Epidurals, Cf and hemoptysis

LouLou · Jan 29, 2007

Okay I'm mildly freaking out - need to chill out and get info. and then go from there in terms of what my current obstetrician can and can not do for me.

Here's the situation. I'm 16.5 weeks pregnant. My prenatal care has been through a high risk OB dept at large city hospital. They told me on my first visit that I had to have an epidural for delivery "because we want you to be concentrating 100% on your lungs and breathing and not pain." I haven't had a problem with the idea of having one as I say I'm not trying to be a hero just deliver a healthy baby while keeping me also healthy...until yesterday.

I have started to interview doulas (birthing coach/assistant to couple). Yesterday I spoke with one and reiterated, like I do to the doctor each time I see him or her (there's 10 of them!), that I can not lay on my back (for exam purposes) and therefore will not be delivering on my back because laying on my back triggers hemopytsis (lung bleeding). No one has ever acted like this is a problem. The lady I spoke with yesterday told me (very nicely) that my idea of delivery on hands and knees or squating/sitting (whichever feels right) is NOT POSSIBLE WITH AN EPIDURAL. That initially when you get an epidural you must lay on your back or side (rolling from one to anther to avoid 'pooling') then after say an hour once it's numbed you good it's not removed. They leave it in there and you continue to lay in a reclined position with a spinal drip. She said if you are angled too much upward the mother's blood pressure starts to fall and then it's time for what I really, really, really want to avoid - C-section. I want to avoid this because of all the coughing I do to stay healthy. She said it would be nearly impossible to get me in a hands and knees position since I'd be limp and numb at the waist - even with my husband and her hauling me into position she said I wouldn't be able to hold myself up.

Okay after hearing all this - I want to labor with NO EPIDURAL. Are my understandings as stated above true? If so, I plan to see if the definite epidural is really required given my circumstances and if so I think I'll have to change OB's. They have been all about not bringing on hemoptysis thus far, so maybe they just haven't thought about it.

I don't have an appt. for 2 weeks and if I do need to change OB's I'm getting close to the cut off point of when a new doctor isn't going to 'want' me (either 20 or 25 weeks).

Ahhh!!!! HELP!!!!! Anyone have any experience or knowledge on this subject?

LouLou · Jan 29, 2007

Okay I'm mildly freaking out - need to chill out and get info. and then go from there in terms of what my current obstetrician can and can not do for me.

Here's the situation. I'm 16.5 weeks pregnant. My prenatal care has been through a high risk OB dept at large city hospital. They told me on my first visit that I had to have an epidural for delivery "because we want you to be concentrating 100% on your lungs and breathing and not pain." I haven't had a problem with the idea of having one as I say I'm not trying to be a hero just deliver a healthy baby while keeping me also healthy...until yesterday.

I have started to interview doulas (birthing coach/assistant to couple). Yesterday I spoke with one and reiterated, like I do to the doctor each time I see him or her (there's 10 of them!), that I can not lay on my back (for exam purposes) and therefore will not be delivering on my back because laying on my back triggers hemopytsis (lung bleeding). No one has ever acted like this is a problem. The lady I spoke with yesterday told me (very nicely) that my idea of delivery on hands and knees or squating/sitting (whichever feels right) is NOT POSSIBLE WITH AN EPIDURAL. That initially when you get an epidural you must lay on your back or side (rolling from one to anther to avoid 'pooling') then after say an hour once it's numbed you good it's not removed. They leave it in there and you continue to lay in a reclined position with a spinal drip. She said if you are angled too much upward the mother's blood pressure starts to fall and then it's time for what I really, really, really want to avoid - C-section. I want to avoid this because of all the coughing I do to stay healthy. She said it would be nearly impossible to get me in a hands and knees position since I'd be limp and numb at the waist - even with my husband and her hauling me into position she said I wouldn't be able to hold myself up.

Okay after hearing all this - I want to labor with NO EPIDURAL. Are my understandings as stated above true? If so, I plan to see if the definite epidural is really required given my circumstances and if so I think I'll have to change OB's. They have been all about not bringing on hemoptysis thus far, so maybe they just haven't thought about it.

