General Anesthesia C-Section Because of Scoli Surgeries

[Traintrackspine]

Hello, I had 13 spinal fusions and 2 Harrington rods placed in 1994. Then two surgical revisions in October 2007 involving flatback syndrome - had rods reattached, two incisions, ten osteotomy wedges, four fusions, artificial discs, etc. done.

I am 20 weeks pregnant, and my surgeon does not seem concerned but will not see me in his office. He says all decisions are now up to my OB (which I understand). So far, not many complications except for marked back spasms in my lower-right. Hubby helps me a lot around the house, so I deal with it. OB wants me to either go completely natural with childbirth, or to have a general anesthesia C-section since she thinks I can't have an epidural.

I have two questions:

1. If you have been pregnant with similar hardware installed in your back and/or revisions, how did it go?
2. Did you require general anesthesia in a C-section or did you go natural? How did THAT go?

[LindaRacine]

I've known people who have had epidurals after a long fusion to the sacrum, but I think it generally is only available in large hospitals with anesthesiologists who see a lot of patients like us.

Good luck.

--Linda

[rohrer01]

Congratulations on your pregnancy!

Just a question. Why does your OB want you to go completely natural or c-section? I understand the general anesthetic for the c-section just because they don't want to be messing around with your spine. But what is wrong with IV medications during labor or is she just referring to no epidural w/vaginal delivery?

I had a c-section under general anesthesia for other reasons. I'm not going to tell you the what's or why's, but I STRONGLY urge you to demand brain wave monitoring during this process if this is what you choose to do. It's just putting some stickers on your forehead to make sure you are unconscious before the procedure starts.

Again, congrats and enjoy your pregnancy!

Rohrer01

[Susie*Bee]

Dear Traintrackspine-- I'd like to add my congratulations too. That's such an exciting time! If you want to read of lots of other people's experiences, just do a search on pregnancy and you'll find a bunch. I remember a lot of posts over the years-- even one who accidentally got pregnant at 3 months post-op. Some had their babies naturally and some had C-sections, but sometimes it was because of the baby's position, not because of the hardware-- and there may have been a couple with epidurals... I don't know how the hardware affects childbirth, but I had all 3 of my babies naturally without hardware. If you prepare with Lamaze or something similar, it's do-able and gives your baby a good start. Of course, so would a C-section.

I wish you all the best with your pregnancy and am excited for you! There's nothing quite like being a mommy!!! (Although being a grandma is awfully nice, too!)

[Traintrackspine]

Congratulations on your pregnancy!
But what is wrong with IV medications during labor or is she just referring to no epidural w/vaginal delivery?
1

Thank you so much! The doctor says she won't do IV medications during labor because of how they could affect the baby.

[Lorraine 1966]

I had my two children naturally and honestly did not have any problem at all, in pregnancy or with either birth. In fact with my first child they said that the harrington rods in my back actually helped me strength wise to push my bub out. Since I have had injections into my back to try and help me with the pain, they have not worked as far as getting rid of the pain, but the actual injection part was not a problem. I do wish you all the best and congratulations. I have read a lot on here about rods and delivery and I am sure if you go searching you will find quite a lot on the subject.

Hope all turns out OK for you,

Lorraine

[rohrer01]

Thank you so much! The doctor says she won't do IV medications during labor because of how they could affect the baby.

I would say that more people than not have IV medications during labor with a vaginal delivery. I don't know if your labor will be more painful because of the fusion or not, but if you want pain meds, I would see a different doctor.

How far are you fused? Are you fused to sacrum? If so, I'd imagine that would make it more painful.

In your last couple of weeks of pregnancy your body releases a hormone called "relaxin" (it's what makes your lower back and hips hurt like the dickens). It does just what is sounds like it would do. It relaxes the joints like your SI (sacroiliac) joints and your pubic symphasis, along with your hips. This allows your pelvic girdle to stretch as the baby comes through the birth canal. If your SI joints are fused I would personally insist on pain meds if you try vaginal delivery, or else go with the c-section.

Also, the epidural is the call of the anesthesiologist, whether he/she can do it or not. It's NOT the call of the OB. It sounds like your OB is bullying you a bit. I hope I'm wrong, but it gives me a bad feeling.

Remember c-sections do weaken the uterus quite a bit, especially if you have repeeat c-sections. This may limit the number of children you can have. I would always advise someone to try for a vaginal delivery if they can. Since the "no pain meds" is for the baby's safety and not yours, that is a personal decision YOU must make, not the doctor. The drugs don't stay in their systems long and millions of babies survive their mother's pain meds during delivery just fine.

If you opt for a c-section, that baby is going to get a heck of a lot more drugs than something given to you in the IV for a vaginal delivery! General anesthesia goes straight to the baby and the baby gets anesthetized, too. That's why they have to lighten up on the dose of the general anesthesia (this referrs back to my previous c-section comment about monitoring brain waves to make sure you are really out).

