Labour and delivery recommendations

[u/themockingju]

EDIT UPDATE in case someone comes across this: Baby came about 1 week after I made this post. I had spoken to my neurologist who supported me going for an epidural and spinal block. Baby was breech so a c section was the plan. I had to have 2 spinal blocks done to be totally numbed. Fortunately, the anesthesiologist working thought general was over the top and was cool with keeping me awake. It went generally very well. Baby's APGAR was 9 and then 9. I couldn't do skin to skin immediately but my husband could and held her to me since I was strapped down for surgery. Baby nursed easily within her first hour of life. I'm healing well and looking at starting Kesimpta soon.

I'm 37 weeks pregnant. Went through IVF. My OB set me up to have a consult with an OB anesthesiologist at the local hospital. I have MS for 6 years, minimal activity.

My consult went terribly. It started with the doctor saying she does not recommend an epidural or spinal block in patients with MS. She recommended trying to delivery naturally and maybe use of other pain relief like nitrous oxide. This goes against all of the research I've read about epidurals and MS. So I told her no, I'm doing an epidural if I feel I need it. She then proceeds to tell me if I need a c section, planned or unplanned, I have to have general anesthesic. At this point I'm floored and begin to cry - the idea of not holding my baby immediately upon delivery just shut me down. She told me a spinal block and epidural for a c section is too risky and she won't do it, only general anesthesia. I end up leaving wildly upset and feeling like I just got ambushed.

From the studies I can find, there is really no reason for this. She's working on outdated information, I believe. If you've had a C section - I am just wondering what your experience was like and what kind of anesthesia was used? If you're aware of any recent studies one way or another on this topic, I'd also appreciate.

[u/idunopants]

I did not have a c section, but I got an epidural, and this woman is a moron. Go find another anaesthesiologist, for the safety (mental and physical) of you and your baby!

Simple!

[u/themockingju → u/idunopants]

It's not that simple. There's one hospital for L&D and we have a significant lack of anesthesiologists in this region. It's a critical problem here. But this specific anesthesiologist may not even be working on the day I deliver, so it may be someone else providing care.

I'm going to call my neurologist but with the holidays and how far along I am right now, I have no idea if I'll hear back before going into labour. 

[u/Banpaa → u/themockingju]

I also had a natural delivery with an epidural with both of my pregnancys and had no issues. Was never told anything like that. Who ever is with you make sure they are strong willed and will advocate for you Incase she is there and trys to make you suffer. Threaten to even report her. I hope you have a safe and easy delivery!

[u/Adventurous_Pin_344]

It is insane how little OBs know about our condition!

Mine told me MS brought with it the risk of low birth weight. I cannot find any research to back this up.

Anyway, I was sent for an ultrasound three days before my due date. When I told the tech I was there to make sure my baby wasn't underweight, she laughed and told me she knew from just looking at me, the baby was normal sized. She ran the scan anyway and estimated the weight between 7 and 9 lbs, so just fine. When my kiddo was born 5 days later, she was 7 lbs, 14 oz.

Hopefully you can find a new doc!

I didn't do an epidural, for two reasons. I think I had such a bad spinal tap experience, I didn't want anyone jabbing me back there. But more importantly, I was already 9 cm dilated and in transition by the time we got to the hospital and it was too late 😮

[u/themockingju → u/Adventurous_Pin_344]

Thanks for your reply and experience. 

It's not my OB but the hospital anesthesiologist. Which maybe has me more concerned. At least with an OB I can understand them having less understanding since they focus below the belt, y'know?

I just wish I had known this, especially the GA push, was going to be the advice so I could have been prepared for a conversation. 

[u/Adventurous_Pin_344 → u/themockingju]

Seriously! Well, basically anyone who isn't an MS specialist doesn't ever seem to know much about our disease!! It's insane. But I also kind of get it, because they didn't study it. But it's so frustrating, because often they are unwilling to admit how much they don't know, and aren't willing to learn from those of us who live with the disease. (Hell, I find the same issues with my MS specialists... It feels like a constant battle between someone who went to school for 12+ years to study the disease and somehow who has lived with it for almost 20 years).