I don't have an appt. for 2 weeks and if I do need to change OB's I'm getting close to the cut off point of when a new doctor isn't going to 'want' me (either 20 or 25 weeks).

Ahhh!!!! HELP!!!!! Anyone have any experience or knowledge on this subject?

LouLou · Jan 29, 2007

Okay I'm mildly freaking out - need to chill out and get info. and then go from there in terms of what my current obstetrician can and can not do for me.

Here's the situation. I'm 16.5 weeks pregnant. My prenatal care has been through a high risk OB dept at large city hospital. They told me on my first visit that I had to have an epidural for delivery "because we want you to be concentrating 100% on your lungs and breathing and not pain." I haven't had a problem with the idea of having one as I say I'm not trying to be a hero just deliver a healthy baby while keeping me also healthy...until yesterday.

I have started to interview doulas (birthing coach/assistant to couple). Yesterday I spoke with one and reiterated, like I do to the doctor each time I see him or her (there's 10 of them!), that I can not lay on my back (for exam purposes) and therefore will not be delivering on my back because laying on my back triggers hemopytsis (lung bleeding). No one has ever acted like this is a problem. The lady I spoke with yesterday told me (very nicely) that my idea of delivery on hands and knees or squating/sitting (whichever feels right) is NOT POSSIBLE WITH AN EPIDURAL. That initially when you get an epidural you must lay on your back or side (rolling from one to anther to avoid 'pooling') then after say an hour once it's numbed you good it's not removed. They leave it in there and you continue to lay in a reclined position with a spinal drip. She said if you are angled too much upward the mother's blood pressure starts to fall and then it's time for what I really, really, really want to avoid - C-section. I want to avoid this because of all the coughing I do to stay healthy. She said it would be nearly impossible to get me in a hands and knees position since I'd be limp and numb at the waist - even with my husband and her hauling me into position she said I wouldn't be able to hold myself up.

Okay after hearing all this - I want to labor with NO EPIDURAL. Are my understandings as stated above true? If so, I plan to see if the definite epidural is really required given my circumstances and if so I think I'll have to change OB's. They have been all about not bringing on hemoptysis thus far, so maybe they just haven't thought about it.

I don't have an appt. for 2 weeks and if I do need to change OB's I'm getting close to the cut off point of when a new doctor isn't going to 'want' me (either 20 or 25 weeks).

Ahhh!!!! HELP!!!!! Anyone have any experience or knowledge on this subject?

Mommafirst · Jan 29, 2007

Lauren, I'm reading this and sensing you are panicking. So try to calm down. I do not have CF, but I do have some experience in some of this... I hope it will help you. 
 
First of all I had a regular epidural with my first son. I labored for a looooonnnggg time with no progress. So before giving in to the c-section, I was willing to try whatever I could to get the baby down and labor moving faster. My OB wanted me on my hands and knees. I was very numb from the epidural, but between my will and my hubby and the nurses, we were able to get me in that position for some time. It wasn't easy, and any shread of modesty I had before went completely out the window, but it is possible. I had had issues with my blood pressure dropping while I was laying down on my back, but had none of that on my hands and knees. 
 
Second of all, there is now something commonly referred to as a "walking epidural" and I believe it doe not numb everything. It keeps you mobile so you don't have to have a catheter, can do some walking to progress the labor, and can feel the contractions when its time to push. Have they said whether this can be an option for you??? 
 
I'm sure that having a birthing coach/doula is a great thing, but from my experience they are very pro non-medicated births. Is it possible this woman isn't aware of some of the newer epidurals available? 
 
Don't despair, I'm sure you can do this!!!! 
 
One more thing, I did wind up having a c-section -- I've had three. And if it comes down to it, and it is what is best for you and the baby, it really isn't horrible.

Mommafirst · Jan 29, 2007

Lauren, I'm reading this and sensing you are panicking. So try to calm down. I do not have CF, but I do have some experience in some of this... I hope it will help you. 
 
