Scared about no pain relief

Ok, so I have never experienced labour having a c/s 1st time around scheduled 2 weeks before due date. This time around am going for a VBAC, and I am really anxious about the idea of possibly not being able to have an epidural. I don't have a very high pain threshold so I wonder how I would cope.

The reason for possibly no epidural (I think this was right) is that with a VBAC they want it to move along as quickly as possible, so they may need the labour to be asissted with some kind of induction, and whatever it is that they use - the anaethestist at the hospital don't like it to be used in conjuction with an epidural, so it is a case of either one or the other.

Was wondering from any VBACers out there what kind of pain management they were allowed to use, and if they have only had c/s before if they were scared at the thought of going through labour as well and not being able to cope with it?

I haven't had my VBAC yet, so can't really help too much. I didn't knwo that they didn't allow you to have an epidural. My OB said they won't induce, as the risks increase, but I hadn't yet heard about no epis.

I had pretty much decided anyway that I don't want an epi, mostly because I REALLY want to birth upright. I don't want to lay down & make it harder for myself to push t the baby out. That is my #1 reason for not wanting an epi.

That probably doesn't help - sorry! I will be interested to hear what others have to say...

Linda, I am the same, I want to be in the best possible position to open up my pelvis so I can get bubs out if it is a tight squeeze, but the option of the epidural there would just feel more reassuring.

I have my 30 week appointment next week, so will start going into it with doc in more detail then

Yeah, I agree. To know that it is just an option does give you more peace of mind. Do you know if they just 'don't encourage it' or if it is not an option at all? I haven't asked yet., but I will.

I recently had a client who said she had a very low pain threshold, her hubby would pay her out all the time as she would moan all night with something as little as a stomach ache so I prepared for the possibility to be transferred out of the birth centre. She got through without anything in the birth centre :) It's all about how you educate yourself, who's around you and who's caring for you. Do you have a doula lined up? Especially important in VBACs.

Wow! That's great!

You know I've been thinking, if you think of the pain as a positive, then it will make it easier to cope IYKWIM? At least that's what I'm hoping LOL.

The Pink Kit is great, check it out... has some VBAC specific stuff too.

Min...I was scared out of my mind!! My first was c/s due to breech and that was over 13 years ago! My second little man was born Monday just gone and he did great and was a successful VBAC with no drugs. I did a hypnobirthing course and in my opinion that was the best thing I could have done. It was amazing how even though I had to change my course of birth plan due to Oskar being in distress that the hypnobirthing continued to work for me..although I did ask if I could have gas if I needed it cos he had to be vacuum assisted and they told me it was too late anyway..lol. I think then my mind and what I'd learnt at hypnobirthing just took over and I got through it with no problems at all.

I think there is a thread somewhere with hypnobirthing practioners listed?? Kelly or a mod may be able to let you know where it is.

That's interesting Kelly, I hope I surprise myself like that!! Am not really into the whole Doula thing, would feel uncomfortable with it, My husband will be with me to give me any support I need. Aside from him it will be midwife care unless there is a problem, my doctor will be hanging around in case there is any problems.

Cass, did you do a birth story? I would be interested to read it. Haven't considered hypnobirthing, what can I say - I guess I am a pretty conventional sort of gal, but am always interested to hear and open to different views and methods etc.

I think one of my main problems is I tend to panic, as in I might be in pain and thinking this isn't meant to be happening, something is wrong!! When I had my general for my thyroid op, I can remember the feeling going under, and I started to cough, and I was trying to sit up because I was positive I was something was going wrong and I was choking, and I can remember them holding me down.

Cass - that is fantastic!! Well done!! I can't wait to read your whole birth story!

Kelly - I've read about the pink kit. There was a mention that it could be purchased through BB. Is that right? Are you able to point me in the right direction?

Hey Min I'm doing the hypnobirthing thing too. It's amazing how many people pay me out with cliches of the clock swinging back and forward and someone telling you to go to sleep or cluck like a chicken.

I've gotta say I love it and the whole "hypno" part is a bit of a misnomer; it's more along the lines of training yourself to think differently through meditiation and visualisation so you can interpret the pain messages in a different way. Seriously difficult to explain but really REALLY worth a look in, especially if you experience any panic or anxiety - the fundamentals of hypno birthing are really about slowing down your breathing and relaxing so it helps in all aspects of relaxation - not just for child birth.

Anyway, sorry if you knew all this and I just sounded like a whingey preacher! Just wanted to say I'm doing it via distance learning and it's really worth it for me! I go at my own pace and listen to CD's at night in bed as I'm going to sleep.

