In an emergency or when bleeding occurs, general anesthesia may be necessary. If you already have an epidural catheter in place during labor and then require a C-section, your anesthesiologist usually can inject a much stronger drug through the same catheter to increase your pain relief.
Women who have a Cesarean section usually have a choice of two or three options: A general anesthetic, where they are completely unconscious, and two types of regional anesthetic known as “epidural” and “spinal” anesthesia.
Under most circumstances, undergoing a c-section via Spinal Anesthesia or Epidural Anesthesia (rather than General Anesthesia) is preferred since it involves less risk and has the advantage of allowing you to be awake during your baby's birth.
Spinal anesthesia: A woman whose C-section is planned will typically receive spinal anesthesia, also known as a “spinal” or “subarachnoid” block. The anesthesiologist injects medication into the cerebrospinal fluid that bathes the nerves and spinal cord.
Most C-sections are done under regional anesthesia, which numbs only the lower part of your body. This allows you to be awake during the procedure. Common choices include a spinal block and an epidural block. Some C-sections might require general anesthesia.
Even though labor and vaginal birth can be hard work, they are generally easier on a woman's body than a cesarean. Recovery after vaginal birth is usually shorter and less painful than after a C-section, and allows the woman to spend more time with her baby.
The typical C-section takes about 45 minutes from start to finish. After your provider delivers your baby, they'll stitch your uterus and close the incision in your abdomen. Different types of emergencies can arise during a delivery.
What kind of anesthesia is used? A cesarean is done with a spinal block or epidural anesthetic. If you've been laboring and a cesarean is needed, you may already have an epidural, so that can be used. If a scheduled cesarean is being done, a spinal is used to provide a faster block for the procedure.
The procedure for spinal anesthesia is similar to epidural anesthesia for labor or for cesarean delivery. The difference is that medicine is injected directly into the spinal sac. A thin needle is used to reduce the chances of a spinal headache.
Preeclampsia is a hypertensive disorder complicating 5% to 7% of all pregnancies. The best anesthetic technique for cesarean delivery in such cases is regional anesthesia.
If you have had a general anaesthetic, you will stay in the recovery room until you wake up, usually in about 30 to 60 minutes. You will be able to see your baby when you wake up. Your baby may be allowed to stay with you unless the team is worried about your health or the baby's health.
The average hospital stay after a C-section is 2 to 4 days, and keep in mind recovery often takes longer than it would from a vaginal birth. Walking after the C-section is important to speed recovery and pain medication may be supplied too as recovery takes place.
At first you may be asked to only eat ice chips or take sips of water, at least until your provider is certain you are not likely to have very heavy bleeding. Most likely, you will be able to eat a light diet 8 hours after your C-section.
General anesthesia is rarely used
General anesthesia for cesarean delivery is not the norm in North America. Fewer than 5 out of every 100 C-sections in the US are done with general anesthesia, according to the Society for Obstetric Anesthesia and Perinatology.
Sleepy baby
Babies born by caesarean section may be a little sleepy. They may need some extra encouragement to stay alert during the first few feeds. Skin-to-skin contact will encourage them to latch and feed more often.
Trouble breathing or shortness of breath after having a caesarean section can be a sign of fluid in the lungs or a pulmonary embolism (a blockage in the arteries of the lungs caused by a blood clot), Dr. Liriano explains. When you're pregnant, you're more likely to form blood clots for various reasons.
The biggest difference between spinal blocks vs epidurals is their amount of pain relief: spinal blocks provide total pain relief, while epidurals provide partial pain relief. The reason for this difference is that the former is an anesthetic, while the latter is an analgesic—no sensation versus no pain.
Although there is no pain, there may be a feeling of pressure as the needle is being inserted. For a spinal block, an anesthesiologist injects medication into the spinal fluid through a needle inserted in the lower back. After the medication is administered, the needle is removed.
This means that with a baseline cesarean rate of 8% in women without an epidural, 12% of women with an epidural will have one or 4 more women per 100 or 1 more cesarean for every 25 women.
The spinal part offers rapid-onset pain relief without producing weakness of the legs. The epidural part provides flexibility of continuing the analgesia. The technique can be tailored to enable women to walk around the labor floor without feeling pain.
The main advantage is adequate pain control without affecting the sensation of pressure allowing the parturient to feel the need to push. Epidural anesthesia is also very popular in general surgery since it can be used as a sole anesthetic during an operation and as a continuous infusion for postoperative pain control.
As mentioned in the introduction, spinal anesthesia is in common use for surgical procedures involving the lower abdomen, pelvis, perineal and lower extremities; it is beneficial for procedures below the umbilicus. There needs to be patient counseling regarding the procedure, and signed informed consent is necessary.
When can I go home after a c-section? You will usually stay in hospital for 2-4 days after your c-section. If you and your baby are well, and you have someone to help you at home, you may be able to go home after 24 hours.
The Night Before Your C-section
You will not be allowed to eat, drink or smoke after midnight. This includes candy, gum and water. Try to get a good night's sleep. You may brush your teeth in the morning.
Once the baby is delivered the uterus is closed with a double layer of stitching. Four of the five remaining layers are stitched with a single layer of stitching, but one layer is not restitched as it heals better – with no buckling and reduced chance of scar tissue developing, without restitiching.