low dose vs. walking epidural

[nattstar]

i am due in a couple of wks and i am considering having an epidural...and i really like the idea of being able to still somewhat feel contractions and being able to still walk and move around.
so can anyone tell me if there is any difference between a low dose epidural and a walking epidural...as both of them have been mentioned in the forum but im not sure if they are the same thing or not??
thanks! :)

[emma2938]

hi there,

I askd about a walking epidural and was told they are not given in australia any longer as they are a risk to the patient (if they fall over and hurt themselves as they are partially numb).

HTH

Emma.

[LuvMy4Babes]

Well I had for 3 out of my 4 children what I thought was called a "mobile epidural". It took away the nasty contraction pain but I was still able to feel my legs, get up to go to the toilet or walk around and felt all of the pushing sensation.

No numbness afterwards and no need for a catheter either.

Absolutely brilliant :)

[~Emmylou~]

They are the same thing.

You will find that their availability varies widely between hospitals.

Most hospitals are willing to give a low dose epidural which has some advantages in terms of being able to feel some sensation - but they are usually unwilling to allow you to walk around with it due to the liability issues mentioned above. Nine months pregnant women wandering around with catheters in their backs and only partial feeling in their legs tends to make them nervous ;) So you still end up with many of the drawbacks in terms of being stuck on a bed.

[nattstar]

Well I had for 3 out of my 4 children what I thought was called a "mobile epidural". It took away the nasty contraction pain but I was still able to feel my legs, get up to go to the toilet or walk around and felt all of the pushing sensation.

No numbness afterwards and no need for a catheter either.

Absolutely brilliant :)
May i ask which hospital you went to? as i am in perth as well :)

[LuvMy4Babes]

May i ask which hospital you went to? as i am in perth as well :)

Sure that was at Woodside Hospital but it closed down and now they operate from Kaleeya Hospital in East Fremantle.

[em1984]

i had a low dose epi, could completely feel my legs but most of the contraction pain was gone. could also feel to push noah out, it was great. i did request to stand upwhen in transition and completely off my trolley :D im glad they advised me against it, it just would have been too dangerous. I agree, it was great but with the back pain im sufferring now, i will endeavour to avoid an epi in the future...

[nattstar]

thanks for your help ladies... :)

[MamaLlama]

They are the same thing.

So you still end up with many of the drawbacks in terms of being stuck on a bed.

Except if you're not in pain this is not really a disadvantage.

I had a walking epi overseas and it was fantastic. They were willing to let me walk to the bathroom with assistance, but really I didn't care to. And i was perfectly comfortable staying in bed.

Now if you're in agony - THEN you want to move around... with the epi, no desire to move.

[Tam-I-Am]

Being confined to a bed is ALWAYS a disadvantage in childbirth regardless of pain felt, as it doesn't allow a woman's pelvic outlet to utilise gravity to a) open to maximum capacity and b) push the baby down and out of the birth canal.

It increases the chances of vaginal tearing due to less than optimal positioning, and also increased greatly the chance of an instrumental birth becoming necessary.

[~Emmylou~]

Except if you're not in pain this is not really a disadvantage.



Movement in labour is not simply about relief of pain.

Walking, rocking etc move the hips and pelvis. This assists the baby to move into the best position to be born and to move through the pelvis itself. Remaining upright keeps the pelvis as open as possible to give the baby the maximum amount of room.

You may have no desire to move around after an epidural but that doesn't mean that doing so wouldn't help the process, even if you aren't experiencing pain.

Women needed to give birth well before epidurals were invented - and as such were designed to do it in an upright and active fashion, the same way we do everything else. Not flat on their backs and immobile.

[NibbleCurlynBub]

I think your original question has been answered..

Perhaps you could look into other options of pain relief to try before opting for an epidural (due to liability reasons and your wish for mobility) like bath, shower or gas. :)

[stellarella]

Except if you're not in pain this is not really a disadvantage.

I had a walking epi overseas and it was fantastic. They were willing to let me walk to the bathroom with assistance, but really I didn't care to. And i was perfectly comfortable staying in bed.

Now if you're in agony - THEN you want to move around... with the epi, no desire to move.

The disadvantage is that being active is actually a very important part of the labour process.

Staying on a bed during labour, especially during the second stage has an increased risk of malpresentation, foetal distress and maternal tears (amongst other things).

[nattstar]

thanks everyone for your input.. i do understand the benefits of standing and moving around during labour... which is the main reason i want a low dose epi rather than a normal one...well if i do end up having one hopefully they will let me get up... even if it means the hubby has to assist me... wish me luck! (8 days till im due!) :)

[ashyashy]

Hello,

Just to let you know... from my experience
I had a little baby 6 weeks ago and i was all against having an epi because everyone tells you that it will cause you to have a c-section, tear, pro longs labour ... the list goes on.

Well i ended up having one, and i had no problems at all... my labour was 5 hours. No tears, no stiches, could feel when i needed to push. You just have to make sure you have a low dose (A little bit of feeling) yes i could still feel my legs but i would not be able to walk tho... but once i had him 1 hour later i could walk.