I would not want to go to a doctor that would withhold pain meds to a woman in labor. I think it's cruel and his/her options are totally contradictory. Sorry if I offend, but I've had three children including the one c-section under general anesthesia. My baby didn't cry right away from the meds used during my c-section. He's fine though. There were no lasting side effects, so as not to worry you.

Sincerely,
Rohrer01

[Karen Ocker]

labor/childbirth anesthesia

In a solid fusion to the sacrum, I as a retired anesthetist, cannot see how a needle can be advanced into the upper epidural space. It might be possible to do a caudal(tailbone epidural space),saddle block or pudendal block. The last 2 are given in the perineal area. Also local to the birth canal area. There is no reason for a c/s unless labor problems ensue. I was earlier fused to L-4. The doc tried a low spinal for my D&C but it did not work and I had to go to sleep.

[rohrer01]

In a solid fusion to the sacrum, I as a retired anesthetist, cannot see how a needle can be advanced into the upper epidural space. It might be possible to do a caudal(tailbone epidural space),saddle block or pudendal block. The last 2 are given in the perineal area. Also local to the birth canal area. There is no reason for a c/s unless labor problems ensue. I was earlier fused to L-4. The doc tried a low spinal for my D&C but it did not work and I had to go to sleep.

I was hoping you would chime in with your knowledge. I can't understand why a doctor would say NO labor meds because of the risk to baby, but then okay to a general anesthesia??? It just doesn't make any sense.

[Traintrackspine]

Sorry to respond so very late; yes, I am fused all the way to the sacrum and the doctors are not willing to risk it. Because I also have the osteotomy wedges and one potentially busted out disc, pushing is considered risky.

I'm 35 weeks tomorrow, and aside from pretty crazy back pain, things are going ok. Thank you everyone for all the information!

In a solid fusion to the sacrum, I as a retired anesthetist, cannot see how a needle can be advanced into the upper epidural space. It might be possible to do a caudal(tailbone epidural space),saddle block or pudendal block. The last 2 are given in the perineal area. Also local to the birth canal area. There is no reason for a c/s unless labor problems ensue. I was earlier fused to L-4. The doc tried a low spinal for my D&C but it did not work and I had to go to sleep.

[SIsForSarah]

I tried to deliver naturally, but couldn't due to the baby facing the wrong way (not a breech birth - he was "sunny side up"). They gave me pain meds through my IV during labour and pushing. I ended up with a C-section under general anaethesia. My baby is now 15 months and he is doing great - there were no lingering effects. I've since had another consult as we are considering having another and the anaethesiologist recommended C-section under general anaethesia. As Karen said, he couldn't see how the epidural would reach all the places it would need to go with my fusion. He alleviated my worries about the general anaethesia by letting me know that 30 years ago, most C-section births were under general and there were no lasting effects on the babies. Congratulations on the little one on the way!

[jerseyot]

I totally agree with Rohrer and Ocker...I have a 3 and 5 year old (as many of you know!) and I had both "au naturale" ----- NO, it was not fun and YES, it hurt like heck but it's labor --- so it hurts either way! My son was full of back labor as he was face up, face down, face up - that little guy was all over the place during labor. Push to birth was 2-1/2 hours and although i was BEGGING for a c-section by abut 7-8cm, I did make it thru just fine...I was hard and hurt like hell but I was fine and so was my baby boy.

Baby #2, my daughter was a different story!! Still no epidural as I was stll fused T2-L4 with Harrington rods at the time. Once my water broke, active labor went ALOT faster and I swear with just 3-4 pushes she came flying out of me like a butters roll~!!! BUT, that being said, with her I ended up needing to be "knocked out" 30 minutes after she was born to have a D&C due to bleeding a just wouldn't stop. Nothing like the recovery from a c-section, but a bit traumatic at the time----believe me, I was begging for them to knock me out with both labs once i got to 7-8cms, but I retrospect I'm glad I didn't! YOU ARE STRONG and our body knows what to do --- it doesn't need instructions!!! I totally agree that if needed, I'd opt for IV meds to takethe edge off - they are ALOT safer than general anesthesia, which can (and often DOES) make for very "sleepy" newborns -- not the crying screaming active ones that you typically imagine just after they're born.

You'll know what's right for you --- TRUST YOUR INSTINCTS and TRUST YOUR BODY!!! Whatever you decide, it will all work out --- they wouldn't give you drugs that were unsafe for you or your baby and if you have ANY questions, you have another 18-20 weeks to research tem and talk to about the. With your doctor!! I had a midwife for both -- in a hospital and OB was there if anything came up (like the uncomtrolled bleeding with my daughter) -- talk to them!!! Even if you have an OB, ou can stll talk to him/her AND a nurse midwife if your doctors office has one. They are EXTREMELY knowledgable and a wonderful resource!! Best of luck!!!