I am going for a VBAC this time, and want to avoid the whole epi/pit/cascade that occured last time (after 19 hours of high dose pit horror without pain meds, I got an epix3 PLUS a spinal, but it didnt work)
my OB is somewhat nervous about laboring a VBAC without an epi in case of the need for emergent c-section due to rupture (I know, I know, <0.5% chance). Im probably just going to completely decline, but she suggested having the catheter placed with no meds given so that it's available if needed emergently so they wouldnt have to put me under if the worst was to occur.
My question is: does anybody know anything about laboring in a tub or shower with an epidural catheter in place but no meds? Im thinking that it probably WOULDNT be the world's greatest plan in terms of avoiding infection and issues, but if its not too risky, I might consider *thinking* about it. I DO want the option of water, though, I think it would help a LOT.
Im kinda thinking though, that if it's a REAL emergency (splash and crash) that it wont matter since we wouldnt be able to wait for meds to kick in anyway and if it's an "emergency" with a 30 minute decision to incision, they would be able to get a spinal in anyway, since they have to have "immediately available" anesthesiology in the hospital, right?
unless your hospital makes some sort of special exception, there is no way they will let you be submerged in water if you have an epidural in your back, even if its clamped. the risk of getting tub or shower water around the catheter into your spinal canal could be catastrophic if bacteria got in.
at my hospital we use catheters like that all the time for people with rib fractures. they absolutely CAN NOT SHOWER if they have a catheter in.
if you want a tub birth, go for it!! if there is an emergency a spinal isnt the only option. they should be able to have you in the OR under general anesthesia in three minutes flat. in a true urgent emergency there is no reason to do a spinal. they would just put you to sleep.
Last edited by Carolyn85; 05-25-2011 at 04:56 PM.
Baby #3 due July 6 2013
hm, good to know.
In that case, I will probably just completely decline - im not excited about the idea of meningitis, and like I said, if the worst would occur and a crash c-section be necessary, even if I HAD an epi, Im 99% sure they'd STILL put me under isntead of waiting for higher dose meds to kick in.
Id rather do it 100% natural anyway.
For me, if I had the epidural catheter in I would be more inclined to just get the meds rather than do it au natural. Why even put myself through getting a huge needle to the spine if I'm not even getting drugs?! If there IS a true emergency and baby needs out NOW then they'll just knock me out anyway.
I would just decline it. If it's that much of an emergency, they're going to put you under general. That's what happened to me. After 13 hours of natural labor, I had finally broken down and gotten the epidural. About 15-20 minutes later we were in a crash situation (both me and baby) and even though I had the epidural placed, they put me under general. If it's really an emergency, there's probably not time for the meds to kick in, whether the epidural is already placed or not.
Ditto what the others said. Having a catheter in probably isn't going to make a difference in what they would do in an emergency situation. Also, depending upon your anesthesiologist, they may want to do a test dose to make sure the catheter is in the correct position.