I had the best birth experience ever! I had no pain, laid there joking having a good time and was painless afterwards too.

I guess everyone is different, so it is up to you in the end what decision you make!

[MamaLlama]

Hello,

Just to let you know... from my experience

I had the best birth experience ever! I had no pain, laid there joking having a good time and was painless afterwards too.

!

Ditto :yelclap::iagree::smiliedance:

It was bliss. And the anesthetist who gave it to me I literally still have a bit of a crush on. He was 50 and balding but he walked on water as far as I'm concerned!

Also did you know that they don't really cause
those interventions. Rather, if you are unlucky enough to have a labour with a series of interventions you are more likely to ask for an epi (not surprisingly, many many inductions are much worse than regular labour and thus more likely to ask for an epi). Once you adjust for that effect they don't correlate with higher intervention rates t all (let alone have a causal relationship). Proved in the US a few years ago.

It should have put those myths to rest but sadly they persist.

[~Emmylou~]

Proved in the US a few years ago.

It should have put those myths to rest but sadly they persist.

Nothing of the sort was "proved" by one study that compared women having epidurals and women having other forms of pain relief. Perhaps you'd like to post a link to that study, it's interesting reading. As a single study, it doesn't hold weight against the vast bulk of evidence to the contrary.

[MamaLlama]

I don't think we can't. I just don't want to and can't understand why anyone would! :laughing::laughing::laughing:

The study was about early epis compared to late epis and with a control group of no epis I believe. And no, at 11pm at night I'm not wading through my still-in-boxes house to find the ref.

Point is, there ARE myths. Even you agree on that :laughing::laughing::laughing:

[misskittyfantastico]

I don't think we can't. I just don't want to and can't understand why anyone would! :laughing::laughing::laughing:


Why? Because it's normal. I'd use a smilie, but you used 'em all up.

[~Emmylou~]

The study was about early epis compared to late epis and with a control group of no epis I believe. And no, at 11pm at night I'm not wading through my still-in-boxes house to find the ref.



That's ok. Let me help you out. I happened to have bookmarked it a while back for future reference and have it at my fingertips. No need to go digging through an archive box.

http://content.nejm.org/cgi/content/full/352/7/655


Methods: We conducted a randomized trial of 750 nulliparous women at term who were in spontaneous labor or had spontaneous rupture of the membranes and who had a cervical dilatation of less than 4.0 cm. Women were randomly assigned to receive intrathecal fentanyl or systemic hydromorphone at the first request for analgesia

In simple terms - They took 750 first time mothers who were either already in labour or had SROM and were dilated less than 4cm. They then randomly decided to give them either an epidural or a shot of morphine the first time they asked for pain relief.

Yes, the control group had "no epis". But they had morphine.

Explain to me, please, how this in any way relates to women who labour unmedicated?

You've been so quick to point out the flaws in other studies relating to both epidural use and more recently homebirth. But I've yet to see any response to the criticisms of this one study that you claims makes all others null and void.

[MamaLlama]

:laughing::laughing: That's not it! :laughing::laughing:

That's the one about early epis only. That was publicised in terms of "dont' let them make you wait for it".

Which is also a very valid point.

And btw the results of the Northwestern one are very good too all round.

By way of anecdote:
I have a friend whose husband told my DH (when we were both new mums) "Oooh she hardly took any drugs at all, I'm soooo proud of her!". So she said "oh yeah I had a shot of peth, that was all. Managed, just."

And my DH said "oh (me) had the epidural straight up. Much safer than peth all round, and such a comfy labour".

Classic.

I think its a great point that demerol is more dangerous than an epi by an order of magnitude and this isn't the only study obliquely showing that. The myth is that you somehow step up risk when going from "just an iv" to a "catheter in your back" where the reverse is true. Regional anesthesia is WAAAAAY safer.

And just plain nice.

[misskittyfantastico]

Gotsta love the anecdote:yelclap:

[~Emmylou~]

Well then - let's consider that one dealt with already since it would have made an appearance at some point, no doubt.

:)

I'm off to bed now. But I'm happy to continue this tomorrow. I hope that there'll be something more substantial to discuss. IYKWIM.

:laughing::laughing::laughing::laughing:

[veve]

please remember to post politely ... all posts that are viewed as argumentative, or aggressive will be removed..

This is a thread where we can SUPPORT the choices available to women ..

we can disagree as to what the BEST option is - as long as its done in a polite manner ..

thanks
Jenny

[newbi]

hey mums,

just wondering if anyone knows if they are available in melbourne hospitals?
Or even better at the mercy on burgandy st?

Thanks x

[Pinky81]

Sure that was at Woodside Hospital but it closed down and now they operate from Kaleeya Hospital in East Fremantle.

