Q about epidurals and how late is too late

KateLouise

My understanding with epidurals is that you hit a point where it's too late to request one, and I thought that was around transition/7cm.

But then I've known plenty of people who have gotten to the pushing part and ended up needing an emergency c-section because baby got stuck. The c-section has been done with an epidural and not under general.

So how does that work.

When they say, "it's too late" what do they mean? Do they mean but by the time we get it all set up we expect you will have had your baby? 

sschwege

I know one woman who was fully dilated and they were trying to give her an epi. They attempted to give it to her twice and missed at which point the doctor said that she had done the hardest part and encouraged her to go without it which she did. So I think it's never really too late.  Maybe for it to be fully effective it should be given before you are at 7-10, maybe it's too effective so close to pushing, which is to say you might be too numb to effectively push.  This is mere speculation on my part though, maybe someone else has more info.

  

honkytonk_kid

The epidural takes a while to take effect, so really it's not "too late" until baby is almost out. I think it has to do more with 1. being too late for convenience- calling the anesthesiologist, getting the epi in, labor possibly slowing down, etc and 2. once you have gotten to the point where one would consider it "too late," most women have gone through the hardest part of labor anyway, so there's the mindset of "Well, you might as well just get it over with."

An epidural will effectively (in most cases) numb you regardless of when it is given. The issue/fear is not wanting to go through the hassle/cost/risks/etc of getting an epidural only to feel everything and be numb AFTER the birth. So unless you're within 15-20 minutes of birth- and really, how can that be predicted?- it's not TRULY too late for pain relief, it's just a matter of weighing desire for pain relief against the possibility of poor timing.

LadyTyler

Usually when I hear this, it is for situations where the anesthesiologist is not immediately available.  If they need to call him, wait for him to get there, and get ready before even starting it, it might be pointless if you are near the end.  The other points about timing being difficult also make sense, regardless of whether the doctor is on call or not.

Nechie122

The way they explained it during out hospital tour was this: They always turn down the epi during pushing so women can feel when to push. So there's no point in doing it after, say, 8cm because by the time they get an IV bag of fluid into you, insert the epidural, and wait for it to work, they'd be turning it down anyway.

That said, right before pushing, I asked my OB, "It's too late for an epidural, right?" And she said, "It's not too late, but I thought this was what you wanted." I always wonder whether she meant that or not.

kacelle

What I didn't realize before I was in labour was that they require you to be hooked up to IV fluids for 45 minutes prior to administering an epidural.  I don't know if this is the case everywhere or just at the hospital where I delivered.  I had an epi-free induction, but asked for an epidural during transition.  They hooked me up to the fluids, but I was complete before the 45 minutes were up.  I was so glad that pushing was the easy part!

I'd also think that they don't want to give an epidural right before the pushing stage because it'd make it really difficult to feel what you were doing and would increase the likelihood of tearing (because you wouldn't be able to follow your body's cues). 

chicsub

I got mine right around 9 cm, but I was stalling out and they were giving me Pit at that point.  I only progressed to 9 1/2 and never pushed before my c/s. 

Kitttkattt

If pushing is taking very long and the woman requests it, I have seen it done as late as that. There's no such thing as too late as far as a specific point in labor. It depends on length of labor.I had one woman request an epidural at 3 cm, 20 minutes later when the anesthesiologist got there, she felt like pushing and had the baby just a couple minutes later.

Pugs05

With my first I had planned on getting an epidural.  When I got to the hospital I was a 10 and pushing (labor progressed really fast) and I was told it was too late b/c he would be here before the epidural could take effect.  They also didn't think i could keep still for it to be administered.  It ended up being the best thing though b/c I loved how I could get of of bed as soon as I gave birth.  I am now planning on going natural with my second as well.

Sharon21

We took a birthing class at our hospital that was taught by a nurse there. She said that you can have an epidural anytime up until the baby is crowning and really the only reason you can't get one at that point is that you would have to sit on the edge of the bed to get it and you can't do that if the baby is crowning. I think it all depends on the hospitals policy.