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Pregnancy

Talk about every stage of pregnancy, from early symptoms to preparing for birth.

General anaesthetic for CS?

25 replies

zephyrcat · 11/07/2007 11:04

My 4th CS is fast approaching and I'm absolutely petrified!! My first 2 were fine, ok 1st was emergency so a bit scary but not enough to put me off an elective for number2 - which went perfectly. Number 3 was horrid and was the main reason that I was adamant not to have another baby. However fate has stepped in and now I'm dreading having a CS. I know that it is more dangerous to have a CS under general anaesthetic but wondered if anyone has any experience of it?

OP posts:
Jas · 11/07/2007 11:08

I did but that was due to it being a crash cs.
When planning my next baby I planned a vbac (and did get one) but had agreed with my consultant that if a cs was needed at any point it would be under ga. I have a back problem which I was not prepeared to risk aggrivating by use of a spinal.

have you spoken to your consultant about it?

I know some women feel bonding is an issue if they "miss" the birth, but I have great memories of coming round to find I had a dd and didn't have a problem at all.

zephyrcat · 11/07/2007 11:11

Hi Jas. Do you know all the pros and cons of having a GA for a CS? My consultant appointment is not until I'm 36 weeks and to be honest I was a bit worried about asking in case they tell me off for wanting to do it (last time I saw the consultants at this hospital they were horrible!)

I worry about not being awake when the baby is born in case there is a problem, but at the moment my fear of the actual CS being as awful as last time is overriding that...

OP posts:
Jas · 11/07/2007 11:49

Hi,

I have been looking for some info for you but can't find anything helpful at the moment.

There are slightly more risks to you through having a GA and recovery time is generally a bit slower. The big con is missing the birth, but this isn't always a problem (wasn't for me) and I guess if it is planned you can arrange who gets to look after/see your baby befoere you do.
I think it is unlikely that your dh/p will be allowed to be in the room for the birth.

I'm fairly sure your consultant will try to talk you out of it. The only person I know who planned one was talked out of it on the day and ended up having her baby without anyone there with her, but also not getting her GA

Hopefully someone with more helpful info will be around soon. I know there are others on here who have had a GA delivery(although mostly in emergency circumstances).

How many weeks are you now?

Jas · 11/07/2007 11:49

Hi,

I have been looking for some info for you but can't find anything helpful at the moment.

There are slightly more risks to you through having a GA and recovery time is generally a bit slower. The big con is missing the birth, but this isn't always a problem (wasn't for me) and I guess if it is planned you can arrange who gets to look after/see your baby befoere you do.
I think it is unlikely that your dh/p will be allowed to be in the room for the birth.

I'm fairly sure your consultant will try to talk you out of it. The only person I know who planned one was talked out of it on the day and ended up having her baby without anyone there with her, but also not getting her GA

Hopefully someone with more helpful info will be around soon. I know there are others on here who have had a GA delivery(although mostly in emergency circumstances).

How many weeks are you now?

AsiaG · 11/07/2007 12:10

Hi,

I've also had 3 CS and await another one, although in a couple of months (I'm 13 weeks only). Two of those were under GA (emergency). As far as I know the main risk in having GA in pregnancy is that they may not be able to put a tube in your throat, and it may happen that your stomach contents is aspired into your lungs, causing complicactions. However I personally didn't have any problems with GA (not sure whether had the tube or not), and recovery time seemed simillar to that after spinal. Hope that helps.

bundle · 11/07/2007 12:11

I've had both, if you can, go for a spinal rather than a GA, it took much longer to recover after a full anaesthetic and i felt more detached from the whole experience (though it was a crash c/s and I didn't have any choice)

OldieMum · 11/07/2007 12:16

I'm afraid I can't tell you about a personal experience with having a CS under GA, but I do remember having a conversation about this option with a friend before I had my first elective CS. She had had a GA. The actual procedure was fine, but she said it was difficult to deal with a newborn when feeling muzzy after the GA and that, however scared I was about being conscious during the CS (and I was scared), I should really think about the consequences for my first couple of days with the baby. I have had several GAs in the past (for other procedures) and it does take about 48 hours to start feeling mentally alert again. I went ahead and had the epidural and found the whole thing much less scary than I had feared. It was the same with baby number 2.