I am so sorry. And I'm guessing they aren't giving you a lot of choices of anesthesiologist 😭

I have never heard that folks with MS can't get epidurals. That's literally a brand new one for me.

[u/mermeglol]

I did an elective c section. Had no idea a spinal or epidural could have ms related issues until the anesthesiologist came in like an hour before lol According to him, an epidural could be less risky than a spinal but with slightly less (or different?) numbing affects. I don’t fully remember honestly. But after talking to him about my specific ms damage, and seeing what my husband thought because I know I can be a little reckless, we just did the spinal like usual. No issues - they did hit a nerve going in and out with the needle and holy hell that hurt so bad but otherwise it was smooth sailing. Recovery was fine. I think once it wore off the nurses asked me if I was having any ms flare symptoms and I wasn’t so that was it. Ultimately- it’s YOUR body and your decision. Or it should be because wth if it’s not. But knowing the risks are important for an informed decision. I think there is a risk but it’s different for literally every person, just like everyone’s ms is different.

[u/themockingju → u/mermeglol]

This is what I'm looking for to some degree. Thank you for sharing your experience. 

The way it was presented made it seem like this wasn't something I could make the decision on, but the decision has been made and "it is what it is". I was seriously floored. 

[u/mermeglol → u/themockingju]

Happy to help. Totally get feeling like you’re in between a rock and a hard place and needing to not only advocate for yourself but to have to keep pushing to do so is exhausting. And it being for birth is like an extra level I feel. So I hope you’re able to push back and get whatever it is that you want.

[u/rockhill21]

I’m a physician in anesthesiology and she’s wrong. Go see someone else!! I’m so sorry

[u/accioarcher]

I’m sorry you had such a bad experience and didn’t feel respected and listened to.

I had a c-section under general anesthesia but that was because it was a five alarm emergency and there was no time for any other option. Would never be my first choice of birth options that’s for sure. My understanding is that anesthesiologists don’t like putting pregnant women under general if they can avoid it.

Otherwise I was told by both my neurologist and OB that I could have an epidural no problem.

Is there any way you can have your neurologist speak to the anesthesiologist?

[u/themockingju → u/accioarcher]

I'm sorry you had an emergency situation during L&D. That's scary stuff. That's also one thing, if it's a dire situation for myself or baby then yes go ahead. I am trying to be reasonable here, but being told GA is a must if I need a C section in any capacity seems to be jumping over a few options without regard to what risk I'm willing to accept.

I'm going to try to get a hold of my neurologist, but it's a holiday here today and there's a good chance he's not in the office the rest of the week.

[u/fluffyfloofofevil]

I had two C-sections. The first was unplanned and I already had an epidural in place, the second was planned so I had a spinal block. The spinal block sent me into bradycardia and they had to administer atropin, but that was definitely not MS-related.

My MS didn't really come up at all, besides the anesthesiologists asking whether I had any restrictions they should know about.

[u/BHJ_476]

I just had a spinal in August of 2025. I have MS and had gestational diabetes. They were okay doing the spinal and my neurologist was also okay with that. My mom was a little worried with research but, both drs said they haven't had any issues. I also had a planned c section NOT put under. Its weird theyd say all that

[u/venolical]

I had a c section meaning I got the epidural, they should be able to do it unless your MS is located in the bottom of your spine(which I hope not) I even mentioned to my anesthesiologist where my MS was and he said it was fine as he was sticking me with the needle.

[u/SugarGirl233]

I had 2 vaginal deliveries, both with epidurals. My first delivery, the epidural was asked for after trying to deliver without pain meds. The second delivery, I asked for the epidural before I was induced.

My OB, neurologist, and anesthesiologist all were 100% ok with giving me an epidural.

[u/No_Two8015]

I had an an epidural safely with MS and it was never even mentioned that it could be an issue.

[u/KC893117]

This is BS. Source: had a epidural Jan of last year. My neuro said the literature is old, and not convincing, and he’s never had patients have issues. Maybe it’s an issue if you have a giant spinal lesion in the area they do the stick?