First of all I had a regular epidural with my first son. I labored for a looooonnnggg time with no progress. So before giving in to the c-section, I was willing to try whatever I could to get the baby down and labor moving faster. My OB wanted me on my hands and knees. I was very numb from the epidural, but between my will and my hubby and the nurses, we were able to get me in that position for some time. It wasn't easy, and any shread of modesty I had before went completely out the window, but it is possible. I had had issues with my blood pressure dropping while I was laying down on my back, but had none of that on my hands and knees. 
 
Second of all, there is now something commonly referred to as a "walking epidural" and I believe it doe not numb everything. It keeps you mobile so you don't have to have a catheter, can do some walking to progress the labor, and can feel the contractions when its time to push. Have they said whether this can be an option for you??? 
 
I'm sure that having a birthing coach/doula is a great thing, but from my experience they are very pro non-medicated births. Is it possible this woman isn't aware of some of the newer epidurals available? 
 
Don't despair, I'm sure you can do this!!!! 
 
One more thing, I did wind up having a c-section -- I've had three. And if it comes down to it, and it is what is best for you and the baby, it really isn't horrible.

Mommafirst · Jan 29, 2007

Lauren, I'm reading this and sensing you are panicking. So try to calm down. I do not have CF, but I do have some experience in some of this... I hope it will help you. 
 
First of all I had a regular epidural with my first son. I labored for a looooonnnggg time with no progress. So before giving in to the c-section, I was willing to try whatever I could to get the baby down and labor moving faster. My OB wanted me on my hands and knees. I was very numb from the epidural, but between my will and my hubby and the nurses, we were able to get me in that position for some time. It wasn't easy, and any shread of modesty I had before went completely out the window, but it is possible. I had had issues with my blood pressure dropping while I was laying down on my back, but had none of that on my hands and knees. 
 
Second of all, there is now something commonly referred to as a "walking epidural" and I believe it doe not numb everything. It keeps you mobile so you don't have to have a catheter, can do some walking to progress the labor, and can feel the contractions when its time to push. Have they said whether this can be an option for you??? 
 
I'm sure that having a birthing coach/doula is a great thing, but from my experience they are very pro non-medicated births. Is it possible this woman isn't aware of some of the newer epidurals available? 
 
Don't despair, I'm sure you can do this!!!! 
 
One more thing, I did wind up having a c-section -- I've had three. And if it comes down to it, and it is what is best for you and the baby, it really isn't horrible.

JazzysMom · Jan 29, 2007

I cant help you with this completely. I didnt have an epidural. I had a spinal block. Quite truthfully I dont know why, but now I am curious if it has to do with my history of hemoptysis tho I was laying flat on my back the whole time since it was a c section. If I could do it again I would get the epidural since after delivery I had pain & continued to do my treatments with nothing more then tylenol. I just "assumed" I had to tough it out. I also didnt complain much because of this mindset so they didnt know how much pain I was in. I wouldnt freak yet. Just inquire & get as much feedback from others here & in the medical profession. Know what YOU are talking about in case the doctor doesnt!

JazzysMom · Jan 29, 2007

I cant help you with this completely. I didnt have an epidural. I had a spinal block. Quite truthfully I dont know why, but now I am curious if it has to do with my history of hemoptysis tho I was laying flat on my back the whole time since it was a c section. If I could do it again I would get the epidural since after delivery I had pain & continued to do my treatments with nothing more then tylenol. I just "assumed" I had to tough it out. I also didnt complain much because of this mindset so they didnt know how much pain I was in. I wouldnt freak yet. Just inquire & get as much feedback from others here & in the medical profession. Know what YOU are talking about in case the doctor doesnt!

JazzysMom · Jan 29, 2007

I cant help you with this completely. I didnt have an epidural. I had a spinal block. Quite truthfully I dont know why, but now I am curious if it has to do with my history of hemoptysis tho I was laying flat on my back the whole time since it was a c section. If I could do it again I would get the epidural since after delivery I had pain & continued to do my treatments with nothing more then tylenol. I just "assumed" I had to tough it out. I also didnt complain much because of this mindset so they didnt know how much pain I was in. I wouldnt freak yet. Just inquire & get as much feedback from others here & in the medical profession. Know what YOU are talking about in case the doctor doesnt!