I'm sorry you have had a bad experience with your last CS. I do hope you manage to find a solution than helps you feel better about it all.

saralou · 11/07/2007 12:28

i think a GA can cross the placenta so babies can be more sleepy when born.

i had a GA for my crash section and i am actually very upset that i wasn't there for his birth... i missed out on his first few hours of life (i also had terrible problems with pain and ended being given lots of pain relief which knocked me out) when i got all the photo's back that my friend had taken i sobbed 'cause i wasn't in any of them.

have you had a chance to spak to your consultant or anaesthetist about your fears... they may be able to put your mind at rest or suggest ideas??

saralou · 11/07/2007 12:30

spak is not a word... speak is howevr!!

zephyrcat · 11/07/2007 12:56

Hi everyone, thanks for your replies. I'm so torn between what to do! One half of me thinks nothing is worth going through another bad CS but then I don't want to miss my child being born. I had my first 2 CS in different hospitals and the last one is where I will be again. The consultants were horrible from the start, the anaesthatist was horrible and it took so many attempts to get the needle into my back, then I saw it was the horrible consultant that I hated actually doing the operation so all in all it was a disaster from the word go! It was only last year so I'm dreading that it'll be the same consultants again.

I think the tube issue would be ok as I get a table to take in the morning to neutralize stomach acid - I guess that is a risk for emergencies. I had heard about the longer recovery time which is a worry too - is it really that long?

OP posts:
lulumama · 11/07/2007 12:59

zephyr

rather than opting for a GA.....why not discuss your fears with your consultant, and address all the concerns with him / her?

GA does cross the placenta, so baby has to be removed very quickly, and you will feel odd for a while, and miss the first moments after birth......

you can write a c.s birth plan, for an elective c,s. which might help to make you feel better about it

odds of having same aneasthatist are quite low, surely?

saralou · 11/07/2007 13:05

do you know which consultant care you are under? it would probably be the same again f he is still their... but you can ask to switch consultant care, your midwife should be able to do this for you!

also, when they put the tube down they apply pressure to your throat to stop vomit going into the lungs... it is a risk for anyone having a GA.

after my section i was up and about at 3am... got in the shower at 8am... i can't really compare though only ever had the GA, not had a spinal! i work as a nurse and i tell my patients it's a 2-3 day hangover after a GA (only without the fun night out 1st!)

zephyrcat · 11/07/2007 13:07

Would my midwife know who my consultant was last time or are those notes held by the hospital?

OP posts:
saralou · 11/07/2007 13:35

teir are ways of finding out through the hospital if you can't remember, your midwife should be able to find out for you... your gp may ven hold that on record!!

flamingtoaster · 11/07/2007 13:49

My first CS was an emergency one under GA, and my second was elective, again under GA. I wasn't worried about missing the birth/first few hours because I knew my husband would be there to look after the babies. After the first CS when I came round there was a picture of hubby holding baby on my bedside table (although DS was in Special Care). Next morning a midwife arrived with DS and as soon as he was put in my arms it was instant love so I didn't have any bonding problems. With DD I came round quicker, she came straight back up to the ward with hubby and me - and again I didn't have any bonding problems at all. Hope you have a happy experience whatever decision you make.

GrowlingTiger · 11/07/2007 15:57

I had an elective under GA. I had had difficuty with a spinla block on a previous occasion and was very fearful of having a repeat. They did in fact insist on trying a spinal block before administering the GA but stopped when I became a gibbering screaming wreck. With the GA they did have to whip the baby out quite quickly, and dh isn't allowed in the room. I had no difficulties in recovery, came round fairly quickly etc, started feeding straight away.

lovelythings · 12/07/2007 10:10

Hi,
Just thought I would throw my hat in to the ring for this one.
After being told for 15 years I couldnt have children I found I was pregnant at the grand old age of 40!! Consultant recomended C/Section but when I questioned about hubby being there he said it would be via Spinal Block.
On the day they had 5 attempts at getting spinal in, all went well and had the joy of seeing my little miracle born etc and hubby there too - both of us sobbing as he was born to the sound of M People 'What have you done today to make you feel proud'.

