if you delivered vaginally - epidural/meds ?

nikinikinine · November 2010

I just had a long talk with my OB about vaginal twin delivery. I was originally hoping to go med free for the twins - well, actually, I reserved the right to change my mind after the first contraction

But I mainly wanted to focus on analgesics and not a straight epi.My OB told me with twin vaginal deliveries they strongly recommend an epidural at 4-5cm dilated and here's why:1.) if baby B flips and they have to do a breech extraction they need to be able to reach up into your cervix and pull the baby out. The pain is quite intense and the pressure is outrageous. They will not do a breech extraction without an epi. They won't even attempt it.2.) if you are one of the 5% that has to do a vaginal delivery followed by a section the epidural is already started and all they have to do is push more meds. (rather than taking precious time away from your baby and getting started).I feel like I have no choice about meds now if I deliver vaginally. I'm kind of okay with that, *maybe*. Just wondering if anyone skipped an epidural, or is this pretty standard for a twin delivery?

GiGi1221 · November 2010

I didn't have any drugs at all and delivered vaginally. It's your right- you just have to know that you would most likely be put out if it turns to an emergency c-section which my ob said even with an epi it is likely that you would be put out with one...

I loved my birth experience and would do it again tomorrow.

Melin086 · November 2010

I did end up getting an epi but I was at 9cm when I finally decided. My OB wasn't going to push me to get an epi, but warned me that I would be put under if they had to do a c-section.

Temp159135562506975 · November 2010

if your doctor will not perform a vaginal birth without it- it's NOT your choice. The doc has the right not to do it for liability reasons.... people sue for stupid sh!t like that - saying they don't want pain meds and then being PO'd when thigns don't go as planned and they are in horrible pain or have complications b/c they had to wait to get the epi in time for an emergency c/s, etc...

so you need to find out if you have a choice or not.

This is VERY common - no surprise to this board (at least those of us who have been here for a while).... quite honestly - i can't imagine taking the risk just to go med free - there are so many ways thigns can go wrong - esp in a twin delivery.

MamaCrystal · November 2010

I had previously had a med-free delivery, and I really wanted the same with the twins, but I knew there were more risks. I had an epi placed but it was turned down extremely low. I could feel everything, and it actually ended up feeling the same as my prior med-free delivery. It was a nice compromise because my doctor could relax knowing that the line was placed, and I got the delivery I wanted!

GiGi1221 · November 2010

I'm sorry what I meant was it's your right to want to go med free and to find a provider that supports that. Med-free was very important to me and I wouldn't have stayed with a Dr. that was not supportive of that, unless of course there was a major medical reason.

leelee1718 · November 2010

My OB had the same discussion with me, and the thought of them having to reach in to pull out Baby B terrified me and that basically made my decision for me... I really wasnt set on either way until he told me that.

I had my older daughter med free and labor was sooo much more enjoyable with the epi.

BeccaLandes · November 2010

My OB said that he would absolutely place it (that was his rule), and I had thought that I would just labor up until the end without any meds.

I went into labor at 4 am, and my contractions were 3 min. apart within 2 hours, with no relief in between. I got the hospital at 6:45 and demanded the anesthesiologist be sent to my room ASAP, without even signing the papers for admittance! I was in SO MUCH pain I could not believe it. I wish that the epidural had not been as strong as it was, because I really did not feel anything during delivery, but I was so relieved to get it, I was miserable before I did.

sawyer918 · November 2010

I wasn't forced to get an epi, but I knew I would want one. The major reason for me was that just in case kind of thing if things went wrong. I also didn't want my first and only delivery to be one where I was miserable.

babydontforget · November 2010

My peri practice told me that they'd be willing to do a "vaginal trial" without an epi, but explained the same risks your doc did. Though I think I would have wanted to try for a med-free birth with a singleton, I decided that it was just too much with a twin delivery. And honestly, that decision felt freeing to me.

Perhaps because I felt so at peace with the decision to get an epi, I found the epi to be wonderful. I had very minimal pain while dilating to 4-5 cm; no stronger than generic period cramps. Then I got the epi, which was easy. After the epi I took a nice nap. And then when I woke up it was time to push. I felt no pain whatsoever while pushing, though I could still feel the urge to push.

