Anesthesia in cesarean sections

Two types of anesthesia may be used:

• Regional anesthesia (epidural or spinal): This involves “freezing” your abdomen. The medication is given through a needle inserted into a space surrounding your spine. If you choose regional anesthetic, you’ll be awake and alert. After the birth, if your baby is healthy, she or he will be bundled and given to you or your support person to cuddle.
  • Near the end of the surgery the anesthesiologist may inject additional pain medication into the epidural space to help keep you comfortable after surgery.
• General anesthesia: You will be asleep during the birth of your baby. When you wake up after surgery, you and your baby can snuggle together. This is not used very often, usually when the baby needs to be delivered quickly because of life-threatening problems with the mom or baby.

Both anesthetics have some risks and benefits. Discuss your options with your doctor and anesthetist.

We encourage your support person to be present during the birth. Your support person can help you relax and talk to you during the birth if you don’t have a general aneshtetic.

• In most cases one support person can be with you in the OR. The support person will have to change in to clean scrubs, put on shoe and hair covers, and wear a mask covering their nose and mouth. They are usually situated at the pregnant woman’s head and are given a stool to sit on.
• If it is an emergency cesarean birth there may be no time to get the support person ready.

It helps to know the following:

• You will have some abdominal pain. Medication is available to help you feel more comfortable. The medication offered is safe to take while breastfeeding, and decreasing your pain will aid in your recovery.
• Ask your healthcare provider if your baby may be placed skin-to-skin right after birth. This will allow you to begin breastfeeding and bond withyour baby. The nurse will help you find a comfortable position for you and your baby.
• Having a cesarean birth does not affect your milk supply. Your nurse will help you find a comfortable breastfeeding position for you and your baby.
• You will most likely start on a liquid diet and then move to solid food. You will have an IV in your arm until you are able to keep fluids down. You may have a catheter in place for a few hours to help you pass your urine.
• Some types of sutures (stitches) are absorbed. If your sutures are not this kind or if you have staples, your hospital nurse or public health nurse will remove them.
• You are not only recovering from the birth of your baby but from surgery as well. Taking care of yourself will help you recover more quickly. A good diet, plenty of fluids and rest are important. Ask for and accept help from others

If the cesarean birth is an emergency, you may have little time to prepare. Emotions after a cesarean birth vary widely. Some new mothers feel relief when it’s all over, yet may also feel a little disappointed. If you are upset or worried, talk with your healthcare provider, partner or someone you trust. Many women who have had a cesarean birth can have a vaginal birth with a later pregnancy (VBAC). Discuss this with your doctor before or during your next pregnancy.

Generally it takes about 4 to 6 weeks for the incision to heal completely, but most women feel very well before this time. Until you are healed, it is important to:

• Take it easy: During your recovery, avoid housework, and do not lift anything heavier than your baby. Don’t lift your baby in the car seat. Have someone put everything that you and your baby might need on the same level in your house so you wll not have to go up and down stairs continuously. Or if you are having a planned cesarean section, you can do this before the baby arrives.
• Support your abdomen: Use good posture when standing and walking. Hold your abdomen near the incision during sudden movements caused by coughing, sneezing or laughing. Hold a pillow to your abdomen when you stand up or move in bed. To get up from lying down, first roll on your side, then push yourself up to a sitting position.
• Limit company for the first few weeks: Too many visitors will keep you from getting the rest you need to recover and care for your newborn. Accept helpers, people who will make you meals, do your laundry and tidy your home.
• Rest: Take daily naps for the first 3 to 4 weeks or longer.
• Stay hydrated: Drink lots of fluid. You will likely need extra fluids to replace those lost in delivery and breastfeeding. Also, empty your bladder frequently to help reduce your risk of urinary tract infections.
• Avoid driving: Until you can deal with making the sudden movements you need to make when driving in traffic, let someone else take your place behind the wheel.. This takes up to 6 weeks. Before you take the car and baby out together, make sure you can manage the baby’s car seat without hurting yourself. It is a good idea to contact your car insurance provider to find out how your coverage may be affected by your surgery.
• Keep your incision clean: Shower every day after the first 24-48 hours to keep your incision clean, unless your healthcare provider says otherwise. Don’t scrub the incision site as this may pull on the staples or stitches. Pat dry with a towel when done.

If you have any questions about your caesarean birth, call your healthcare provider or Health Link Alberta at 811.