6 months later I woke up and was unable to move, went to A&E and that started a 2 year troll around various specialists - neurologists etc., they found that with all the attempts of putting spinal block in they had managed to push an infection in to my spine.

Outcome - unable to enjoy my son, unable to play with him down on the floor etc., unable to pick him up as back is agony 24/7, on 12 painkillers a day, 4 anti-inflam a day, blood pressure is through the roof and have gained 7 stone in 6 years as unable to move. Have now become registered disabled and work full time - so not a great life - HOWEVER - I wouldnt have swapped the experience of 'being there' for the birth.

I have my miracle son and he is now 6, my back is getting worse but do you know what? My son is understanding and loving and has no idea that this happened whilst I was having him - nor will he ever know.

Get hold of your consultant and give him a good shake, they are there for YOU, tell them what YOU want and to hell with what they think you should do. Dont let them dictate to you how you have your baby. Your midwife should be supporting YOU and your decisions.

Good luck with your baby, no matter what your decision you will love him/her just as much as your other little ones. Just do what YOU want to do and what you feel better doing. Hope all goes well. xx

ManxMum · 12/07/2007 12:24

1st - emergency CS under GA, four hours before I came round and a lot of coughing afterwards
2nd - elective under epidural
3rd - elective with spinal

Best advice I can give about having a spinal or epidural, is to use the gas and air to make the anaesthetist job easier whilst inserting the needle. Saying that, I do suffer with back pains now, but that could be the extra load I am carrying around the waistline!

stramash · 12/07/2007 13:32

Hi zc

I think it would be helpful for you to have a chat to an obstetric anaesthetist at your local hospital before your planned CS.Most places have clinics where women with medical problems can be seen well beforehand in order that the anaesthetic can be planned. They would also see people with specific requests like yours or women with needle phobia for example.

There are small but increased risks to a GA in late pregnancy. This is largely down to the physiological and anatomical changes which take place. For example, pregnant women are always treated as having a " full stomach" when undergoing anaesthetic - this is because the baby squashes your stomach and makes you more prone to reflux ( as you obviously know!).Precautions , such as antacids and a specific way of getting you off to sleep, are undertaken to avoid this.

In late pregnancy your body consumes more oxygen ( because of the baby's requirements). This means that your blood oxygen level drops much more quickly if there is a problem under anaesthetic than it would if you weren't pregnant.

Pregnant women are more likely to difficult to intubate ( or pass a breathing tube into the wind pipe). This is due to anatomical differences ( such as oedema and big boobs!). Historically, this led to problems in the 1970s and 1980s when most CS were done under GA. Failure to intubate and oxygenate the mother led to maternal deaths . This was the main reason that most CS started to be done under spinal or epidural in the 1990s.

So far so scary. Most GAs are now done for emergencies when there is no time for a spinal or when a spinal is clearly contra-indicated ( clotting problems, back surgery etc). However, the absolute risk of a planned GA CS is still very small. Your chances of a failed intubation for example are 1 in 300 . There are now clearly defined "drills" of what to do if this happens and so your chances of coming to serious harm even if this does occur are even smaller.

I would think the main drawback to you would be, as others have mentioned, missing the birth yourself and your partner not being present. You might also feel groggy and a bit out of it for a while.

The bottom line is that no anaesthetist can force a patient to have a spinal if they don't want one. Most would give you a GA if you asked for one & definitely if you absolutely insisited( although they would explore your reasons first and explain the risk/benefit as above) Patient refusal to spinal is an absolute contra-indication to doing one. It sounds like the problem wasn't the spinal itself last time but the rather rude manner of those involved for which there is no excuse.

I'd suggest asking your midwife if she could arrange for you to see an anaesthetist well before your CS. They will have your old anaesthetic charts and should be able to see what happened. Be frank if you do see them. If the problem was a rude anaesthetist then tell them so . It's likely that they'll be aware of who their grumpy colleagues are.

HTH.

FairyBasslet · 12/07/2007 14:16

I had a GA with my DD who was footling breech but not diagnosed as such until I was 9cm dilated. It was all very dramatic and rushed but fine to be honest. I do remember the anaesthetist pressing gently on my throat to stop any vomit as someone else has mentioned, but aside from that, no other discomfort.