It was really great. Now, if I ever deliver again--whether twins or singleton--I will get an epi again.

However, I fully respect any preferences that any woman has about birth, and any choices she makes with her doctor. If you want to try for med free and your doc is supportive, go for it.

nbptbride · November 2010

My ob and mw were fine with an unmedicated delivery. If there was a need for an emergency c/s, they would've put me under anyway. Do what feels right for you and find a practicioner that is willing to give you a choice!

Desired11 · November 2010

I don't have experience with the twin delivery yet, but would like to add that I had a drug free birth with my first dd and an epi with my second. On the second, I only had 8cc which was low. However, both the births felt the same. I would suggest talking to your DR to see if it is possible to have it in with a low dosage...that way it is ready for you if you need it.

macchiatto · November 2010

Could you get a walking epidural, or have the epi placed but wait on meds, or wait till you're 8 cm to get the epi? I wanted as natural a labor as possible but since I ended up being induced, it wasn't terribly natural.

I did walk around, labor in different positions, etc., but after the amniotomy the contractions were WAY too intense, and coming right on top of each other with no time to regroup in between. I got the epi about 7 hrs in to active labor, and it was 2 hrs after that I was ready to push. Three hours of pushing and Baby A came out, and then Baby B did flip and I did end up needing a breech extraction. So in my case it was a really good thing i had the epi, but in retrospect I would've asked them to turn it down during the pushing stage so I could've felt the urge to push better. I think that slowed things down.

blondek8 · November 2010

I had/have zero desire to have any baby med-free. My OB didn't force me to have an epidural but strongly encouraged it. I didn't need the encouragement -- I knew I wanted one. I loved mine. I felt nothing during delivery to the point where I had to ask when I was contracting so I could push. I didn't want or feel the need to feel my labour. I felt enough before I got my epi at 5cm. I had both a positive induction with Cervadil and Pit and a positive epidural/delivery. Wouldn't change a thing. Good luck with whatever decision you go with!

nikinikinine · November 2010

macchiatto:
Could you get a walking epidural, or have the epi placed but wait on meds, or wait till you're 8 cm to get the epi? I wanted as natural a labor as possible but since I ended up being induced, it wasn't terribly natural. I did walk around, labor in different positions, etc., but after the amniotomy the contractions were WAY too intense, and coming right on top of each other with no time to regroup in between. I got the epi about 7 hrs in to active labor, and it was 2 hrs after that I was ready to push. Three hours of pushing and Baby A came out, and then Baby B did flip and I did end up needing a breech extraction. So in my case it was a really good thing i had the epi, but in retrospect I would've asked them to turn it down during the pushing stage so I could've felt the urge to push better. I think that slowed things down.

that is so much what I was afraid of, being induced having pitocin rush my labor and not be able to get ahead of it and then getting an epidural and having it stall my labor.

I see the benefit of having the epi, especially if a breech extraction is needed, etc. I just want to be able to read my body's cues. I'm so glad to read about your experience. Thank you for sharing it.

Rose.9.6.03 · November 2010

I knew I wanted an epi from the beginning - but it was actually hospital policy (not my peri's) that all twin deliveries have epidurals and be done in the OR. I have heard of twin moms who just had the epi line set up, but no actual drugs.

schoolsoutbride · November 2010

Found a couple of helpful threads from MDC:

https://www.mothering.com/community/forum/thread/427897/twin-breech-extraction-can-i-handle-it

Including a woman who had a breech extraction with no drugs:

https://www.mothering.com/community/forum/thread/948708/breech-extraction

I've been thinking about this a lot and have raised a ton of new questions I want to ask the midwives and OB about at my next appointments.

