Supine Hypotensive Syndrome: An Epidural Blackout

July 14, 2019

Imagine the horror as you welcome an epidural, relief, into your body after a long stretch of contractions (and having to hold a specific position for several minutes while the anesthesiologist placed a needle the size of your face into your spine), only to instantly start blacking out while you hear rapid, loud beeping in the background. The nurses faces start to get fuzzy and you notice your breathing getting slow and short, but you cannot seem to force your body to take a deep breath to help your oxygen flow...This horror is not an allergic reaction.This is not a labor complication.Your body is not broken.This is Supine Hypotensive Syndrome.

What is Supine Hypotensive Syndrome?

SHS is defined as a sudden drop of blood pressure in a pregnant woman when she lies on her back, due to Caval Compression (compression of the abdominal aorta - the main artery in the abdominal cavity - and the inferior vena cava.)The only cure to this is to GET OFF YOUR BACK and GET INTO A DIFFERENT POSITION!

Have you experienced dizziness, nausea, shortness of breath, even fainting/unconsciousness when you lay on your back while pregnant? Has a doctor ever talked to you about why?

Position Matters!

Have you ever been told your body isn't capable of birth?

What if it wasn't your body, but instead your epidural restricting you to only laying on your back?Or, what if it was the need to be monitored in the bed, on your back, every 20 minutes?Did you push for a certain amount of time, only to become absolutely exhausted because it was so hard to breathe?

Did you/your baby's heart rate drop so rapidly after the epidural that your birth resulted in a cesarean?ALL of these 'complications', and many others, could have simply been fixed by allowing you to move and change positions.It's infuriating to think that, isn't it? I get it, because I have been there.

Final Thoughts

Doctors don't talk about this, they likely don't even know about it actually because their textbooks won't tell them this, but I will. Even if they did know, would they say anything? Would they make the effort to roll you onto your side or encourage you to move around, if they knew it could allow you to have a birth that didn't leave you with trauma? Or is it prime and optimal to have you lying on your back in stirrups for their convenience? They are well-trained surgeons so whats another cesarean to them?

And yes, YOU CAN move into a different position with an epidural. Ask for the lowest dose possible, and ask exactly what medication they are using for your epidural. Are you comfortable with Fentanyl, for example? A WALKING epidural can allow for much more movement, and quicker leg function and healing post-birth, too.Have your support team help you get onto your hands and knees. You may put a ball or a stack of pillows in front of a bed placed in seated position, face the back portion of the bed, hold the ball or stack of pillows and rest comfortably on that, while still allowing gravity to do its job on your pelvis. Using a peanut ball in between your legs as you lay on your side can be optimal as well, as it keeps your pelvis open and ready for baby.Take control of your birth with education, one step at a time!