April 2014 Moms

Epidural vs. Spinal Block

I was talking with my doctor at my last appointment about pain management. For DS I had an epidural in for over 13 hours and literally felt nothing, it was amazing. When it came time to push I couldn't feel my contractions and never had an urge to push. The nurse had to tell me when I was having a contraction. DS was born with the vacuum on my last push before they sent me to an emergency CS.

Because of this I wasn't sure if I wanted an epidural again. When I told this to my doc (different doctor and hospital than DS) he said that I could get the spinal, which works the same as an epi, but is just one shot and wears off after about an hour. He said that he tells women to never count on having an epidural because the conditions have to be just right and there is more risk to
Mom and baby with the epi vs. the spinal. He said unless a mother is pretty insisntent he only does spinals. My last doctor and hospital never even mentioned this option to me.

Can someone who has had a spinal during a vaginal delivery tell me a little more about it and how you liked it? Has anyone has both an epi and a spinal that can compare the 2?

Thanks!
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Re: Epidural vs. Spinal Block

  • ekmebmekmebm
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    I had both when I had my c-section. I was in labor for 36 hours and got an Epi at the 24 hour mark. They gave me the spinal in the OR right before my c-section and my epi was still working. The only thing I remember about either is that if felt like lightning was being shot through my body when I got the spinal and I screamed because I thought "oh no, he just paralyzed me!" For my RCS I am getting a spinal again, but I know what sensation to expect this time.
    Kate & Eric Married 10.10.09

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  • I didn't even realize they still offered spinals for vaginal labor anymore. What happens when it wears off? Like you said, it only works for about an hour... I had one with my c/s and can't really even imagine it being very effective for pushing during labor -- there's no way I could have felt anything to push.
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  • I've never had either, but, it sounds like they just gave you too much medicine in the epidural. I'm surprised they didn't just mention that you could have less medicine given to you??
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  • I've never had a vaginal delivery, but I have experienced an epidural and spinal, and personally I liked the spinal better. It wore off quicker and I was able to get up and move around a lot quicker than previous times I had the epidural. I'm definitely getting the spinal this time.
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  • I'm a FTM and this seems so strange to me only because I just got done with birthing classes and I'm with @AcaAwkward‌ what happens when it wears off? My instructor said that a spinal only last maximum of 2 hours and that's why for vaginal deliveries people are given epidurals because the epidural can last how ever long you need to deliver. Also it supposedly numbs you way more than an epidural does. I don't think this would be more effective for you to know when to push.
  • He said they would give it to me when they knew I was about an hour out from pushing, that way it would be starting to wear off when I push, so I could feel the contractions, but still have some pain control.
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  • sonjarae82sonjarae82
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    edited March 17
    Have you considered a natural birth? Women have been managing pain naturally through movement since the beginning of time. Watch, "the business of being born" on Netflix. Hospitals want you to move it along and have major surgery (c-section) because they benefit.
    kelley72
  • I've had an epi 3x and no epi, shot of stadol for last delivery.  Personally I prefer the shot.  It game me a little moment to breathe, get my concentration back right before/during early part of transition and then I could feel and push effectively.  I am a no thanks to the spinal mainly bc of the shot itself.  I am not a fan of epi for several reasons but please do continue your search for all options wether pain relief medicine or other... Hope you have a wonderful delivery

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  • maelicmaelic
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    I had a consult with anesthesia at the hospital where I'm delivering and they recommend the epidural. The spinal is an option for a c-section but they don't consider it a good option for laboring. They can titrate the meds down when you're getting ready to push while the spinal is a one-and-done deal they can't really intervene on. 

    Could you schedule a consult to talk things through with the anesthesia team that would actually be doing either procedure? 
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  • Are you looking for pain management during the course of labor or just during the end and delivery?

    Like you and your dr said, the spinal is a one time injection that will wear off in a couple of hrs. The epidural is a continuous infusion of pain meds. Usually the anesthesiologist can titrate the medication dose of your epidural to give you more or less, depending on your needs.