AliciaMomof4 · November 2010

My Epi. with all 3 pregnancies sped up my labor and my Dr. said it tends to relax you right away and your body can work hard to get ready to get that baby out. I actually went from 3 to 10 cm. in 5 min. with DD #1 after the epi. after 39 hrs. of previous labor. I then went from 5 to 10 cm. in about the same time with DD #2. Lastly, with the twins I went from 4 to 10 cm. in about 30 min. after the epi. With all 3 I still pushed great and could feel the pressure to push immediately. I wanted to be awake for the twins birth no matter what so in case of a section I went again with the epi. It actually helped me when they had to turn it up for my pain in my stomach after Baby A was born. They had to "hold" Baby B in place so he wouldn't flip while we waited for him to descend enough for me to start pushing. That pain alone I could feel and was bad with the epi. turned up. I agree with previous post that says there are so many things that can happen in a twin delivery. I was so happy with the end result of all 4 of my deliveries with the epi. I had them all vaginally and could still feel the urge to push without the unimaginable pain through the end. Good luck with your decision!

macchiatto · November 2010

I think if you do want to go med-free or just as natural as possible, it really might be worth getting a doula. That's the other big thing I would've done differently; I think I would've found one really helpful. (I did look into getting one but the one everyone recommended had just moved to TX. :P I contacted her and the person *she* recommended was someone I knew from grad school so I would've felt weird having her be my doula.

) But if I have another baby, I want to take Bradley classes and hire a doula!

Stina4242 · November 2010

I feel the same way as you! I am hoping they will give me a light epi but we will see. I agree about reserving the right to change my mind after the first contraction (love the way you put it). However, this could be my last pregnancy and I really want to experience child birth, which I know sounds crazy. I want to feel when to push and feel the babies, but I also have to do whats best for the three of us.

jcthomas1281 · November 2010

My OB said I could chose which way I wanted to deliver as long as the boys were both head down. she just assumed I wanted pain meds. She assumed correctly! I really hate that my meds wore off as I was delivering because I honestly didn't get the full experience, the joy of them being born because I just want it to all be over I was in so much pain. I was begging for them to put me out and do a c-section. I couldn't even open my eyes to see anything until much later. and sewing you up without good meds?? OUCH!

To each her own, but I am pro drugs all the way!

MamaCrystal · November 2010

I hate hearing people talk about labor pain like it's the most horrible thing on Earth... it's really not. I've had a delivery with an epi turned up way too high, a delivery completely med-free, and a delivery with an epi turned down really low, that I actually think didn't even work (the twins). My favorite delivery? The completely med-free one.

Yes, things can go wrong with twin deliveries, but things can also go wrong with epi's. When I gave birth to my 1st son, I was at a new hospital with an inexperienced staff. My nurses didn't recognize that I was in transition when I finally asked for an epi, so they just gave me one without checking my progress. Sitting still for that epi was way more excruciating than the contractions I was having because... AFTER the epi was placed, they checked me... 10 cm!! But everything slowed way down after that. The nurses had me start "practice pushing" before I actually should have been pushing. After 1.5 hours of real pushing and vacuum assistance, Sam was born. My mom was holding oxygen over my face and she and my husband were yelling at me to push because Sam kept popping in and out... I was too worn out from pushing and couldn't even feel that my baby kept crowning and going back in. I ended up with 4th degree tears, most likely from the combination of vacuum, too much pushing, big baby, etc. I went to the ER with unexplained pelvic pain 6 weeks later, and the nurse couldn't believe how swollen I still was. I truly believe that if I hadn't had that epi, his delivery would have gone MUCH differently.

Alicia - The fact that you progressed quickly after the epi's may or may not have actually been because of the epi. I progress the same way with my babies. The last 2 times, I've actually gone into the hospital at 4-5 cm and only get up to 6 cm in hours of labor. Then, BOOM. 10 cm. My last 3 babies practically delivered themselves (our nurse did deliver our 2nd son), because I shocked the staff with how quickly I progressed. They've always said "But I just checked you!" With my 2nd son, my nurse checked me and I was 6 cm literally 5 mins before he was born.

Anyway, it took a lot of soul-searching to agree to have an epi placed for my twin delivery because I had such a horrible experience with one. I realize that's not everyone's experience and some people swear by them, but there's no denying the fact that they have slowed down many deliveries.

OP: If you do get an epi, make sure that it's the kind that you control with a button. This way, you're not getting an immediate strong dose. They'll start it off lower and you can push the button as needed. This was one big difference between my bad epi experience and my decent one.

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