Righto. Enough from me!

Best of luck whatever you decide to do!

x

I haven't taken on the Pink Kit yet, we're affiliates though :) It just means I have to order in stock in lots, so when I have saved for a bit, I will get started ;)

I haven't done my birth story yet. What chickenlittle has said is pretty much how it is...they word "hypno" is only one name for it, some I believe call it calm birthing. I can't speak highly enough about how it helped me.

I think that is one reason that when it came down to it I was able to go "right, we just have to do what we have to do" and handed over to my body and baby - which is just one of the affirmations associated with hypnobirthing. It's to relax, trust your body and baby to know what they are doing. So I believe this is what I did, I just knew we each had our job to do and I think you'd be surprised at how calm you can actually be in a situation you may have previously been panicked by.

Min, pain relief for a VBAC as far as I know is the same for any other labour, it's the inducing that's different.

Generally they don't use gel to induce labour because of the ciolent contractions it can cause the uterus putting extra strain on your scar.

A VBAC they will give you a trial of labour, it's rather crappy though, as you are only allowed each stage for a certain ammount of time. And for you, as you didn't actually labour last time, this will be more like a first baby labour for you. Get what I mean ?

As you say you tend to panic perhaps the hypno birthing would be a great thing for you to look into. Might help to relax your body and mind.

Tehya was my VBAC and my longest labour at 10 hours. Sure it was hard, and I'd be lying if I said I wasn't in pain, but it is productive pain. I got through it, one contraction at a time. Each one down was one closer to meeting my little girl.

It sure pays to fill you head with as much info as possible.

Goodluck hun. I hope it all goes great for you.

I just thought I'd add that I didn't labour with my first at all either. Didn't think to mention that until I saw Trish had mentioned it...it was totally unknown which is why I think I was so afraid of the concept. I don't think they induce a VBAC anywhere as far as I'm aware cos as Trish said it's more intense. The other interesting thing with hypnobirthing is that what you perceive at the moment to be pain actually isn't...it's very hard to explain, but I actually wasn't in pain...I had discomfort but not pain.

Trish, I know you had Tehya at home, so I guess you had a lot less rules than hospital VBAC's, you weren't worried at any point when it had gone on for so long that you might rupture? Is 10 hours considered a long birth, I know they don't let you labour for too long with a VBAC, but what sort of time frame is considered too long?

I will do a few question's asking hun, but I'm pretty sure that at hospital I would have been reaching my limit. Oh BTW the only reason my labour went on for so long was because I had a bowel obstruction. I was so blocked up but couldn't move down past it. An enema soon fixed it though.

Nope, was not worried at all about my scar. It was perfect the whole way through, and with uterine rupture, apparently you really feel it.

My advice for you would be to stay at home for as long as possible if you want to avoid intervention. Walking is great to get bub into a good position on you it to put pressure on your cervix. Shower's and baths are great for pain relief too.

I think it is totally unreasonable the time limits doctors put on labour. 'Apparently' a normal woman is supposed to dilate 1 cm an hour, or else it is failure to progress. As long as mum and baby are doing well then there is no reason why labour can't take much longer(and often does, especially in vbac because it is considered a first labour), and if you labour in the comfort of your own home with no stress etc. then that can help speed things up because you aren't worrying.
I am planning a home vbac in August, and have hired a private midwife so any problems will be picked up much faster than in a hospital, where they rely on machines to tell them everything, rather than closely watching the woman. Standard protocol for vbac's is constant foetal monitoring, so you are unable to move freely which is extremely important. Alot of places will induce with the drip, but I don't think the gel is used much. The chance of uterine rupture is very small, and even if it does occur is not usually a full rupture, and no symptoms will even be detected because it doesn't have any effect on bubs(in a tear, not a full rupture). Actually almost as many uterine tears(sorry can't remember the proper word) are detected in women who go in for an elective 2nd c/s, as those in women who do vbac.
This is a very emotional subject for me. After an awful experience with my first, I have done so much research and am appalled at the pressures, and limits that hospitals place on healthy women, just because they have had a c/s.
Min, have you thought of hiring a doula to help you minimise your need for pain relief??

I too am really upset that they are going to limit the time I have to labour. I will try to stay at home as long as possible, then tell them it hasn't been long LOL.

As for the monitoring - I didn't know you couldn't move around!!! Argh!! Can you ask for the scalp clip which allows more movement? My biggest fear is not being able to move where I want to...

Linda, some hospitals have a mobile monitor but quite often they will say that they can't get a proper reading and want you to lay on the bed, which we all know is the worse place to be.

