epidural with vbac

[tammac77]

Hello,
:wave:
Just wondering if anyone has been able to have an epidural with a vbac? My first pregnancy I was dead against epidural, now that I am planning a vbac I have decided I want one to help me relax and have as stress-free a labour as possible. I feel that if I am not in pain it will be easier to remain calm and focus on what I am doing.

However my gp has said that I cannot have an epidural with a vbac as it can block the pain of a uterine rupture. As I will be closely monitored I won't be able to move around or use the shower. I am afraid I will be stuck to the bed, attached to monitors with no way to alleviate the pain. He did say an epidural was possible, but that I'd have to have a pretty good reason.:fingerscrossed:

I'm just wanting people to share their experiences of vbac - ie if an epidural was allowed/not allowed, what pain management was used and advice on whether i should insist on epidural if that is what i want or whether it is better to go with what my gp said.

Any help would be great. Thanks! ;)

[DQ]

I also want to try to VBAC with my next pg. But if what your GP said is infact correct, no wonder women opt for a second or third c/s. Doesn't sound like a real positive birth experience to me, being strapped to monitors and kept on a bed with no pain relief???????? Sounds bl**dy terrible to me!

[Briannabear]

My ob has said that you can have an epidural with a VBAC. I personally dont want one because of the reason your GP said but each to their own.
They do monitor bubby's heartrate through your contractions every so often just to make sure everythings ok. Apparently if bubs heartrate drops it can be an intication of rupture.

However, having something like an epidural can cause your labour to slow down, therefore creating the possibility of another c/section due to the time limits that the hospitals place on your labour.

It probably depends on hospital policy regarding VBAC's as to how often and how long you have to be monitored. You can be firm and stand your ground though. :yes:

[kadownie]

Hi- I would tend to avoid having an epidural if you are planning a VBAC for a couple of reasons. The main one being, if you have an epidural it is hospital policy that you also have syntocinin (sp?)- and the research shows you are at much much greater risk of having a uterine rupture with the use of syntocinin- I will find the stats for you. Of course you don't have to have the synto- but the epidural can stop or slow down your labour...

As for being locked down on the bed- the hospy would like to do that so they can keep it all under their control- this also places you at risk of having a longer and more painful labour- you do not have to comply with these policies- but don't wait until labour to sort all of that out. You could go and have a meeting to discuss your birth wishes with someone at the hospy- preferably someone with some power (management) and come to some agreements. Perhaps you could agree to be monitored by doppler/EFM every hour- that way you aren't hooked up to the machines and you can use the shower, move around etc etc..

Have you thought about perhaps hiring a doula or a birth support person who can advocate for you in labour- so you don't have to be the one fighting for your wishes?? Also, have you considered learning some relaxation exercises to help you cope with the pain.

Hope this helps-

[~MinkeyMoo~]

I had a successful VBAC in March and ended up having a epi. I didnt plan on one but D turned posteriour in labour (unbeknown to me) and I really needed the relief after 24 hrs from the first onset of pain. My OB never said I could not have one, although I knew that there was a change of slowing down labour. As it was it worked the opposite on me. I went from 5cm to fully dilated in under 2 hrs and still was able to feel the need to push. I wasnt given syntocinin with it.

As for constant monitoring, ask if you can move around. If I hadnt had the epi I had discussed with the OB and OK'd intermitent monitoring so I could use the shower etc.

Good Luck

[tammac77]

Hi again,

Thanks for the responses. It is so hard to know what to do. With my first, because the reason for my caeserean was fetal distress I was stuck on the bed for ages (could stand but not walk) They had put on the internal monitor (don't know what it is called but it is attached to the baby's head) so I couldn't remove it and walk away when I wanted to. I really hated it. I felt the gas did nothing so I was really looking forward to an epi!!

Don't know if anyone knows if this is true, but I read somewhere that if you wait until you are 4-5cms dilated before having the epi that it is unlikely to slow down the labour. I don't want syntocin if it increases the risk of uterine rupture, but the idea of just gas is scary!! What are my chances of elective caeserean? Though, I don't want that either because the recovery is longer.

Would appreciate people's stories, what worked for them etc. Thanks to those who have already written.

Tammac

[Shanaynay]

Hi Tammac,

I had an epidural with my VBAC :)
Thru my whole pregnacy I told myself I would ask for an epidural because I wanted to be relaxed and in control to give my myself the best chance possible at a vaginal birth.
(I actually only ended up getting the epidural just before I was ready to push - so it did nothing - but anyway...)
I had various caregivers thru my pregnancy tell me I couldn't have one because it could mask the signs of uterine rupture etc...
Towards the end of my pregancy I found a fantastically supportive ob who said I could have an epidural, not to worry about the whole rupture thing because it is unlikely to happen anyway, and the midwifes would stick a monitor on every now and then to make sure things were ok.
(I actually ended up being on the bed the WHOLE time because of fetal distress - but anyway...)
He did say that he didn't believe epidurals slowed labour etc... but they did sometimes make the pushing stage a bit longer. Mine was just under 2 hours, which is fairly long, but to me that was the easy part anyway.

