Q. This is my first baby and my obstetrician has recommended that I schedule a C-section. I have been informed that a spinal is most commonly used for this operation because it is safer than going to sleep. Is this true? I am petrified of being awake during the operation, and I don’t want anyone touching my back. Can the anesthesiologist force me to have a spinal? Finally, my husband wants to be in the operating room for the birth. Will they allow him in the OR if I am asleep?
A. Regional anesthesia (spinal or epidural) is indeed the best and safest anesthetic for you and your baby. Medications used during general anesthesia all cross the placenta, and can cause the baby to be sleepy for a period of time after birth. In addition, general anesthesia involves other risks during pregnancy, particularly related to breathing and possible difficulty with the insertion of a breathing tube into your lungs. It is standard practice to insert this breathing tube if you having general anesthesia. For these reasons, most anesthesiologists use general anesthesia only for truly emergency cesareans or when there is a medical reason not to have regional anesthesia. Spinal anesthesia allows you to be free of these difficulties with general anesthesia. The needles used for spinal anesthesia are very small, the anesthesiologist will numb a small area of the skin on your back before the injection, and he/she will explain each step and work through the procedure with you. Approximately 95% of cesareans in the USA are done with regional anesthesia, so you have plenty of company! In some cases, if you are particularly nervous, a small dose of a sedative, like valium, can be given prior to the operation, and more administered during the procedure.
Speak to your anesthesiologist or obstetrician about this prior to the day of the delivery if you want to know their own personal practices. Moreover, you could call the anesthesia department at the hospital where you plan to deliver and discuss all your concerns with an anesthesiologist before the day of the delivery.
In virtually all cases where general anesthesia is used, the husband is not allowed in the delivery room. The reason is that the husband is allowed to be present in the operating room to provide emotional support to you during the procedure, something which obviously can not be done if you are asleep. If general anesthesia is used, the baby will be brought out to a waiting area for your husband to see shortly after delivery.