general, as I had an epi while I was in labour, but it only worked on the left side of my body. By the time I went to theatre, they topped up my epi, but it only worked on my back and my legs, I could feel EVERYTHING in my abdoment still, so was told I needed the general.

It resulted in complications for me during theatre, high blood loss which resulted in a touch and go situation with my life, DD was perfectly fine however. I needed a blood tranfusion 2 days later as my iron levels went from a normal 130 down to a dangerously low 60.

For me, it was the worst thing ever. I was in recovery, passed out still for 2 hours, so by the time I got to see DD for the first time she was clean and dressed. I couldn't breastfeed for the first 7 or so hours as I kept passing out still due to the general. The blood loss resulted in poor milk supply, so it was dried up come 3.5weeks post partum.

Not only did I miss the birth of my first born, but so did DH as he wasn't allowed in theatre due to me having a general.

It's not something I would ever, ever do again as my experience was so horrible. I would much rather try again for an epi, despite the first one not working or go for a spinal if I needed a nother c-section.

However I am determined for a VBAC unless mine, or my babies life is at risk this time.

I know my story was awful compared to the others, but please take it into account. Things going wrong with epis/spinals (spinals have a better success rate) is rare, and despite the fact I have a phobia of needles, I would much rather have either of those and be awake for the birth of my baby and have DH present, than being knocked out in a theatre missing the most precious time in a mothers life.

[brookeme]

Both mine were emergency under general.
DS was in foetal distress so I was in within 1/2 hour of getting to hospital, no labour at all.
DD was trial labour/attempted VBAC, for 11 hours with no luck and foetal (and mother) distress, so rushed in for a c/s under general.:no: I was not impressed at all! I wanted the epi.
But apparently it was too late and had to rush in.:thumbsdown: Have had issues ever since! Im still not over it.
Im so glad I found this thread, cos I had a friend just tell me that she preffered the general(epi made her sick) and I started to doubt the epi for next time, as I am determined to have a great birth experience.
Good luck I hope everything works out fine for you and bub.:thumbsup: