Cesarean under general anaesthetic

[Hopeful98]

Hi there

I have had a spinal fusion to correct scoliosis which goes down as far as L2/L3. I met with consultant gynae and was referred to a consultant anaesthetist to discuss birth plan but the consultant gynae thinks that it is unlikely that the anaesthetist would be able to administer an epidural or spinal block because of the spinal fusion. He said that if, for some reason, I need a cesarean, it would more than likely need to be under general anaesthetic.

Wondering if anyone else has experience of having a cesarean under general anaesthetic?

Thanks

I've had two and I strongly recommend it - I don't think I'd have coped psychologically very well with being awake.

Do you have any specific questions about it?

I did, it wasn't ideal but in the end it was the only way to deliver my son safely.

I had one but it was an emergency and I wasn’t expecting to be under GA.
For me physically I recovered really quickly, mentally I found it harder but I think it was more due to the nature of how it happened rather than the Ga itself.
When I was planning for subsequent c sections I did make some requests incase it happened again. I requested DH to have skin to skin, I also requested that nobody was to hold baby(apart from DH and any medical staff) as with my first my in-laws and my mum all held baby before I was able.

I’d love to hear about this to as I will be having a caesarean and will most likely need to be general due to neurological conditions and previous neurosurgery.

@Mumoftwo1312 and others who can answer

I’d like to know - How long after the birth were you awake and able to meet your baby? Was your husband/partner able to do skin to skin whilst they were waiting for you to wake up? Did you feel your requests/preferences were respected whilst you were out? How long were you in hospital afterwards?

For both births I was in hospital two nights.

My first birth was emcs and I lost a lot of blood (over 3pt) and had sepsis. In talks afterwards the doctors said this was probably because I'd been in labour so long. The second time I lost barely any blood, a few shot glasses worth. I probably could have come home after just one night but I opted to stay longer.

With both, it was an hour or two before I was properly "with it" to breastfeed the baby. My dh did skin to skin and gave formula in that time, for dc1 - for dc2 he got rushed to nicu unfortunately but was out the next day.

One thing I'm evangelical about: please ignore the hype about the so-called Golden Hour, and ignore anyone who says it affects breastfeeding. You have years to bond with your baby, the first few hours make no difference (in my strong opinion). I breastfed my dc1 for 2.5 years, the fact we started by combi feeding was no problem. I breastfed dd longer and more easily than most mums I know who had the most glorious hypnobirthing experiences - it's just uncorrelated.

My ds is now a month old and although he drank only formula for his first day (I was too ill to visit him in nicu till later in the evening), he is now almost EBF, just one formula bottle a day, which he doesn't really need, it just gives me a break. He's put on weight like a champ at every weighing.

One thing I'd warn you is that you might wake up feeling very disoriented, even a bit panicked. It's normal from what I read.

With my first, I was already coming down with sepsis so I felt quite unwell indeed when I woke up - nb this is much rarer with elective c section.

With my second it went much better, I've recovered so quickly, but I was still quite panicked when I woke up. I clutched my anaesthetist's hand (the nearest person when I woke up) and kept asking her not to leave me and burbled about how I'd had a nightmare when I was under (I don't remember this very well!) She gently swapped her hand for my dh's and we laughed about it when she visited me on the ward later.

@Mumoftwo1312

Thank you so much for answering my questions. Really helpful to hear that you were still able to bf. I’m also diabetic (T1) and baby is therefore supposed to be fed immediately after birth to prevent their blood sugar crashing so good to know my DH could potentially do that without interfering.

Your dh should be able to do the first feed if all is OK- pack some of those ready sterilised formula bottles - but just in case if your baby has to go to nicu the nurses will give him the first feed. My baby needed an intravenous sugar drip as his first "feed" - i don't have diabetes and I'm not sure but i think this is also a possibility if you have diabetes. But honestly you can bond afterwards, it doesn't affect the breastfeeding journey in my experience.

I had an emergency C section under general owing to back problems - they didn't want to risk siting a needle for the spinal block at speed.
It was fine. But I was very sleepy and spacey for about the first 24 hours.

In a way it was also nice for dh, in that although he wasn't able to be present for the birth, he got the first hold and cuddles with baby.

@FindingMeno
Yes, I think it would be nice for DH too although the idea also stresses me out a bit. Partly because I’m a control freak but mainly because he gets pretty stressed in hospitals (autism and ADHD) and hasn’t much experience with babies although great with toddlers and up so I think he is likely to feel pretty overwhelmed.

