Elective sections - under general?

[NemophilistRebel]

I had an EMCS where I was awake and all was fine but have heard some people say that their elective sections have been under general.

Is this the case sometimes as I imagined all electives you would be awake for?

I've had an emergency under a general and my husband was not allowed in the room. My elective was by spinal block, I wasn't given the choice and can't imagine it being done electively due to the risks of a general

My elective was almost done under general as there were issues getting the spinal in place but thankfully it went ahead without being general, I wouldn't have liked that. Not normal practice for an elective as far as I know.

Thank you both PP that is reassuring

Might have to be a general if there's likely to be a problem siting a spinal block eg if there's a back problem. The obstetrician would talk it through though in advance and it would be planned for.

Always prefer regional anaesthesia for elective section, and in fact emergency where time/situation allows.

It’s very very rare to have a GA elective and usually due to some maternal issue like blood clotting etc.

It’s never really offered as a choice, due to the risk profile in favour of regional.

As PP says, elective sections done under GA (decided beforehand) are very rare.

Most GA electives initially start out as regional anaesthesia. But become GA due to incomplete coverage of the anaesthetic, or the woman becomes too distressed by the sensation of the surgeons operating (not pain!). Inability to administer the regional can also lead to GA, but they will keep trying (with as many anaesthetists they can call in), for as long as the patient wants before going to GA.

These reasons for GA are also very, very, uncommon, and the vast majority of electives go without a hitch.

A relative has a CS under a GA last year as there was no time for a spinal and they had to get the baby out there and then.

I had my first elective under GA, the baby was going to be very unwell and may not have survived the delivery. There was no question of have a local anaesthetic as there were so many people in the theatre and my DH clearly wasn't needed. The wonderful staff still managed to make the experience as positive as possible including keeping me up to date with how the baby was as soon as I was awake ( she was baptised with my DH there and taken immediately to theatre)
My second elective was with a spinal, DH was present and it was an altogether different experience. ( we knew the baby was healthy) Have to say though that the staff were a lot kinder first time around, particularly the midwifes.

My first emcs was so traumatic for a couple of reasons, I asked for a general for my second (didn't fancy vbac due to being over 40 and managing to get an optimally positioned baby stuck due in my pelvis). My consultant said I'd need to speak to a consultant anesthetist who listened to my reasons and said that whilst everyone would prefer me awake and would work to ensure a much better experience, if I didn't believe that was possible, I could have a general.

My notes stated that I could choose up until the morning of the surgery and that if I opted for a spinal, at the first sign of distress they would knock me out if that's what I wanted.

As it happened, I went into labour early and ended up being pushed rather strongily into spinal by the consultant who ended up delivering dc2 (to the point that the anesthetist asked me if I was okay/felt bullied/wanted her to get another consultant when we were alone). Strangely enough whilst I think I would have opted for a general if encouraged to make the choice alone, I ended up with an absolutely amazing emcs and bedside manner apart, the consultant was right, by the time they put 3-4 minute old dd on my chest, I'd stopped caring about everything else.

That sounds like a very positive outcome of a scary situation @Dinosauratemydaffodils

The patient info leaflet I've been given states that 96% of women get a spinal, not GA. Can't remember if that is in my hospital, my Trust or the country though.