Landy · Jan 29, 2007

I can't really help you much w/ your hemoptysis questions, but I had an epidural when my daughter was born and I wanted to give you a tip. When they numbed me, they did it too high up & I couldn't feel anything basically from my boobs down. It was very freightening to cough & not be able to feel myself cough. When my OB/GYN came in, he was perturbed that they did it that high with someone with CF. Anyway, just something to keep in mind.

Landy · Jan 29, 2007

I can't really help you much w/ your hemoptysis questions, but I had an epidural when my daughter was born and I wanted to give you a tip. When they numbed me, they did it too high up & I couldn't feel anything basically from my boobs down. It was very freightening to cough & not be able to feel myself cough. When my OB/GYN came in, he was perturbed that they did it that high with someone with CF. Anyway, just something to keep in mind.

Landy · Jan 29, 2007

I can't really help you much w/ your hemoptysis questions, but I had an epidural when my daughter was born and I wanted to give you a tip. When they numbed me, they did it too high up & I couldn't feel anything basically from my boobs down. It was very freightening to cough & not be able to feel myself cough. When my OB/GYN came in, he was perturbed that they did it that high with someone with CF. Anyway, just something to keep in mind.

thefrogprincess · Jan 30, 2007

There are low-dose epidurals that you can recieve so that you can be more relaxed but still mobile. Also you could try getting on your hands and knees using a birth ball for support. Its just an exercise ball that you could put under your chest to help support you. I've never had a baby but we are thinking of starting our family soon and I have been doing a lot of research. Good luck!

thefrogprincess · Jan 30, 2007

There are low-dose epidurals that you can recieve so that you can be more relaxed but still mobile. Also you could try getting on your hands and knees using a birth ball for support. Its just an exercise ball that you could put under your chest to help support you. I've never had a baby but we are thinking of starting our family soon and I have been doing a lot of research. Good luck!

thefrogprincess · Jan 30, 2007

There are low-dose epidurals that you can recieve so that you can be more relaxed but still mobile. Also you could try getting on your hands and knees using a birth ball for support. Its just an exercise ball that you could put under your chest to help support you. I've never had a baby but we are thinking of starting our family soon and I have been doing a lot of research. Good luck!

LouLou · Jan 30, 2007

thanks for your advice guys.
Lynda, that's good to know about the positioning of the needle stick effecting the lungs.

So I'm interviewing doula's like I mentioned previously. Here are some comments from one regarding the topic of this post....she seems like a good fit for me.

-It is true that in most cases you do have to be on your back or in a semi-reclining position when you get an epidural, simply because you loose the use of your legs which makes maintaining any other position nearly impossible.
-what the benefit of "concentrating on your breathing not on pain" I prefer "coping with your contractions" would be, I don't know. Did they mention that epidural drugs can lower your blood pressure? Will that be a problem for someone with CF? -Although, let me state that as a doula I don't do any medical services (nor are they permitted by DONA) and that my questions just reflect my concern about what may or may not be an issue for your situation.
- I did want to mention that "epidural" is a delivery method for some form of pain reducing medication. Just like a needle would be. Some of these medications are opiates. Have you checked with your CF specialists to see if there are any problems with you receiving these types of drugs? Now I seem to be asking the questions. But are your specialists for CF working with your Maternal Fetal Medicine group? If not, have you approached both of the groups to see if they will work together?
-Alternate birthing positions seem to be custom made for you. In fact HUP has a page on their website that explains Delivery Positions and the drawbacks and benefits of them. Just check on- <a target=_blank class=ftalternatingbarlinklarge href="http://pennhealth.com/health_info/pregnancy/000135.htm">http://pennhealth.com/health_info/pregnancy/000135.htm</a> maybe you can print this page and bring it to your caregivers and discuss it with them. As for your labor, I would like to keep you moving eg; walking, rocking, sitting on the birth ball, slow dancing until you decide it's time to rest. Then if you were up to it, try all again. Gravity and movement are your best friends in labor.
-Remember that no medical proceedures can be done to you without your permission. You need to make your decision based on full disclosure and what is in your best interest.

