This is a highly emotional and positive life changing experience. It is however also very nerve racking as understandably mums and dads are concerned about the unborn child along with the safe surgery for the mother.
Fortunately the techniques which we use now are well refined and when undertaken safely have good outcomes for both mother and baby. Most anaesthesia for Caesarian Sections are done under spinal or epidural anaesthetic. This decreases the chance of medication transferring across to the baby as well as being safer for the mother.
- After placement of an intravenous cannula (for giving medications) we have the mother sitting on the operating bed
- Antiseptic prep is applied to the back to start the sterile process – this will feel cold on your back
- We will help the mother get into optimal position for placement of the block
- Skin local anaesthetic is injected prior to the placing the spinal or epidural
- Occasionally the placement is tricky, where it may take a bit longer
- It is essential that the mother communicates any discomfort to the anaesthetist
- We will check the block with ice and other testing to ensure it is adequate before commencing the operation
- It is EXPECTED that the mother feels touch and pressure during the procedure, but NO PAIN
- again communication is key to ensuring comfort
- if the block is inadequate prior to starting, we will resite the block. If after starting the operation the mother is uncomfortable, a general anaesthetic is utilised
In rare circumstances the block cannot be placed or is inadequate, a general anaesthetic is utilised. When a general anaesthetic is used:
- The baby may be sleepier at birth with an increase chance of needing breathing support
- there is an increased risk of breathing related issues for the mother
- The father cannot be in the room
In the setting where the mother has an epidural placed in labour, but then required a caesarian section, provided the epidural is working well then we can utilise this to top up using much stronger solution. If the epidural has been inadequate, it will be re sited prior to the caesarian section.
For risks of anaesthesia, please see risks of anaesthesia page. Briefly risks for spinal and epidural anaesthesia include
- discomfort during the placement
- patchy or inadequate block causing discomfort during the procedure
- headache (1:100)
- back ache
- very rarely nerve damage (approximately 1:50,000)