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Pregnant and desperately need advice

Hiya All, New to the forum so a tad nervous. I would really appreciate some advice from those of you who have had children since being diagnosed or from anyone who can help. I’m 23 weeks pregnant with my second child and unfortunately I am one of the unlucky msers whose symptoms have increased since being pregnant- it was the same with my first child. My first birth was traumatic and lead to an emergency c section; frankly if it wasn’t for my natal hypnotherapy cd I believe ut would have been a lot worse. After speaking to the anaesthetist weeks before the birth I decided to have a general anesthetic rather than epidural as he suggested that there maybe some progression in the diease if I had an epidural. Although I was knoecked out during the birth the GA was fine and despite the traumatic way in whuch my son came into the world he is perfectly healthy and gorgeous with it. Being high risk I am under a consultants care and in a recent appointment with him I was advised to have an epidural rather than a GA as its a safer option. Now I’m confused as I obviously want to go with the safest option but I have to think about any risk of the disease progressing any further. So I would be extremely grateful if anyone can advise me of their experiences during birth, especially if you have had a c section, whether you opted to epidural or GA and if epidural whether whe re has been any unfortunate progression in your MS. Unfortunately I do not know anyobe who has ms yet alone anyobe whohas had children since bejng diagnosised which makes this pregnancy just as lonely as the first. You would be helping an extremely confused heavily pregnant women. Merci b.

hi

have you asked your ms nurse?

are they saying that general anaesthetic is safer for your ms but not your baby?

seems that its the consultant obstetrician who wants you to have an epidural.

​would be interesting to have him there with your ms consultant and listen to their discussion.

​i fully understand your reluctance to avoid the epidural, after having a lumbar puncture which is basically the same procedure.

it is entirely your choice, your body, your ms.

you could argue that you need to avoid ms progression if you are to be able to care for your baby.

ask what the risks are to baby from the general anaesthetic.

oh sweetheart i’m so glad that i’m getting on a bit and my kids are grown up.

don’t let all this take the joy out of your pregnancy. i believe that baby picks up on how mum is feeling.

what does your partner say? parents?

it’s still up to you so make your decision then have a lovely calm pregnancy.

let everyone spoil you.

carole xx

Hiya

I had 2 babies in the last 2 years. The first pregnancy was problem free, the last one I had 4 bad relapses. I was also consultant led and had an anaesthetist appointment in both pregnancies. Nobody said to me anything about ms progression with an epidural and my neurologist didn’t say anything about it either. I have 2 teenagers also (pre ms diagnosis) and had an epidural with my eldest due to a very long labour and baby in distress. Can’t say I’ve had any more problems due to it or not. I have rrms which has been described as severe and rapidly evolving but I’ve never once had anyone ask me with regards to ms if I’ve had an epidural in the past nor have I ever heard that it can make things worse.

As pigpen says, I would get your ms nurse to liase with your neurologist for his opinion.

Hope your pregnancy goes well and you get your answers so you don’t have to worry.

Lorna

Hi Merci

You’ve made your decision to have a GA after speaking to anaesthetist-the correct person to help and advise. They would not allow you to have a GA if they felt you or your baby was at high risk from it.

What reason/s did the consultant give for epidural being the safe option?

Perhaps speaking to your midwife may help?

All procedures have risks, GA, local or epidural. The consultant should be working with the team looking after you and making sure you get clear consistent advice.

Good luck

i was given loads of conflicting advice following the premature birth of my first son.

there were special care nurses calling at my home.

special care midwives.

my lovely health visitor.

all except my health visitor were telling me to breast feed but my jack didnt have his sucking reflex and i was exhausted with trying.

my mum wanted me to get him on the bottle because he was hungry.

my health visitor said i should follow the advice that i was most comfortable with.

so my mum was right and he thrived on the bottle.

the health visitor used to call him little buster because he was gaining weight.

it’s so difficult when the professionals are giving conflicting advice.

go with your gut instinct.

carole x

I’m not, and have never been, pregnant, but it’s the first I’ve ever heard of an epidural increasing the chances of progression!

Does your neurologist actually agree this is true? If not, I’d trust a neurologist over an anaesthetist over what does and doesn’t increase the risks.

As I understand it, hardly anything has EVER been conclusively proved to influence progression. I think smoking is one of the few things that may be demonstrably linked, but I’ve never heard of epidurals being a factor.

