Navigating Labor and C-section Anesthesia: What to Expect

While the idea of having a newborn renders sweet, soft iterations in the mind of a clean, quiet nursery with a rocking chair and a sleeping babe, the idea of labor and delivery can be very overwhelming for many women. A common concern among pregnant women is anesthesia during labor or for a cesarean section.

At worryfreeanesthesia.com, we feel that understanding what to expect can help alleviate anxiety and ensure a smoother experience. Knowledge can also give patients authority over their care and lead to better questions before the anesthesia is administered. Let’s delve into the world of navigating labor and c-section anesthesia to shed some light on the process.

Navigating Labor and C-Section Anesthesia: What to Expect

The truth is that labor and childbirth are not the most comfortable moments in a woman's life. Luckily, there are options to help make the experience much easier for a laboring mom. Generally, when a woman presents in labor or for induction of labor, at some point a labor epidural will be offered to help manage the uncomfortable feeling of contractions. Epidural anesthesia allows for continuous pain relief during labor. Most hospitals will allow a labor epidural to be placed as soon as the laboring mom is starting to progress (when your cervix begins to dilate) and requests an epidural. The thought of having the epidural placed can feel overwhelming.

Enter your hero...the anesthesia provider!

Prior to placing an epidural, an anesthesia provider will discuss the process with you, including potential risks and benefits. Just like any other procedure or event in life, there can be risks with epidural anesthesia. Those risks are incredibly uncommon, however, and you have done your homework here. You know what's happening and how you can make this easier too.

In some places your partner may stay for the epidural, but in others, they do ask your partner to step out to minimize distractions for the anesthesia provider.

The process for having the epidural placed will go something like this...

The anesthesia provider will have you sit up on the side of the hospital bed like it's a park bench, with your legs and feet hanging over one side. He or she will then feel around along your back. Your provider is feeling along your spine to find the best spot to place the epidural.

The provider will use some cold surgery soap to get your back very clean. He or she will also put a drape over your back to keep everything super sterile and clean.

You have an important job now. It's your time to shine! You need to curl your body over that sweet baby belly so that your spine would look like the letter C from the side. Poke your back out toward the provider. This position gives your provider the most space between your vertebrae so the epidural can be placed very easily.

Once you're in the right position, your provider will put a small amount of numbing medicine in your skin. This may feel like a bee sting and lasts maybe 2 seconds. You got this! You're curled. You're breathing. You're doing awesome!

When your anesthesia provider places the epidural catheter, you may feel some pressure at your back, but this shouldn't hurt. Just pressure. Once the right spot is found, the provider will thread a tiny catheter (like a flexible straw) into the right spot. He or she will push a little numbing medicine into the catheter. You may feel a cold sensation down your back for a second.

The provider will then hook the epidural catheter tubing to a pump loaded with numbing medication. This pump continuously infuses medication into the epidural space in your spine. The numbing medication is absorbed by spinal nerves which provides anesthesia and numbness to the parts of your body below the injection site. This numbness will keep you comfortable throughout the rest of your labor and delivery of your baby!

Epidural anesthesia is great because it provides pain relief while still allowing you to be an active participant in the birthing process meaning you will still be able to push but you should not be in pain. How awesome is that!?! Once your baby is delivered, the epidural catheter will be removed. Please know that his does not hurt at all.

Here is a great video from Cleveland Clinic about epidural placement:

What if I'm having a C-section?

If there are complications in delivering your baby vaginally, the epidural catheter can be dosed to allow for surgical delivery or c-section. In cases where a cesarean section is planned or an epidural has not yet been placed, a different type of anesthesia may be used. Spinal anesthesia or a combination of spinal and epidural anesthesia, known as a spinal-epidural, is often utilized for c-sections.

This type of anesthesia numbs the lower half of the body quickly and effectively, allowing for a pain-free surgical experience.

Why Can't I Just Be Put to Sleep for my C-section?

For some moms, the idea of having a spinal or epidural is really hard and maybe the idea of having a c-section while awake is too. Maybe you're one of those moms. So why doesn't your anesthesia team just put you to sleep already???

Well, going all the way to sleep, also called general anesthesia, is always a possibility during c-section. However, administering general anesthesia to a pregnant patient carries more risks than both spinal and epidural anesthesia. Actually, being put to sleep while you're pregnant even carries a lot more risks than being put to sleep when you're not pregnant.

Pregnancy cause changes in the physiology of your body, specifically and very obviously, it changes how your body is shaped, but also pregnancy hormones can affect different processes in your body. Specifically, there are more risks to your airway during pregnancy. not to mention, there is another person in there to think about- your baby.

For these reasons, epidural and spinal anesthesia are by far the safest routes for you and your baby.

So What's the Process for Spinal Anesthesia?

Well, the process for spinal anesthesia is very similar to the process for epidural anesthesia since both involve injecting numbing medication around spinal nerves to produce anesthesia.

