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Childbirth

Share experiences and get support around labour, birth and recovery.

Original poster

Anesthesia and C-section?

35 replies

CartoBarto · 01/01/2023 00:35

I've heard that during a C-section it's normal to be kept awake with an epidural for the safety of the mother and the child. Is this the case? If a mother wanted could she request to not have an epidural, and to be put under with anesthesia before the C-section was to take place? Does anyone know if this can be an acceptable birth plan?
Thank you all!

OP posts:
daschundthroughthesnow · 01/01/2023 17:18

Yes we have no partners in for GAs under any circumstances in our trust, but of course it's possible this varies elsewhere and I wouldn't know.

Chitasaurus · 01/01/2023 17:18

Forgetmenot123 · 01/01/2023 14:45

Was definitely not an option for us. It must be very uncommon to allow a partner in theatre with a general as the anesthetist replying to this thread also said partners would miss the birth?
Was this in the UK and done recently out of interest?

Show quote history

It was 2019 in the UK.

AdelaideRo · 01/01/2023 17:33

Another Anaesthetist. I no longer do obs but have done hundreds of sections.

only ever one GA maternal request one though.

for most patients (and we routinely go and speak to them the next day) one under regional (Spinal or Epidural) is a really positive thing. And it is much safer for mother and baby.

I suggest OP asks for a referral to the obstetric anaesthetic clinic to discuss options personally. I think it is likely to help her make the right choice for her.

I would never allow a relative in theatre/ an area where a patient is having an operation under GA. I’m really surprised to hear that happened.
If things go wrong it is a very dynamic situation and the need to explain/update viewers can be very distracting. Anaesthetic emergencies while rare need prompt urgent responses and explaining to onlookers takes a low priority. Even theatre nursing staff are sometimes traumatised by watching us deal with them.

MummyJ36 · 01/01/2023 19:45

Is there any reason you would like a GA OP?

I had a section recently with spinal anaesthesia and didn’t feel a single thing once the curtain went up. I chatted with the anaesthetist and my husband and DC2 was out in 5 minutes. I heard them cry and they were passed over to me for cuddles. It was beautiful really and I’m so glad I got to experience the birth “awake”.

The numbness wore off quicker than I was expecting post op so I didn’t have the paralysed feeling in my legs for more than an hour post op (if that). It was so nice chatting to the anaesthetist and the midwives during and afterwards. Also my DH got to be present for the birth too.

Do ask to speak to someone if you have concerns. Elective sections with spinal are very well managed.

Sprogonthetyne · 01/01/2023 20:03

DS was an emergency and on the way to theater they told me if his heart rate was stable for long enough to get the spinel block in, that would be the preferred option but if they needed him out quicker, then it would be general.

I think there are quite a few risk factors related to general, so it would only be done if the benifit outweigh the risk.

Somuchgoo · 01/01/2023 20:26

MargotChateau · 01/01/2023 00:44

Hi @CartoBarto

C-section mamma, a few days post section and still in hospital recovering so do ask me anything.

@CartoBarto unfortunately generals anaesthetic isn’t available for maternal preference elective c-section.

The reason for this is that the drugs used for a general, cross over to the placenta and have risk factors for the baby. I asked the same thing myself and also aske
d if I could take an anti-anxiety drug, but that was a no too, for the same reason.
I suffer from terrible anxiety but although the procedure is scary, I was able to get though it and deliver my little baby safely.

I have had two maternal request sections due to severe tokophobia (phobia of childbirth).

For both I was given anti anxiety medication. They had someone from paediatrics in theatre just in case it made baby too sleepy (it didn't), but they were quite relaxed about me having it.

I was very concerned if I could cope with the spinal. They didn't outright refuse GA (I got the impression they'd have agreed us I really pushed) - I actually wanted to try the spinal, but we agreed that if I became upset and started to panic, they'd put me straight out. With a backup plan in place I felt ok to try the spinal. It was the idea of having a paralysed panic attack that worried me.

As it was, the adrenalin of it all, and maybe the drugs meant that once baby was in my arms both times, I haf the biggest grin on my face ever.

I'm so glad I got to be awake when they were born, and cuddle them within minutes of
birth. I'd have missed so much if I'd had a general. I coped so much better than I'd thought.

Hollyppp · 03/08/2023 09:47

RoundAndRoundTheGarden22 · 01/01/2023 01:20

Hi CartoBravo, I’m a consultant anaesthetist who works a lot in maternity. There are 3 options for an anaesthetic for a section.

  1. Spinal anaesthetic. This is by far the most common and the one that’s used almost exclusively in elective caesareans and all but the most urgent emergencies. A very small amount of local anaesthetic is injected into the spinal fluid via a very thin needle. This numbs you from around your boobs down. You can still feel some pushing and pulling but nothing painful. It’s a technique that’s been in use for a very long time and it’s extremely safe. The main side effect is a drop in blood pressure and some nausea but we give drugs to counteract this.
  2. Epidural anaesthesia. This is usually for people who’ve received the epidural for labour pain who need an emergency section. We put a more concentrated drug in for the section to allow for a denser block. Epidurals are different to spinals. They go into the space outside the spinal fluid and are generally used for pain relief not anaesthesia but with the more concentrated drugs they work for performing surgery.
  3. General anaesthetic. This is used in generally 3 circumstances. An emergency which can’t wait for a spinal to work (takes about 10 mins to work), a patient at bleeding risk usually due to a pregnancy related conduction once the platelets drop below a certain level or are rapidly dropping (eg pre-eclampsia)-this is because if their platelets are too low it can cause bleeding around the spinal cord. This complication is never seen in women without bleeding issues. Or 3rd reason is someone who has had a massive bleed before delivery and is too unstable for a spinal anaesthetic. As mentioned above general anaesthetics are not recommended as the baby can be drowsy when born and the mother is at risk of inhaling contents from her stomach or being difficult to ventilate. The chances of these are low but due to the big bump and some other changes much more common than the general population. The other advantages of avoiding a general anaesthetic (some mentioned already) are you don’t miss your baby’s delivery, your partner doesn’t miss your baby’s delivery (they’re not allowed in if the mother is asleep), a spinal or epidural are better for post op pain relief due to the drugs we give in it, less bleeding for the mother (the general anaesthetic causes the womb to be less contracted), and less drowsy after. I personally have never given a general anaesthetic for maternal preference but I’ve heard of it done. As I said general anaesthetic are extremely safe but their are better alternatives.
Hope this answers your questions

This is such a helpful post! Thank you for explaining so clearly, really appreciate it.

(from a Mamas whos just has a CS under GA and wanted some answers)

Hollyppp · 03/08/2023 09:48

** emergency c under general

RoundAndRoundTheGarden22 · 03/08/2023 09:50

Hollyppp · 03/08/2023 09:47

This is such a helpful post! Thank you for explaining so clearly, really appreciate it.

(from a Mamas whos just has a CS under GA and wanted some answers)

Show quote history

Ah glad it helped. Hope you’re recovering well.

elliejjtiny · 03/08/2023 09:59

I asked to have a spinal for the actual birth and then a GA when baby was out so no risk to him but I was told I couldn't. Can't remember why though.

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