I also had my DD at Kaleeya over two years ago now. I had the same epidural and it was GREAT! Mind you I didn't ask for it so I guess it was just standard. I was able to go to the toilet by myself but as for moving around to much I had a drip in and monitors on my belly so I was pretty much confined to the bed. When I was in the second stage I was able to get into a more practical position for giving birth which was also great :) This time around I will be going to Armadale so I am hoping they have the same epidurals :confused:

[mumma2cubs]

Ditto :yelclap::iagree::smiliedance:

It was bliss. And the anesthetist who gave it to me I literally still have a bit of a crush on. He was 50 and balding but he walked on water as far as I'm concerned!

Also did you know that they don't really cause
those interventions. Rather, if you are unlucky enough to have a labour with a series of interventions you are more likely to ask for an epi (not surprisingly, many many inductions are much worse than regular labour and thus more likely to ask for an epi). Once you adjust for that effect they don't correlate with higher intervention rates t all (let alone have a causal relationship). Proved in the US a few years ago.

It should have put those myths to rest but sadly they persist.

OMG - I could have said that word for word :yelclap:

I met with my OB yesterday to talk about this ever mentioned "Cascade of Intervention" which he claims is baloney.

I loved my epi and had a great birth experience

These scare tactics live in the group of women who believe childbirth should be embraced and every bit felt. They are the ones who consider anything that is slightly altering of a natural (and I mean no gas, pitocin, assistance in any way) experience doesn't count as natural birth.

Like my OB says, you are the one that has to go through it and some women get detached and resentful to the bub and have trouble feeding etc because of the trauma the pain can cause. I completely get this because I am someone who faints with sunburn :D

[mumma2cubs]

please remember to post politely ... all posts that are viewed as argumentative, or aggressive will be removed..

This is a thread where we can SUPPORT the choices available to women ..

we can disagree as to what the BEST option is - as long as its done in a polite manner ..

thanks
Jenny

:iagree:

One thing I've found on BH sadly is it's a site with a wealth of information however it's also a site that people are quick to slam the viewpoint of others if it differs from theirs.

This is a reminder we all need!

[BabelFish]

Just a note on the cascade of intervention - it's not baloney, it happened to me, every last single bit of it. I did not want to be induced and was anyway, and every single ounce of intervention that happened after that I believe to be as a result of my induction.

In two months I'll be able to tell you all whether I still think it applies, because I plan on NOT being induced, NOT having an early epidural and delivering my big baby all by myself. And if he is anything like the size of my daughter, then I'll know beyond any doubt that it was the induction that caused the problems and not her size.

Some women might bandy the term about too much, but a cascade of intervention surely does exist - I know, I've lived it.

[mumma2cubs]

Just a note on the cascade of intervention - it's not baloney, it happened to me, every last single bit of it. I did not want to be induced and was anyway, and every single ounce of intervention that happened after that I believe to be as a result of my induction.

In two months I'll be able to tell you all whether I still think it applies, because I plan on NOT being induced, NOT having an early epidural and delivering my big baby all by myself. And if he is anything like the size of my daughter, then I'll know beyond any doubt that it was the induction that caused the problems and not her size.

Some women might bandy the term about too much, but a cascade of intervention surely does exist - I know, I've lived it.

Sorry to hear you had such a bad experience :hugs:

I think that the cascade is entirely probable when done if the body isn't ready or the cervix isn't favourable. It happened to my SIL.

But when the conditions are ideal - i.e soft cervix, partially dilated, allowed to continue labouring off a deadline etc the risk to cascade is low.

I had a conversation with my OB about it - he said that when an induction is done properly and FOR THE RIGHT REASONS (which I think is key) the cascade doesn't exist.

It sounds like in your case, you had a Dr who was more worried about covering his behind than allowing you to trust your body - and that is NOT the right reason!

[BabelFish]

Yes it does sound like that but my induction was for health reasons. I had my baby in the public Women's and Children's hospital and didn't have an OB, so they don't just do inductions for no reason, luckily!

But still, I did feel that it was too early (I was only 3 days over) and I didn't need one and bub wasn't ready for one. I think that the fact that I had to be induced with gel, THEN have my membranes ruptured and THEN the drip meant that I wasn't ready and I knew it.

Anyhoo, luckily for me and DD we're all fine now - but I did tell them that they could induce me again over my dead body. Hahahaha.

[mumma2cubs]

Anyhoo, luckily for me and DD we're all fine now - but I did tell them that they could induce me again over my dead body. Hahahaha.

You poor bugger :hugs:

Mine was a similar story - medical reasons, but I truly think I would have gone into labour on my own shortly after (I presented for induction 3 cms dilated and fully effaced at 38 weeks with first bub)

I hated the fact I was on a schedule to perform - they broke my waters and because I hadn't progressed in an hour, they started pitocin.

That was in the public system - this time around I've convinced my OB that I want close monitoring from 38 weeks and made a deal that if I haven't gone on my own by 40 weeks we'll induce BUT on my terms - which means pitocin only after around 5-6 hours IF nothing is happening.

But my experience was bad because of the pain levels - not interventions as such. I still dilated, was able to push with an epidural etc.