I was fine about not being awake for DD's birth as well to be honest although I was told later that as she was quite big (10lb 5) and in a somewhat awkard position they had a bit of a tug of war to get her out quickly so maybe it was just as well I was knocked out. I'd also had a natural delivery with DS so maybe if the GA had been my first child I'd have been upset about 'not being there'. As it happened the most important thing was to have a healthy baby after it all.

Recoverywise, it was all a bit surreal waking up and feeling so groggy (you have a really sore throat from the tube) then being handed a baby while you're lying there in recovery, thinking what just happened.

I think to be honest it was tougher on DH who had to go through the nightmare of seeing me rushed off, then frantic comings and goings before he knew everything was fine.

I'd say, talk it through with your consultant but also make sure you talk to your DP/DH as well.

jujumaman · 12/07/2007 20:35

I had one with dd1 but after the birth as there were complications sewing me up. I had a very sore throat afterwards and couldn't speak properly which was an issue as they bloody put me in a cubicle with a broken call bell and I couldn't call for help. Then had four sleepless nights in hospital with a very difficult newborn, all in all it was a horrendous start to motherhood. It took several weeks and some cranial osteopathy to get the general out of my system. I would say skip it if you possibly can. At my second elective cs the hospital policy was to meet the anaesthetist the day before and he was very reassuring and discussed what had gone wrong last time, if this isn't your hospital's policy ask to do it anyway. Good luck

notyummymummy · 12/07/2007 22:36

Hello, new to this so please excuse me if I don't know abbreviations etc! I had a GA for my emergency cs and have to say its very much a last resort for lots of reasons. Mainly the risks as mentioned before. However having gone through a traumatic time and being told my baby was at risk I was just very glad to be in the right place to have one ( had wanted nice calm water birth) and that all was well with our son. I had no bonding problems but was very weird to have missed 1st few hours and then was so drowsy that fell asleep trying to breastfeed and managed to nearly smother poor son...not good.

newgirl · 13/07/2007 13:34

have you considered hypnotherapy? ive never tried it but i wonder if it would help you relax on the day while a local was going on

might be worth investigating

also ask consultant if stuff like rescue remedy is allowed - it might be simple stuff like that that might make it slightly more relaxing

i had 2 local c sections and i went in with such positive thinking that i think it really helped me - i was thinking - this is one hour max - and then baby will be here and trying to focus on WHY i was doing this to myself

and remembering that IT IS WORTH IT!!!!

zephyrcat · 13/07/2007 16:27

Thank you all for your replies - it's all very encouraging and making me realise that GA is perhaps not the way to go.

My problem is this - don't laugh!! The area where they insert the needle is extremely ticklish - more than you could ever imagine so as soon as I sense that anything is about to touch that area I jump and move away which obviously makes it very difficult for the anaesthatist. That said, for the first two, having had advance warnings, the anaesthatists were very good and managed first time.

With number 3 they didn't let dp to 'hold me down' so to speak they just made me sit there. I had to walk into the theatre instead of just going in on the bed and stand looking around for a good 10 minutes before they even let me get in a bed - that alone made me a nervous wreck!

Because I was tensing and moving every time they touched my back she missed at least 5 times, hitting the wrong parts of my spine which was painful and a horrible feeling.

A big problem seems to be that when I tell them that my problem is purely being ticklish they don't seem to take me very seriously!

OP posts:
Genidef · 13/07/2007 21:22

I had a GA - came round in an hour, a bit groggy but managed to breast feed, physically wasn't very demanding experience. Maybe this will reassure you? I'd had them before too so it wasn't a new experience in that sense.

That said, the last few hours leading up to delivery were pretty fraught, as the anesthetist had two goes with my epidural, both failures for various reasons, and I went into theatre thinking "Well, let's hope third time's lucky" when I saw him waiting for me. It was a bells and whistles ER style crash CS - I would do ANYTHING to avoid that again, including having another GA.

Yes I feel sad I didn't see my daughter come out, for sure. All the very first pictures are with her dad - not that I resent him for that, but...still for me. one thing he made sure to do was that no one else but he held the baby until I came round. I think that's a good idea - I would have felt a lot worse if other people apart from her dad had the cuddles etc before me.

Good luck - sure it will go well.

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