Anesthesia for a Cesarean Delivery
The most common forms of anesthesia used for cesarean deliveries are epidural and spinal. Both kinds of anesthesia numb you from mid-chest to toes but also allow you to remain awake so that you can experience your child’s birth. You may feel some tugging and pulling during the operation, but you don’t feel pain.
Sometimes the anesthesiologist injects a slow-release pain medication into the epidural or spinal catheter before removing it in order to prevent or greatly minimize pain after the operation.
Because a cesarean is a surgical procedure, a doctor performs a cesarean delivery in an operating room under sterile conditions. A nurse inserts an intravenous line in the patient’s arm and a catheter in the bladder.
After a nurse or nurse’s assistant scrubs the patient’s abdomen with antiseptic solution, a nurse places sterile sheets over the patient’s belly. One of the sheets is elevated to create a screen so that the expectant parents don’t have to watch the procedure.
(Although childbirth is usually an experience shared by both parents, a cesarean delivery is still a surgical operation. Most doctors feel that the procedure isn’t something that expectant parents should watch because it involves scalpels, bleeding, and exposure of internal body tissue that’s normally not seen, which is disturbing to many people.)
Many hospitals allow the coach or partner to stay in the operating room during a cesarean delivery, but this decision depends on the nature of the delivery and on hospital policy. If the cesarean is an emergency, the doctors and nurses are moving quickly to ensure the safety of both the mother and the baby, which may make it necessary for the partner or coach to wait elsewhere.
The exact place on the woman’s abdomen where the incision is made depends on the reason she’s having the cesarean. Most often, it is low, just above the pubic bone, in a transverse direction (perpendicular to the torso). This cut is known as a Pfannensteil incision or, more commonly, a bikini cut. Less often, the incision is vertical, along the midline of the abdomen.
If the baby has to be delivered in an emergency and there’s no time to place an epidural or spinal, general anesthesia may be needed. In that case, you’re asleep during the cesarean and totally unaware of the procedure. Also, general anesthesia may be needed in some cases because of complications in pregnancy that make it unwise to place epidurals or spinals.