Procedures › Caesarean birth
A spinal anaesthetic is most common for a caesarean birth. This page explains what to expect from your anaesthetic, how it is done, the advantages and risks, and the pain relief you will be given afterwards. Your own plan is agreed with your anaesthetist on the day.
A spinal anaesthetic is most common for a caesarean birth. The nerves that carry feeling from your lower body are contained in a sack of fluid inside your back. The anaesthetist injects local anaesthetic into this fluid, using a very fine needle.
You will have a cannula (a thin plastic tube) inserted into a vein in your hand or arm to give you fluid and medicines. The theatre team will place monitors for your blood pressure, heart rate, and oxygen level. The anaesthetist will prepare the equipment for your anaesthetic.
You will be asked to either sit up or lie on your side. Getting in the right position helps the anaesthetist find the small space in your back. They will ask you to curl up over your bump, sometimes described like you are trying to look through your belly button, and push your lower back towards them. They will start by feeling the spaces in your back with their hands, then put some local anaesthetic in your lower back to numb the skin. From this point, most people just feel some pushing in their back.
If you feel any tingling or pain, please tell the anaesthetist as it can help them to find the correct space. The procedure usually only takes a few minutes, but may take longer if it is difficult to find the small space in your back.
When the injection is finished, you will lie on your back, with a tilt on the bed. The anaesthetic begins to take effect within a few minutes. At first, your skin will feel warm, then you may feel pins and needles before becoming numb to the touch. You will feel your legs becoming heavier and more difficult to move. When the injection is working fully, you will be unable to lift your legs up or feel any pain in the lower part of the body.
While the anaesthetic is starting to work, you will have a catheter (plastic tube) inserted to keep your bladder empty during the operation. This stays in until the heaviness in your legs wears off so you don't need to worry about getting to the toilet.
The anaesthetist will do simple tests to check that the anaesthetic is working properly. These include asking you to lift your legs and touching your skin with something soft, sharp or cold and asking what you can feel. The anaesthetist will only allow the obstetrician to start the caesarean birth when they are satisfied that the anaesthetic is fully working.
There will be quite a few people in the operating theatre. This will include:
At the very least there will be seven members of staff in the theatre as well as your birth partner (if you have one).
You shouldn't feel any pain during the operation but it is normal to feel pressure and pulling. Some people describe it as 'feeling like someone is doing the washing-up' in your tummy. If you experience any discomfort, or anything is worrying you, it is important to tell your anaesthetist. Sometimes you may be given extra pain relief. Occasionally, the anaesthetist may recommend changing to a general anaesthetic.
You may experience some side effects, which your anaesthetist will manage. These include low blood pressure (which might make you feel dizzy or sick), itching or shivering.
Although very safe, occasional complications of spinal/epidural can include:
If you have a regional anaesthetic, your birth partner will be able to join you in the operating theatre. They will be asked to sit down and to avoid certain areas of the room. This is to reduce the risk of contaminating sterile operating instruments. If you are to have a general anaesthetic (put to sleep) your birth partner will be asked to wait in another room.
Just before the caesarean starts, a member of the theatre team will confirm your name, date of birth and hospital number to ensure that we have the correct patient prior to the start of the caesarean birth.
A screen will separate you and your birth partner from the lower part of your body and the surgery. The anaesthetist will stay with you all the time. You may hear a lot of preparation in the background. This is because the obstetricians work with a team of midwives and staff in the operating theatre. Your skin is usually cut slightly below the bikini line. Once the caesarean birth is under way you will hear the sound of instruments and suction of fluids from around the baby.
From the start of the operation it usually takes about 10 minutes until your baby is born. The obstetrician will take about another half-hour to complete the operation. However, because every caesarean birth is different, it may take longer than this.
Before your caesarean birth starts, an antibiotic will be put into your drip to reduce your risk of getting an infection. After the birth, a drug called oxytocin is put into your drip to help tighten your womb and to cut down blood loss.
If you feel sick, you may be given medicine to help you stop feeling sick or vomiting. If you feel any discomfort, the anaesthetist may give you extra medicine to help relieve the discomfort and, sometimes, they will need to give you a general anaesthetic. For pain relief after your caesarean birth, see the section below.
Good pain relief is important so that you can move, care for your baby, and recover safely. After your caesarean, we use a planned combination of medicines that work in different ways.
In hospital (first day):
After the first day / at home:
If you prefer not to take opioids:
After the operation, you will be taken to the recovery room where your blood pressure will continue to be monitored. Your partner and baby will usually be with you. Your baby will be weighed if not already done so in the theatre and then you can begin breastfeeding, if you want to.
In the recovery room your anaesthetic will gradually wear off and you may feel a tingling or itching sensation. Within a couple of hours you will be able to move your legs again.
Immediately after the birth of your baby, the midwife dries and examines your baby. A paediatrician will do this with the midwife. After this, as long as they are happy that the baby is doing well, you and your partner will be able to cuddle your baby and, in some cases, have skin-to-skin contact.
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