    I would ask if you could speak with an anesthesiologist regarding which would be better for your needs. You could also ask them if they do combined spinal-epidurals or "walking epidurals." This will give you the immediate effects of the spinal and the epidural catheter is left in place in case you need more relief.
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  • ksulliksulli
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    I had an epi that I could control the dosage on, so I kept it light and was able to move my legs and feel contractions the whole time (though more as pressure/discomfort than pain), as well as the urge to push (and some pain with the delivery, but I stopped pushing the button when I started pushing the baby). It may be a matter of how my body reacted to the epi vs your body, but I will absolutely have an epi over a spinal this time if I need it. I second the 'talk about dosage' suggestion above.
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  • I also agree that you should talk to the anesthesia team at the hospital.  It sounds like they didn't really do your epi right the first time (or at least not the way you would've liked).  A good epi should be tapered off near the end to allow you to feel your contractions and the urge to push (a lot of people don't realize this).  I had an epi with DS1, and this is how it worked for me.
    NoLaLinz
  • Have you considered a natural birth? Women have been managing pain naturally through movement since the beginning of time. Watch, "the business of being born" on Netflix. Hospitals want you to move it along and have major surgery (c-section) because they benefit.

    I'm going to give you the (undeserved) benefit of the doubt and hope this comment was just the biggest Reading Comprehension Fail of all time.

    Might want to brush up on those 4th grade reading skills before you return with any more "helpful advice."
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    babybarnes87
  • I can't imagine using a spinal for labor if you are wanting a vaginal birth. When I had a spinal for my c-section I was 100% numb and essentially paralyzed from the waist down with no choice but to let it wear off in its own time. I have never had an epi but from what I understand it is possible to gradually adjust the dosage as needed.
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  • I was completely numb with my second with an epi, and I pushed her out just fine. Maybe when told to push I remembered how? I'm not too concerned for me, but maybe ask them to back off a bit on the epi when it's about time to push so you can feel more of the pressure if you choose an epi? Good luck in your choice! I personally would choose an epi if given a choice, because they can last as long as you want, and mine really didn't take too long to wear off to where I could walk (that time!)

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  • @sonjarae82 I'm tagging you because I'd really like additional thoughts from you. Not to instigate or antagonize, but because you have been around for eight months, but have never posted before now. And on your first outing, you decided to throw out some ridiculous, totally biased, uneducated information that didn't pertain to the question at hand, and then disappear. What gives?

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  • SerenlaSerenla
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    @sonjarae82 I'm tagging you because I'd really like additional thoughts from you. Not to instigate or antagonize, but because you have been around for eight months, but have never posted before now. And on your first outing, you decided to throw out some ridiculous, totally biased, uneducated information that didn't pertain to the question at hand, and then disappear. What gives?

    She apparently missed all of the NB threads that were started.

    Sorry OP I don't know anything, I've actually never heard of a spinal.



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  • I only had a spinal during my c section, which I don't think would have been useful during a vaginal delivery at all. I was, as others have mentioned, completely numb and useless from rib cage down. With my VBAC, I had a patient controlled epidural, and I was happy to have it that way, I still could feel enough to push effectively and had enough strength/ control of my legs to use them after delivery. I waited to get my VBAC epi until I was at about nine cm, which is not always an option. I would definitely speak with the anesthesiology dept. if you can.
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  • I had an epidural with my first.  I remember when it came time to push, I couldn't feel anything and was having a hard time.  But, then the nurse turned down the epidural, and while I didn't feel pain, I could feel the need to push and what I was doing.  Not sure exactly what I had, but it seemed to work great (I did have 2 hours of pushing, but my son was 9 pounds 13 oz, so that was probably part of it)!
  • I agree with a lot of the PPs, I'm not sure a spinal is your best option. At best, I would ask if you could have a spinal, but maybe still have the epidural catheter placed (this can all be done while you sitting up for the spinal) in case you needed more medicine past the time constraints of the spinal. And agreed, the spinal generally makes people much more numb to a higher level of the body. I would def just talk to the anesthesiologist about your previous experience and how you can avoid that this time.

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  • Thanks for all the helpful advice!! I will set up an appointment with the anesthesiologist! It sounds like the spinal isn't the best option, I'll just make sure they control my epi better this time!!
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