Labor And Delivery

[lavender]

I'm due to have my first baby in 3-4 weeks! ya! I'm really hoping to be able to have a natural labor and delivery, with as little medical intervention as possible....as long as baby is doing good. So far my pregnancy has gone really good. Super POTSy in the first four months...felt less POTSy than my usual in the second trimester....and still doing good but more POTSy in my last few months.

My concern is how my POTS will effect my labor and delivery. I'm a bit worried that the labor will make my heart rate and blood pressure go crazy, and that then the midwife or doctor will be concerned and not allow a natural birth. I'd be currious to hear how others POTS symptoms have responded to labor.

Are there things I can do durring labor and even before, to help keep my heartrate from getting super high? I'll try to drink alot of water before and durring. Is there something better I should drink? I also have thigh high stockings I'll wear.

My midwifes are very supportive of my wanting to have a natural delivery but have expressed that they are unsure of what to expect because POTS is new to them. They asked me how I think I'd respond to an epidural if we have to go that route. I'm not sure, but I'm a bit concerned that I wouldn't handle it well. Anybody with POTS had an epidural?

Thanks!

[firewatcher]

I had undiagnosed POTS with the labor/delivery of both of my boys. With the first one I did not have any pain meds and my HR and BP went so high that they just turned off the monitor (it couldn't possibly be right! ) I did, however, have an IV of saline with that one so my BP did not tank after the birth. With #2, I had an epidural and both HR and BP tanked so low that I was put in shock boots (I LOVE THEM!!!!!!!!!) My little one came out dusky blue, but pinked up once they made him mad. Knowing now how my body would react to both, if I had it to do over, I would get saline and a "light" epidural so that I could feel to push and my BP wouldn't drop so far. There have been several studies recently published about POTS and childbirth/pregnancy. Go to the main page and look at the research section. I suggest you print out those abstracts or articles and give them to you doc/midwife. Prognosis often depends on your underlying cause of POTS (be careful if it is EDS!) Good luck, you should be fine.

(((((((((((((((((supportive Mommy hug!))))))))))))))))))))

[ethansmom]

I have had POTS through two pregnancies and am 30 weeks along with #3. I've had natural, unmedicated births with both and am planning the same with this baby, although this pregnancy has been WAY more symptomatic than the others. I am a bit nervous but trying to remain positive and remind myself that my body knows instinctively how to protect me and the baby, and that everything will most likely be fine.

I did fine during both labor and deliveries, and fine postpartum other than some minor lightheaded spells which I think is pretty normal even if you don't have POTS. I have always felt personally that the potential for the epidural to interfere with my HR and BP was too big of a risk, and I didn't want an experience as beautiful as birth to be tainted by a bad reaction to the meds, so that was the reason for my decision. I did have some palpitations during the pushing phase of my 2nd birth, and my BP spiked really high a few times when the pain got intense, but overall I felt very safe delivering the way that I did. This time, my midwife wants to work with me at the end on NOT pushing so hard/so much so that my heart rate will remain stable, and she has some cool ideas on how we can breathe through the desire to push and basically let the baby come out by herself

I've had one delivery in a hospital, and one in a birthing center (and we're definitely planning the birthing center again this time)- the major difference was that the birthing center was far more supportive emotionally, and they of course don't have pain meds available so the epidural is not an option. The hospitals push the meds way more than they say they will, so if you are adament about going natural, you have to really be strong in that decision because the power of persuasion is strong when you're in a state as vulnerable as labor. Make sure your support person knows your feelings and desires and will be able to advocate for you in the event that you are unable to.

I wish you the best of luck with your little one and hope you have a beautiful, perfect birth and healthy baby!

[mvdula]

Hi lavendar,

I have a hard time dating my POTS onset bc I didn't get Dx until my 4th baby was a little over 1 yr. So, I suspect I had POTS before I was pg with my 4th, as the pg was much stranger/harder than the 1st 3, including massive #s of PVCs in last trimester. I had epidurals w/ my first 2 kids. Fine - no POTS then either. No meds with my 3rd - no POTS then either. Best birth I ever had (despite the delivery pain!), epidural w/ my 4th - nasty, nasty reaction. As soon as it kicked in, I felt very hot (could not cool off, and the ice they put on my neck did very little to cool me off), wanted to leave the hospital, my chest & arms felt dead, and was very panicky bc of this. The Dr, anesthesiologist, nurses were very concerned since I was so upset, so they stood around and stared at me a lot, monitored my hr and bp, which they said were fine (I wasn't looking at the #s), and gave me Benadryl, so I was able to oscillate between sleep & panic. Not fun. It wore off after about 2 hrs (since the initial dose takes time to wear off, and they stopped administering it after I started to have reaction/get upset), at which point I had the baby - that part was actually relatively fast and I felt fine after. But I do not want to relive that 2 hrs. Ever. I don't want to scare you as I have read other posts of POTS ladies who seem to have had no trouble w/ the epidural, but I never plan to have another one.....hope this helps you, and doesn't just scare you!