Bec, I did the same as you and hired an independant midwife - actually I had 2, to be there for my VBAC. Part of my reason for choosing my homebirth was that I did not want the drip in my arm, did not want constant monitoring and did not want to be stuck on a damn bed. Are you going to have a water birth or a land birth ???
My waterbirth was awesome. It's also great for supporting your scar.

Ahh, I see. Well I now have a list of Qs for my OB next visit. I really don't want to be stuck on a bed....

I asked a lot of questions about the constant monitoring. Whilst it is normal protocol in most hospitals to do constant monitoring in a VBAC...you are allowed to discuss this with them. When I first arrived at the birth suite I was only about 1 min apart in contractions and they just wanted to check bubs HB but I wasn't going to have to leave it on if I didn't want to if it showed all was good...I must say that I am SO SO GLAD that I had that initial monitoring because it showed he was in fetal distress...due to my waters not breaking, they were bulging in front of him and he couldn't move and there was a lot of pressure which resulted in them breaking my waters which showed meconium. Apparently the reason they do like to monitor a VBAC is that the first sign of problems will come from your baby and because I didn't want internals and intervention they possibly would not have come across his distress early enough to have got him out safely if I'd refused the monitoring. If all had been ok, then I wouldn't have been stuck to the bed either, they were happy for me to move around. Up until that point for me standing up and leaning forward over something or with my hands on my knees was the most comfortable through each contraction.

I stayed at home for as long as possible (and this was a first time labour), but I actually progressed so fast that my labour was only 3 1/2 hours and I was at the hospital only just over approx. 40 mins before he was born. I felt like pushing before we even left home which I told them cos I think they could tell anyway that I felt like that, so I think that started to raise some concern for them with the added distress his HB was showing. I think I'm starting to ramble, but I guess bottom line of what I'm trying to say is it's important to be flexible to the idea of maybe having to change the direction in which you have to go with your birthing

Wow Cass. So they obviously didn't try to wheel you straight in for a C/S then? Bub was still going to be OK for that little longer while you laboured?

I agree - I am happy to be monitored, I want to know bub is OK. I'm just hoping that I am able to be monitored & also move around. I don't want to just lay there...

I had intermitant monitoring via a doppler. This would have been my preferred way in a hospital setting too though.

I don't think I mind the constant monitoring, not moving around though, if the hospital doesn't allow it - that doesn't mean that I can't get into different positions does it?

Min you can attempt the different positions but if it makes them hard to get a good trace on bub then its back to flat on your back or side on bed.

The thing is the constant monitoring only makes you worry more I think, because your constantly watching / listening to the monitor. I suppose you just have to go with what you are comfortable with.

Trish, I haven't really thought about water or land birth, we have a nice big spa so it would be lovely to birth in there!! I am too busy trying to convince dh that we are safer having the bub at home! We will be having 2 midwives for a homebirth, and I am looking into hiring a doula aswell.

MIn, sometimes you can get a wireless monitor around your belly, I am pretty sure you can shower with that on. Or the internal monitor is another one, you may want to look into that though, I am not sure if it would effect bubs heartrate or not from having it put in.

I am with Trish on this one, constant monitoring is just something that may make you worry, and lets face it, unless there is a nurse sitting there every second watching the trace print out then what is the difference between that and intermittent monitoring?? And you do have a right to refuse anything they want to do. Make sure you tell whoever goes in with you, your husband or partner for example, what you don't want, and let him be your advocate if you are unable. You may be able to negotiate, initial trace on admission, and then only intermittent after that. Oh, and another thing, do some research on the efm, they have extremely high false positive rates.

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Wow Cass. So they obviously didn't try to wheel you straight in for a C/S then? Bub was still going to be OK for that little longer while you laboured?

I agree - I am happy to be monitored, I want to know bub is OK. I'm just hoping that I am able to be monitored & also move around. I don't want to just lay there...

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Nope, he said it was better and faster for bubs to be vacuum assisted than to wait for c/s to be set up. I was only at the hospital for approx 45 mins before he was born and that included the time it took to get into the room, have the monitor fitted and everything. I could've moved around just not in water with the monitor..that is if all was fine and they were also happy to do intermittent monitoring if he was ok on the initial monitor. I will be forever eternally grateful for this little bit of protocol in my case.

That's great Cass. What a relief!

Chicken little: Where did you find the at home hypnobirthing?
i would love to do it although i live hours away from my nearest teacher so i couldnt manage it! although at hoe sounds great!