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I am currently 21 weeks pregnant for the first time after procrastinating for a very very very long time!

My obstetrician has indicated my neurologist will likely have a say on what can and cannot be done as part of birth. I am seeing my neurologist in June and want to discuss the use of epidurals, spinal blocks or full general anesethic for c-sections. I feel my neurologist can have somewhat varying opinion's on certain aspects depending on his mood or the questions we ask!! Consequently, I would like to educate myself on the potential side-effects, if any. From what I understand, no form of anethesia provides undue risk to people with MS or increased disability, however there are so many differing opinions with very little clear medical advice and wondering if anyone can guide me in the right direction to legitimate links?

I would love to have a natural birth and confident it could be achieved, the thought of being numb voluntarily from the waist down can be stressful to think about but I am realistic that births do no always go to plan and if there is any requirement for c-section I want to ensure my husband and/or I are in a position to make a clear decision.

Lastly, are there options to consider post-partum to potentially assist in reducing risk of relapse (e.g. dose of steroids etc) that I should discuss with my neurologist? He can be open in some aspects but in others very much straight down the line medically based and will not do anything out of the norm. I would ideally like to breastfeed as I have read this in combination with it being a few years since my last relapse puts me at reasonable odds to hopefully minimise a post-partum relapse.

Any advice or links would be appreciated.

Thank you
Hi Melanie!

I went natural with my kids. I found a birth center (http://www.thebirthcenter.org/visit.html) that was right across the street from a hospital. It made me happy because they knew what to do to put me in the best circumstances to deliver naturally. It made my husband happy because he knew if anything happened we would go right across the street to the hospital. I loved it, but it's not for everyone. Also if I had gone to the hospital, the midwife would have gone too so that a natural delivery would still happen if at all possible.

12 years ago, when I wasn't on OMS, I had the post-delivery occurrence of symptoms. 4 years ago, when I was a vegan (but not on OMS), my post-delivery symptoms were much much less. Your best course of action is to stick with OMS. Even if you have post-delivery symptoms, they won't be near as bad as they would be without OMS. Either way, make sure to have your care providers around (for me it's my mom and dad and hubby doing dishes, etc....).

All the best!

Janet
From my prior reading I had identified no to spinal block, sorry no links for papers or anything just what I had recalled, epidural was fine.
I had also identified that breast feeding was a yes and that formula was going to be a no, that was enforced after reading The China Study.
The use of a lactation specialist from reading posts helps mothers establish breast feeding if problems are encountered, the hospital should have one, depending on where you are country wise. Also a plus from the point of view of minimising post birth relapse I think as hormones crash less I guess.
Exciting time for you and a good idea to get all gemmed up and prepared :)
See the Pregnancy and MS page for Professor Jelineks advice
http://www.overcomingmultiplesclerosis. ... cy-and-MS/
Hi Melanie,

Congratulations on your pregnancy, what an exciting time for you.

When I was expecting my daughter in 2009 my neurologists advice relating to the birth was that there was no reason for me not to have a natural birth, and that epidural, spinal and c-section should have no impact on the course of my MS.

I ended up being induced at 38 weeks due to development of cholestasis, then failed to progress with the labour so had a c-section with spinal block. As it turns out the cord was wrapped around my daughters arm stopping her from descending. I recovered well from the birth, and didnt find the c-section recovery bad at all.

Prior to my pregnancy I was taking copaxone. At the time his advice was not to breastfeed while on copaxone, he supported me breastfeeding for 6 weeks but recommended to then switch to bottle feeding and recommence copaxone to reduce relapse rate. As it turned out I had great difficulty breastfeeding due to multiple issues including baby's suck and attachment issues, no milk supply, and more. I decided to bottle feed within 2 weeks on advice of lactation consultant, and resumed copaxone earlier. I initially had incredible guilt about not being able to breastfeed but my daughter, but she thrived and is now a happy, healthy, active 3 and a half year old.

I was relapse free for 15 months after the birth.

I'm sure recommendations have changed since then and everyone's situation is unique. My advice would be to get advice from your Drs, have an idea about what you would like to do, then keep open to options as they arise.

Hope this helps, am happy to answer any questions you might have. Best of luck to you,

Annette :)
A recent email query to the website was about breastfeeding and Copaxone, and this was Professor Jelineks reply

The drug's pharmacology means that it does not get into breast milk. In fact, it is recognised by the immune cells at the site of injection, then rapidly broken down, so it doesn't even get into the bloodstream in appreciable amounts. Breastfeeding also confers some protection against relapses so it is worth continuing with it as long as possible.
Thank you for the great advice, it is very helpful.

Admittedly, I have not been as good as I should be diet wise, I found it difficult in the beginning to stomach the normal foods I would eat. Once I had a taste of eating some non OMS foods that I hadn't had for a long time, I have found it easy and pregnancy a "good excuse" to continue. Just need to refocus now I am feeling better and my husband (who also essentially follows diet) will be very pleased as he has certainly gained a few unnecessary kg's of late! :D
Hello Melanie.
I would be really surprised if someone told you not to breastfeed because of MS, though there
might be other reasons. These are the kind of life experiences that we are keeping ourselves well for.

But if you find that you cannot breastfeed for any reason, don't be hard on yourself.
You can be close and present with your child in so many ways.
Most important of all, REST and ENJOY.

Best wishes for a healthy pregnancy,
Sarah
Hi Melanie,

I gave birth at the end of January and everything has been going very well so far, the baby is wonderful and I am still relapse-free :-) I don't take any drug but I follow the OMS programme very carefully, Here are a few points from my experience:

- I spent my pregnancy in the UK and gave birth in Italy- the British anesthetist would have been willing to give me any kind of anesthesia/pain relief (however she said to be careful with Entonox), while in Italy I was refused the epidural during labour as the anesthetist did not want to take the risk of inserting the needle close to a lesion. I washed I had bought a TENS machine!!!

- don't underestimate stress, particularly in the first weeks after giving birth, when you feel insicure and you receive lots of contradictory advices. In my case meditation has been helping a lot (... when my husband comes back home he is able to tell whether I have meditated during the day because I am much more relaxed!!!) Also, try to stay away from baby scales as much as you can, expecially if you are breastfeeding. Checking how much weight the baby has taken can easily become an obsession.

- stick to the OMS program both before and after giving birth, it will make you feel great!!! funny enough a lot of people told me that I have been lucky not to put on a lot of weight during the pregnancy. Diet and excercise pay off ;)

-don't be afraid to ask for help if you are too tired... and find a good take-away restaurant with food that you can eat for the days when you don' feel like cooking :D

-boosting your vitamin D levels is a great excuse for having a holiday ;-)

Good luck!

giovanna
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