[icesktr189]

i just gave birth on the 6th.. i had the epidural and did fine with it because my anesthesiologist researched POTs and gave me tiny amounts at a time. My pulse did reach 150 but i did fine.

good luck!

[icesktr189]

oh i want to mention too i did feel hot when i got the epidural too but you have to remember that if you panic you will experience other symptoms. I felt very lightheaded when they turned it on because i was starting to panic. I had to remind myself to calm down then after i did fine and was able to relax. Also REALLY important is to get PLENTY of fluids before hand. I had 4 bags of saline before they did it

[Heartwillforever]

I gave birth to a beautiful baby girl 3 months ago. I had the epidural and everything went great! I was worried about my hr and passing out the whole time. Instead my bp went high and my heart rate stayed real low.When they put the needle in my bp dropped alot. I was afraid I was going to pass out. I think this was the only time in my life I diddn't have a fast hear rate which was weard.. but great. I hope everything goes good! Congrats!

[bizbiz]

I got sick immediatley after giving birth, but looking back I now realise that I was just undiagnosed, but got worse and worse as the pregnancy went along.

Because I was undiagnosed, I didnt (and neither did the nurses or doctors) know what to do to help. The fact that you know what you are dealing with will make it so much easier.

I had a natural labour (just gas and peth for pain relief) - I was too scared to have an epidural, and I didnt think the pain was bad enough either. My BP and HR were all perfect during labour. It wasn't until after the birth that my BP bottomed out and my HR went through the roof. I believe this was caused by a few things - mainly because I was in labour for days and barely had anything to eat or more importantly drink for days, blood loss and also because I had been pretty much bedbound the last week.

You are on the right track with keeping your fluids up. I felt so much better when they gave me the saline IV drip - maybe you can ask for the drip right after the birth (not sure if you can have it during the actual labour, but if so I think it would help more.)

Good luck, I'm sure you will be fine!

[Rachel]

I have had an epidural with both deliveries. I had an epidural for the last two hours of labor with my son. It was helpful because it allowed me to get some rest and sleep before delivery. I don't think I would have made it through delivery otherwise. My midwife let me wear my compression stockings for labor and delivery, and this helped to keep my bp up. I wasn't taking any POTS meds at that time.

With my daughter I had to have a c-section, and I had epidural anesthesia for that. I wasn't sure how my body would handle such a big dose of the epidural, but it was just fine. It didn't completely numb me, though, and I started feeling the surgery (ouch!). I don't know if that was just a fluke, or if it had something to do with dysautonomia. The anesthesiologist gave me morphine in my IV and that took away enough of the pain so that I was comfortable again. My bp was stable during the epidural. I did take 10mg midodrine an hour before surgery to help keep my bp up (my doctor and anesthesiologist both recommended this).

I hope that everything goes well for you with labor, delivery, and post-partum. I can't wait to heare the exciting news when your little one is born!!!

Rachel

[lavender]

So, if my heartrate does go really high durring labor is that hard on Baby?

Thanks for all your input. it's helpful.

[lalalisa]

Hello,

I'm so excited for you! I gave birth to my daughter 11 months ago and you are in for such a blessing! The beginning is exhausting but every week gets better.

I got some adrenaline surges from contractions that were hard but at least not bad for my baby.

I ended up having a C-section because my daughter (we aren't sure why) wasn't doing well with my contractions (her heart rate dipped dangerously low repeatedly). I had an epidural and they gave it to me quite slowly. The original plan was to have a smaller dosage of an epidural given slowly but once I was in need of a c-section they had to give me a heavier dose of course.

The epidural was just fine. I did take some Midodrine to help keep blood pressure up...

Let us know how everything goes, we're excited for you!!

Lisa

[Rachel]

I think it is okay if your heartrate goes high during labor. My doctors were never concerned about my hr jumping up. When I was pregnant with William my midwife told me that I didn't need to be concerned unless my hr was sustained above 120 for an extended period of time, not just for a few hours. And even then I think the concern was more for me, not for the baby. From my understanding it is the very high or very low blood pressure that can be hard on the baby. You can check with your midwife to make sure.

Rachel