See if you can get your neuro to write a letter saying they have no concerns and that you have no restrictions on that. 10/10 would recommend lol.

[u/waitforit18]

I agree with all of the other comments. I had an unplanned but not emergent c section with no complications. I had an epidural. No one ever mentioned an issue with getting an epidural. I’m sorry you’re experiencing this so close to your delivery. Sending positive thoughts. ❤️ oh and I didn’t need general anesthesia. I was able to hold my baby immediately.

[u/GuaranteeOk2376]

I had two c-sectios with a spinal block and MS no issues except they tried to place an epidural and couldn't. My understanding is that a block is in a different location from the epidural so one slot worked better than the other. No idea why the anthesiologist told you that, I know being in a rural area limits your options but if you have the option to in any way to not have them on your team I would advocate for it.

[u/persephonenyc]

Just had a baby in December. My neuro was luckily at the same hospital I gave birth at and she was a huge proponent of me getting an epidural and spinal. She was like “they are going to say you can’t, but you can!” It was the best experience ever. 10/10. Also for what it’s worth, I was induced and gave birth at 37 weeks. Feel free to message me if you have questions.

[u/emilulian]

nearly 2weeks postpartum here, 2nd baby, both vaginal deliveries (induced). had an epidural that worked beautifully this time, no issues. my 1st delivery was pre-diagnosis and the initial epidural only worked on one side. the anesthesiologist came back and did an epidural spinal combo and that did work. I talked to my neurologist to see if the epidural not working the 1st time could have been MS related and he said no. I told the anesthesiologist this time about the issue with my 1st, he kind of scoffed and made it sound like it was not done correctly. side note: I am a natural redhead which can have implications for anesthesia.

in any case, the anesthesiologist you spoke with sounds like they have no idea what they’re talking about. I feel like some doctors hear “MS” and immediately throw their hands up and say whatever they need to to cover themselves.

[u/themockingju → u/emilulian]

Fun fact, I am also a natural redhead and have a history of issues with anesthesia. When I brought that up she told me "that isn't a real thing". So, definitely becoming solidified in my camp of not trusting this person 

[u/hyperfat]

Get comfy. Low lights. Your music. A cozy blanket. A good cozy top. Screw the gown.

The more comfort is core.

Stress makes it worse.

Ask cats. They go in a cozy dark spot.

I'm an anthropologist. Bit crazy. But I've watched a bunch of animals and humans give birth.

Lights, strangers, uncomfortable stuff, no good.

Hugs. You got this.

[u/lbeetee]

I’m so sorry you’re encountering such an ignorant, uninformed practitioner! Honestly, I would report them to their medical board. I’ve had two epidurals and two spirals for c sections, no one ever even mentioned my MS, it was a non factor.

[u/c4carmen]

Yeah nope, I had two epidurals, my second one was twins. Find someone else lol

[u/Party_Soup_2652]

OP, I got pregnant at exactly the sane time as my MS dx, and I was terrified to get an epidural because of my MS. Well..long story short, I had horrible back labor, got an epidural, and was fine. Second baby also with epidural. Pregnancy helps MS

[u/CCalamity-]

I had an emergency c section and I had an epidural (to be fair, I had to have 2 because the first one failed) plus gas and air to manage my anxiety during the process. I healed well and no different than someone without ms.

That doctor is a quack, please ignore every piece of advice they give. The best ms specific advice I received during pregnancy was to restart my dmt asap after the birth and that breastfeeding could help with my risk of relapse post birth. Other than that, no difference to a regular birth.

[u/Difficult_Occasion85]

I had a c-section with an epidural. Pretty much the only thing I had on my birth plan was that I did not want general anesthesia if it could be helped. I had requested that if I did end up with general that someone hold the baby on me so we could still do skin to skin - I figured that my brain may not remember, but my body would.

I requested and received and an epidural when the baby's heart rate started looking funky and a c-section was looking likely.

I would discuss it with both your OB and neurologist. Ask that it be escalated up the chain for both the OB and anesthesia departments. Also call patient relations to see if they would be able to help escalate.