Showing posts with label prenatal. Show all posts
Showing posts with label prenatal. Show all posts

Thursday, March 9, 2017

Are you having a C-section?

The though of having a C-section can be very scary, but not if you are WELL PREPARED! If your first C-section was an emergent C-section after a failed trial of labor, your planned section will be a much different and hopefully MORE PLEASANT experience.

We use SPINALS for C-sections.

What is an SPINAL? It is ONE SHOT (!!)  into your back and the local anesthetic is injected directly into the subdural space. To get a spinal, you're in sitting position and your back is cleaned. The numbing medication feels like getting the flu shot at your doctors office. The spinal med is injected and within 5 seconds, your legs get warm, tingly and numb. You won't be able to move your legs for couple of hours.

The risk vs benefits of a spinal are SOOO LOW. The risks involved are the same as with Epidural (see previous post). The drop in blood pressure is more dramatic with spinal because onset is so much faster. With the drop in blood pressure, you may experience nausea and vomiting but it is easily treated. The risk of a high spinal, where your diaphragm and respiratory muscles are weakened, is also higher with spinal than epidural. As long as you have supplemental oxygen and your pulse oximeter is reading normal, you are fine!!

LASTLY, I always advise my friends to watch one C-section video on youtube. Once you have your spinal and you are comfortable, the operating room team will allow dad to come inside (must wear disposable scrubs, hat and mask!) to sit next to you.
If you go into the operating room knowing what to see and expect, you will be less nervous. Don't worry, you will not allowed to look over the "blue drapes" to watch the actual C-section!

GOOD LUCK!

Monday, March 6, 2017

Should I get an epidural?

YES!!! Absolutely!! Rest as much as possible, while you can!

I spent the day on L&D, and thought this would be the perfect entry!! ALL my patients were jumping off the wall anxious today, so in the hopes of alleviating others' fear, here is my post on epidurals.

What is an EPIDURAL? Epidural is used for laboring patients. The skin on your back is numbed up with local anesthetic (feels like a flu shot) & the epidural needle is placed (don't worry- you don't see it). When your anesthesia a provider (M.D. or CRNA) finds the right (epidural) space, a small, thin, super flexible catheter is placed and the needle is taken out. You will receive continuous epidural meds through the catheter until the baby is born and then the cather is taken out.You will be numb from your bellybutton down but will be able to move your legs. Strength in the legs will be decreased, so you will not be able to walk around. Takes about 10 minutes for the effects to fully set. You might have heard of a "walking epidural", but for liability issues, no L&D will allow you to walk around with an epidural. You may be TOO COMFORTABLE so that you may not feel the need to push when you are fully dilated. Your anesthia provider (M.D. or CRNA) can decrease the dose so you are able to FEEL the contractions more.
If you need to get a C-section after a trial of labor, a much stronger med is given through the epidural cather and it can be used for the Section.

When can I get an epidural? ASAP! Sooner the better (from the point of the anesthesiologist). Especially if your ob is starting Pitocin. The recommendation used to be 1-2L of IV fluids before epidural or spinal, so the nurse will put in an IV and give you fluids before calling the anesthesiology. Now its recommended to "co-load" instead of "pre-load".

It's OK to be nervous! My birth plan was: HAVE A HEALTHY BABY & GET AN EPIDURAL.
 I place epidurals for laboring patients ALL THE TIME. BUT when it was my turn to be the patient, I was still a LITTLE nervous. JUST a LITTLE.

NO, an epidural: 

  • DOES NOT harm the baby
  • DOES NOT slow the progression of labor
  • DOES NOT cause nerve damage
  • DOES NOT cause back pain

Risks involved:
  • bleeding (but not any higher than with IV placement)
  • infection (but not any higher than with IV placement)
  • headache
  • incomplete relief

Waiting for my epidural



Emilia, less than 12 hours old!