LouLou · Jan 30, 2007

thanks for your advice guys.
Lynda, that's good to know about the positioning of the needle stick effecting the lungs.

So I'm interviewing doula's like I mentioned previously. Here are some comments from one regarding the topic of this post....she seems like a good fit for me.

-It is true that in most cases you do have to be on your back or in a semi-reclining position when you get an epidural, simply because you loose the use of your legs which makes maintaining any other position nearly impossible.
-what the benefit of "concentrating on your breathing not on pain" I prefer "coping with your contractions" would be, I don't know. Did they mention that epidural drugs can lower your blood pressure? Will that be a problem for someone with CF? -Although, let me state that as a doula I don't do any medical services (nor are they permitted by DONA) and that my questions just reflect my concern about what may or may not be an issue for your situation.
- I did want to mention that "epidural" is a delivery method for some form of pain reducing medication. Just like a needle would be. Some of these medications are opiates. Have you checked with your CF specialists to see if there are any problems with you receiving these types of drugs? Now I seem to be asking the questions. But are your specialists for CF working with your Maternal Fetal Medicine group? If not, have you approached both of the groups to see if they will work together?
-Alternate birthing positions seem to be custom made for you. In fact HUP has a page on their website that explains Delivery Positions and the drawbacks and benefits of them. Just check on- <a target=_blank class=ftalternatingbarlinklarge href="http://pennhealth.com/health_info/pregnancy/000135.htm">http://pennhealth.com/health_info/pregnancy/000135.htm</a> maybe you can print this page and bring it to your caregivers and discuss it with them. As for your labor, I would like to keep you moving eg; walking, rocking, sitting on the birth ball, slow dancing until you decide it's time to rest. Then if you were up to it, try all again. Gravity and movement are your best friends in labor.
-Remember that no medical proceedures can be done to you without your permission. You need to make your decision based on full disclosure and what is in your best interest.

LouLou · Jan 30, 2007

thanks for your advice guys.
Lynda, that's good to know about the positioning of the needle stick effecting the lungs.

So I'm interviewing doula's like I mentioned previously. Here are some comments from one regarding the topic of this post....she seems like a good fit for me.

-It is true that in most cases you do have to be on your back or in a semi-reclining position when you get an epidural, simply because you loose the use of your legs which makes maintaining any other position nearly impossible.
-what the benefit of "concentrating on your breathing not on pain" I prefer "coping with your contractions" would be, I don't know. Did they mention that epidural drugs can lower your blood pressure? Will that be a problem for someone with CF? -Although, let me state that as a doula I don't do any medical services (nor are they permitted by DONA) and that my questions just reflect my concern about what may or may not be an issue for your situation.
- I did want to mention that "epidural" is a delivery method for some form of pain reducing medication. Just like a needle would be. Some of these medications are opiates. Have you checked with your CF specialists to see if there are any problems with you receiving these types of drugs? Now I seem to be asking the questions. But are your specialists for CF working with your Maternal Fetal Medicine group? If not, have you approached both of the groups to see if they will work together?
-Alternate birthing positions seem to be custom made for you. In fact HUP has a page on their website that explains Delivery Positions and the drawbacks and benefits of them. Just check on- <a target=_blank class=ftalternatingbarlinklarge href="http://pennhealth.com/health_info/pregnancy/000135.htm">http://pennhealth.com/health_info/pregnancy/000135.htm</a> maybe you can print this page and bring it to your caregivers and discuss it with them. As for your labor, I would like to keep you moving eg; walking, rocking, sitting on the birth ball, slow dancing until you decide it's time to rest. Then if you were up to it, try all again. Gravity and movement are your best friends in labor.
-Remember that no medical proceedures can be done to you without your permission. You need to make your decision based on full disclosure and what is in your best interest.

wanderlost · Jan 30, 2007

She sounds great Lauren!

wanderlost · Jan 30, 2007

She sounds great Lauren!

Epidurals, Cf and hemoptysis

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