Expert: Dr Ian Jackson - please note UK based - 12/3/2008

Question
With my first two pregnancies I had epidurals that did not work. These epidurals both started numbing up instead of down. It seemed to knumb my breast, etc. These were done at two different hospitals. With my third child I did not have an epidural. I am 30 weeks with my fourth child and found out that I may have to have a c-section. If the epidurals didn't work, I am scared that a spinal won't either. I definately don't want to have any feeling during a c-section.

Answer
Hi there April
Everyone is different and there can be anatomical reasons why an epidural doesn't work. However a spinal anaesthetic is a totally different technique and so your problems would not make me worry that you couldn't have a successful spinal.
With a spinal a small needle is inserted into the fluid filled sack that surrounds the nerves in your back. Due to this proximity to the nerves we only need to use a small volume of local anaesthetic e.g. 3 mls compared to 25-30mls for an epidiral.
It also comes on much more quickly and it is easy to check how well it is working before starting the operation. Also as you are awake you can tell them immediately if you feel any pain and they can get it sorted for you.
I would not expect this to be aproblem but make sure you chat to your anaesthetist about your concerns.
Kind regards and best of luck with number 4!
Dr Ian Jackson