Expert: Dr Ian Jackson - please note UK based - 7/14/2010

Question
Hello, I had a epidural during my induction of labour. While it helped immensely with the pain, I was still in discomfort and was aware of each contraction and pressure. I proceeded to need a c-section, the epidural was topped up for this however I still had movement in my legs and sensation on my upper abdomen. I needed to have a GA.
Does this mean I am not a candidate for epidural in the future? Will any future c-sections need to be done under GA?
Thank you.

Answer
Hi Maria
That is a good question. Basically the answer is simple - you can have a epidural the next time and any c-section could be done under an epidural or a spinal anaesthetic. Epidurals can be tricky - even with the best of us inserting them we find only 85% work perfectly first time. We can then usually make another 10% work better by 'fiddling with them' or by just simply replacing them. That leaves about 5% of mothers who don't get what we would define as good pain relief during their labour. If we look at that 5% and then give them an epidural the next time round then most will get excellent pain relief!
This is mainly down to the anatomy of the patient and where the little epidural catheter ends up inside the epidural space.
So next time there is no reason you can't have an epidural for pain relief in labour - and it will most likely work.
If you need a section then given your previous experience I would opt for a spinal anaesthetic which gives you a quicker onset and more dense block and so is ideal for this operation.
I am sorry to hear about your experience and hope that both you, your partner and your child are well. I know only too well that what happened can be quite unnerving for your partner also.
Anyway I hope this helps
Kind regards
DR Ian Jackson