I can understand the anaesthetist having a reluctance to administer an epidural to a patient who has/may have spinal cord problems, but is this established science, or just a feeling?

Despite how well your son has done after you having to have a GA last time, I wouldn’t have thought it’s a route to go from choice. If you have to, you have to, but that’s different. I wonder exactly how many pregnant women with MS the anaesthetist has cared for, and of those, how many “progressed” - and what proof he has it was anything to do with the epidural?

Sadly, most people with MS do “progress” - it’s notoriously difficult to pin it on any one thing. It’s particularly common for women with RRMS to relapse not long after giving birth, but there’s no proof this has anything to do with their care during pregnancy or labour. It’s more likely that pregnancy has some modifying effect on the immune system (so a woman’s body wouldn’t reject the baby), but once the pregnancy has ended, this effect is lost.

I don’t believe it’s because they had an epidural, or even because of pregnancy itself - except in the sense that pregnancy may have dampened the MS activity for a while - but it doesn’t sound as if that’s true in your case anyway.

Tina

Bless you all for your quick responses and frankly priceless advice. You all are so right I should go with my gut instincts and Blossom you are absolutely right - the anaesthetist, in fact 2 of them, wouldnt have advised the GA for my first birth if there were any risks. I briefly asked the consultant why epidural should be chosen and he said "well I want to speak to you while im operaing. I said to him, that I wouldnt be into chatting at that time - just want the baby out safely. I was half joking but actually meant it. So long as the baby comes out safely and im ok I dont care if im chatting or not. At the end of thr day he will not be around if, heaven forbid, I had the epidural and the diease progressed. I think the next step is to approach my ms team at queen sq - maybe try and speak to a maternity consultant at uch. Having treated pregnant woman with ms on a daily basis they would be best to advise. Bless you all again - very much appreciated. Any more thoughts please let me knowxx

have a happy, relaxed birth and a happy, relaxed baby

it was obstetrics advising GA not the anaesthetist, he should chat to colleages at lunch time if he is so keen on chatting!

bless you and your baby

carole x

Hi

Congratulations on your pregnancy!

I have had cesarean sections with an epidural on 2 occasions & am pretty sure neither caused progression of my MS. It did take me longer to get up & about afterwards than a ‘normal’ (that sound awful!) person. I am certain my symptoms got worse when I stopped breast feeding but that isn’t for everyone, I know. In hindsight I wish I had gone onto my Tysabri immediately after the birth (but I wasn’t offered it at that stage).

I don’t think the evidence is there to support GA over epidural but I would think if you have a v strong preference they will let you choose, as long as you are fully informed of all the risks/benefits.

Good luck! Xx

Hi.

I have 2 children. Both pregnancies pre diagnosis but after my first episode of demyelination. I had an epidural with a vaginal delivery first time round. It took me ages to recover as I had bad tears and was utterly exhausted.

I had an epidural with a semi emergency caesarian the second time round. Much quicker recovery and less exhausted (I could sit down comfortably for one thing). I have had 3 general anaesthetics and I don’t feel the recovery is much different from an epidural. I certainly don’t think either of the epidurals made my MS any worse though.

I think you need to be happy and relaxed with whatever is happening - I was terrified the first time round which made everything so much worse. Very relaxed the second time and was 4cm dilated without even feeling any pain. To get to 4cm took 24 hours of agony with my first!

Good luck whatever you (not the consultant) decide.

As far as I know (like all things ms I have done a lot of reading and asking specialists) the idea that an epidural can lead to progression is VERY outdated and there is no evidence to suggest that it will. I had an epidural with both my children and no subsequent issues. I found once I had the epidural I was much more comfortable and felt more in control. Ultimately whatever makes you feel comfortable is the right decision. If you are happy with GA then go with that but if you’d prefer just the epidural then I can’t think why you should be discouraged from this route. All the best and wishing you good health once your baby arrives.

Congratulations! Sorry you’re feeling rough. Had c sections with both of mine due to breech and had epidurals both times. As above, I think the anaesthetist needs to get up to date as epidurals are considered safe in ms unless there are unusual circumstances? My neuro confirmed that I wouldn’t need anything different. Can you talk to an ms nurse or neuro before making the decision so that you’ve got backing for your decision?

I had no ms progression from my epidurals but post partum relapses are common whatever way baby arrives. As previous poster said you might be a bit slower to get back on your feet. My biggest issue was my bladder wouldn’t come back to life straight away but that was the catheter not the epidural.