The anesthesia provider will have you sit up on the side of operating room table like it's a park bench, with your legs and feet hanging over one side. He or she will then feel around along your back. Your provider is feeling along your spine to find the best spot to place the epidural.

The provider will use some cold surgery soap to get your back very clean. He or she will also put a drape over your back to keep everything super sterile and clean.

You have an important job now. It's your time to shine! You need to curl your body over that sweet baby belly so that your spine would look like the letter C from the side. Poke your back out toward the provider. This position gives your provider the most space between your vertebrae so the spinal can be placed very easily.

Once you're in a great position, your provider will put a small amount of numbing medicine in your skin. This may feel like a bee sting and lasts maybe 2 seconds. You got this! You're curled. You're breathing. You're doing awesome!

When your anesthesia provider places the spinal, you may feel some pressure at your back, but this shouldn't hurt. Just pressure. Once the right spot is found, the provider inject medication into the right spot. It is common to feel your legs and bottom become warm.

Your operating room team will help you lie down on the operating room table and sometimes they put a little bump underneath your left hip. Occasionally, moms can report feeling a little nauseated after the spinal. This is normal, but let your anesthesia provider know if this happens. They are your hero! They can fix it!

Your anesthesia provider will carefully monitor you throughout the c-section and that numbness will keep you comfortable throughout the procedure and delivery of your baby! Because you have a spinal, you will get to meet your baby as soon as he or she is delivered. That's awesome! Often your anesthesia provider or a nurse in the room will be able to take a first family photo for you.

Here is a great video from a hospital system, EvergreenHealth, that shows the process for how this anesthesia group performs spinal anesthesia in their hospital. Please be aware that the purpose of WorryFreeAnesthesia.com is to decrease your anxiety. This video does show needles because that is how this procedure is performed.

What is the real difference between a Spinal and an Epidural, and are there any downsides?

For you- the patient- the major difference between spinals and epidurals is that the spinal anesthesia procedure ends with one single shot of medication, while epidural anesthesia requires that small catheter mentioned above to be threaded into the epidural space and a continuous infusion of numbing medicine while labor and delivery are happening. Both the epidural and spinal procedures usually happen at the same general spaces on your back.

It is important to note that while anesthesia during labor and c-sections is generally safe, there are risks associated with any medical procedure. Risks are very rare but can include headache, nausea, infection, and decreases in blood pressure. There is also a minute risk of inadequate anesthesia. These risks will be discussed with you beforehand, and your medical team will take all necessary precautions to minimize them and to address any issues very quickly if you let them know.

It’s important to communicate openly with your healthcare providers about any concerns or preferences you may have regarding anesthesia.

Recovery from spinal and epidural anesthesia typically occurs over a few hours after delivery. The numbing medication that was injected gradually wears off. Your nurse will help you stand once the medication effects are gone and you should be pretty much back to normal.

For c-sections, you may experience some soreness at the incision site, but pain medication will be provided to help manage any discomfort. Your medical team will closely monitor your recovery and provide guidance on post-operative care to ensure a smooth healing process.

One last thing...What Happens if my Epidural or Spinal Stop Working During my C-Section...

Ok. Let's acknowledge that failure of an epidural or spinal during a C-section is a very valid concern. It is always preferable to maintain anesthesia for C-section using regional anesthesia like an epidural or spinal for safety reasons. Epidural and Spinal anesthesia are hands-down the safest types of anesthesia for your C-section. They are extremely reliable and work for the overwhelming majority of expecting mamas. However, in extremely rare cases failure can occur.

Also, we could acknowledge here that there are cases where epidurals and spinals are not the safest, such as with extremely low platelet counts or other conditions that may affect the ability of blood to clot.

If something extremely rare like this happens to you, general anesthesia (going all the way to sleep) may be the only alternative. And that is ok. Anesthesia is a continuum and as providers, we are constantly adjusting to each individual patient's need.

Want to learn more about general anesthesia? Click the image below to read General Anesthesia: The Patient Experience from Start to Finish

General Anesthesia: The Patient Experience from Start to Finish

Congratulations Mama!!!!!

Still worried about anesthesia for your delivery? Click the image below to read How to Overcome the Fear of Anesthesia: Tips for a Better Surgery Experience.

How to Overcome the Fear of Anesthesia: Tips for a Better Surgery Experience

Navigating labor and c-section anesthesia can feel overwhelming, but with the guidance and expertise of your healthcare team, you can approach these procedures with control and confidence. By understanding what to expect and actively participating in discussions about your care, you can make informed decisions that prioritize your well-being and the health of your baby. Your healthcare providers are there to support you every step of the way.

Feel free to reread this article a few times prior to your due date to help you mentally prepare, because we know, prepared patients have better outcomes.

Want to learn more about anesthesia? Click on the worryfreeanesthesia.com logo below for more Articles and information.

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Have a question about this article or a suggestion? Email me! jen@worryfreeanesthesia.com

**Information provided is intended as general healthcare information for the public and should be used as a guide. This information should not be substituted for the specific personal advice recommended by your own healthcare team who are familiar with your specific health history.*