I had an unplanned general anaesthetic in my planned section and it was absolutely fine . They put the baby next to while I was still asleep after he was born for a little while and then took him out to my husband for some skin to skin while I was being stitched up .
I was asleep for about 1 and half hours and held my baby 2 hours after he was born

The only issue I found was that I woke up in quite a lot of pain from not having the spinal which would normally give you relief for a few hours afterwards .
I would recommend collecting some colostrum before your section if you are planning on breast feeding , it was brilliant as I wasn't up to attempting to feed the baby myself for a few hours after so my husband was able to feed him instead .

One thing I will say is wait until you have seen the anaesthetist before knowing for sure you can’t have a spinal/epidural. As it’s not their area of expertise obstetricians are not always right when they say it may not be possible.

I had a section under ga planned due to a complex medical history and it was grand. Woke up after an hour, I had lost some blood so felt a bit rough but I had another sleep after seeing my son and I felt much better and was able to walk to the bathroom after a few hours.

Thank you so much @Mumoftwo1312 , that's very reassuring. The gynae mentioned that it comes with higher risks so it's nice to hear some positive experiences.

Thank you for the tips, love the idea of DH doing skin to skin!

A friend had a GA section and one of the nurses took photos for her- she found this really helpful as she was worried about the weirdness of going under pregnant and waking up with a baby- being able to see the photos helped her process that transition.

The consultant I spoke to said that the risks are pretty equal with either method, just different risks if that makes sense. For example spinal anaesthetic comes with (very very rare) risk of spinal injury. Whereas GA comes with a (tiny, basically vanishing) risk of choking. I don't think it's ever happened during a c section in this country because they're so careful about nil by mouth.

He (the consultant) said most mums just "prefer" spinal because of bonding, wanting to experience the birth etc. Whereas for me, a c section was medically advisable for my second but it was me that strongly preferred GA and pushed for that. No one, none of the obstetricians or anaesthetists, tried to dissuade me beyond "are you sure that's what you want". (I was sure!)

As I said above, I'm evangelical about the first few hours being relatively unimportant for bonding and the breastfeeding journey. It's only a big deal if you make it one, in my view.

I personally didn't want any photos or videos of the birth because I have quite bad medical phobia now (after my first birth). Everyone is different though, the midwives did offer to take some photos, so you could have that if you wanted. They offered to take a photo of my baby being lifted out, and of the first observations (apgar check) but I declined.

I’ve been told the same as OP due to a spinal injury to my L4 so this is all reassuring to hear.

How long did it take for anyone who’s been through this to wake up and meet your baby?

I’d wait until you’ve seen the anaesthetist before getting too excited. If the metalwork stops at L2/3 then a spinal may well be possible, but depends a bit on what the metalwork is, any other features about you that might make it difficult, etc. An epidural is less likely to work and comes with a higher risk of infection if there’s metalwork so they may advise against that though (but again depending on risks benefit specific to you it may be worth a try). A GA is generally avoided as far as possible in obstetrics because for most women and their babies it is the higher risk option, but for some women (eg who can’t have spinals) it is the safer of the two options. GA is always the back-up plan if a spinal doesn’t work/isn’t possible. The anaesthetist will be able to explain where that balance of risk and benefit lies for you in the various different contexts in which you might need anaesthesia. If they think an epidural isn’t a good idea they should be able to talk to you about pain relief in labour if you’re planning a vaginal delivery.

The main differences afterwards with GA vs spinal are that it’s a bit weird waking up not pregnant; although you’ll wake up within minutes of a GA being turned off not everyone remembers that time; pain can be a little more difficult (but we know that and try to anticipate/manage it). None of the GA drugs affect whether you can breast feed. HTH.

I've had one section under GA and one with a spinal. The GA was very disorienting, particularly because it was my first baby. I went to sleep pregnant, woke up feeling awful and woozy and they handed me a baby and told me to feed him. I struggled to stay awake but every time I fell asleep my oxygen monitors started beeping and woke me up again...
If you can avoid it, I would but it's not the worst thing ever, I still decided to have another baby!

Thanks for sharing your experience. Great tip for the colostrum, thank you!

I’ve had 4 sections, 2 were under GA. I much preferred them to being awake! They don’t keep you under for long and baby can be taken straight to your partner as long as everything is ok. Then you wake up without all the stress of knowing they are sewing you up etc.

I wasn't under ga for my section but echoing what @Mumoftwo1312 has said, don't worry about the initial few hours I had preemie twins who needed help at birth and then I lost a ton of blood and wasn't with it at all. They were combi fed and then breastfed until they were 9 months and we have a lovely bond. Not everyone can have low intervention, Instagram births but that doesn't count other things out.

I had a c section under general anaesthetic, and it was very calm and recovery was easy. My baby was fine and breastfeeding was fine.