So point being, yes I had an epidural, and I did find an ob supportive of that decision (actually he kinda recommended it) and I do want to say the instant it went in I felt 200% more in control, so I highly recommend you persist if you really want one.
Hope that helps xx

[cherrygirl]

I had to stay in a ward at the hospital once i had dilated 1cm. They gave me some pethadine and it was great because i got a bit of sleep. Later that night when they were telling my husband he had to go i got really distressed because after all the months of being warned about VBAC complications i was not being monitored or checked at all. When i was upset and saying that there were alot of contractions the nurse sent someone in to time them and they were not regular so they left me again. The labour ward didn't want me because they were busy.
I walked and showered and walked and showered and finally just before midnight the night nurse said ok lets get you downstairs. She took me down without calling the midwives so they couldn't refuse me.
I was told to shower and then given a lecture on toughening up because i was not going to have the baby for a vary long time.
I was so confused at how they knew that because they didn't even have a look. I told the midwife i needed to stand up and she said that now i was in the labour ward i had to be monitored so i couldn't -she was just being nasty though.
Finally i got her to do an internal and i was dilated and trickleing water. She asked for my husbands phone number and ran out to ask a nurse to call him then ran back in and started setting up the gas. DH wouldn't answer the phone because he was asleep so i was in the bed pushing, sucking on the gas and calling on my mobile. Finally DH ran through the door and 45mins later DD2 was born.
So - No epidural because there was no chance to have it and honestly I'm glad i didn't. I had an episiotomy but that didn't bother me at all.
A quick hint - if you are having a VBAC and you didn't go into labour at all before - tell the midwife. They see its a VBAC but they assume you know what the labour is all about and i had no idea.
BTW Had bub at 1:40am Sat and went home 9:00am Sun - my choice next time is VBAC without a doubt.

[lilpearl]

There are a few problems with having an epidural, that relate specifically to VBAC's. One is, if you have an epidural, you will be monitored closely, and this can restrict movement a great deal (which can slow down labour, and put undue pressure on the blood flow to the baby) The baby has, therefore, more chance of becoming distressed, and needing to be born via emergency caesarean. Also, monitors often pick up a baby in "distress" when they are not really in distress. Monitors are not very good at all at picking up true distress. There's plenty of study into this, though I have nothing at hand to quote...but if you go to maternity coalition or such, they should have articles for you to read.

Epidural use increases ones chance of caesarean by as much as 50%, in general. This is due to a few reasons. There is the monitoring, which picks up "distress" that doesn't really exist. There's the fact that restriction of movement prevents optimal positioning to keep labour flowing freely, as it's best to be upright, using gravity, squatting, enabling the babies head to put lots of pressure onto the cervix and get well into the pelvis, and in the right position for birth. Epidural use often slows labour down. Now, when it comes to VBAC, it isn't thought safe to be induced, so if they do induce you, there are the risks associated with that (and, in any induction, one's risk of caesarean is very high, as induction can cause distress for the baby); and if they wont induce you, well, labour has slowed and they'll want to whisk you in to theatre for a caesarean (which you can, of course, refuse, and this would be something to have in your birth plan....but then to get labour going again, the epidural would be turned down, and you'd have heavy contractions without having built a tolerance to them). Etc etc...excuse my rambling!

So, these are just some things to think about. Epidural use is fairly major intervention and if your really keen for a VBAC, you may want to look into more natural ways of pain management. Fearing the pain will only tense you up and put you in a lot of pain. Many women have pain-free labours. You may even want to look into hypnobirthing. (This does not mean that you will be in any more a trance than one is meant to be in when in labour, you'll be in total control of letting go).

Just some suggestions. Good luck! :thumbsup:

[kimmariee]

my last 3 pregnancies i had a vbac and with all of them i had an epidural, i was never told i couldn't have one but i was told it sometimes slows labour down and that i'm not allowed syntocinin so if i didn't progress had to have another c/section. I found being active for as long as possible helped not slow me down and so i could deliver naturally.

I think there is lots of different opinions on this out there and if you find out as much information as you can then go with whatever you feel most comfortable with, as it is your body.

[~Candy~]

HI there, I've had 3 vbacs and my 1st vbac I had an epidural. I was never told about any probs that may happen, they just monitored baby's heart rate and when it was time, they told me when to push! I definatley recommend vbac if your able to :)

[Peaceangels]

DS2 was Vbac and I decided I wanted an epidural for part of the labour - my labour with DS1 was 23hours which ended with an emergency c/s and I was totally exhausted afterwards - so I wanted the epi with #2 purely to have some time to rest (knowing that I was going home to two young children).
I did not have the synotocin along with it and I was quite happy to lie still for 3hours to rest (with monitor's attached). The hospital policy was to let the epi wear off so that I could totally feel the contractions for pushing.
It is purely personal choice, everyone is different and every labour is different.