We will continue our discussion with the preferred type of anesthesia you will likely encounter as well as cover the use of epidurals and spinals; then segue into the c-section procedure and what to expect once the baby is delivered and your recovery.
The preferred type of anesthesia for C-Sections is Neuraxial Anesthesia.
After arriving at the hospital and meeting with your anesthesiologist, you are moved to the operating room and hooked up to various monitors as you prepare for surgery.
Depending on how long you have been in the hospital, you may already have a working epidural. Your anesthesiologist will inject a strong medication through the epidural that will essentially make you numb from the middle of your chest to your legs over the course of several minutes.
Please be prepared! This numbing is a highly unusual feeling and many women find themselves quite anxious because they will no longer be able to move their pelvis or feet.
Take a couple of deep breaths and realize this is actually a good sign that the epidural is working well. Your anesthesiologist will be by your side coaching you through this experience.
If you didn’t have an epidural, the staff will have you sit on the side of the bed with your feet hanging over the edge, and then either a spinal or an epidural will be placed by your anesthesiologist.
What's it like having an epidural or a spinal placed?
For you as a patient, there is relatively little difference between a spinal and an epidural.
The spinal goes a little deeper and it is typically a single injection, while the epidural is a couple of millimeters shallower and may include a small flexible plastic catheter through which more medication can be pushed later. However, the effect is the same, you will be numb from the middle of your chest down.
In either procedure, the placement will be done while you are sitting up. Since both the epidural and spinal are done by anatomical landmarks, your Anesthesiologist will feel your back and determine the exact application spot.
Then you will feel a touch of cold from a cleaning solution to steriliz your skin and a plastic drape going over your back.
In general, spinals and epidurals feel the same as an IV placement. There is an initial poke that stings slightly and then you will feel the numbing medication take hold over a few seconds.
This whole process can take 1-20 mins depending on the case as it’s done by “feel” and sometimes there are anatomical variations that make the procedure more complicated.
So remain calm and relax as best as possible (for someone potentially in labor). If you start to get uncomfortable, you can always ask for more numbing medicine.
C-Section procedure after the anesthetic is administered
As you begin to numb, you will be laid down on the bed and still be able to move your hands, shoulders, and head.
Sometimes the numbing sensation may cause shortness of breath. While this is normal, please let your anesthesiologist know; as additional oxygen can be provided for your comfort.
Your anesthesiologist will then test the block using either something cold or sharp to make sure the spinal/epidural is working appropriately, then call in the obstetrician to clean your abdomen and place a sterile drape that will go over the top of your head. You will be able to see side to side and up top, but not where we will be working.
Next, the obstetrician will do a final “test the block”, which essentially means they will poke your belly with a sharp instrument to make sure the epidural/spinal is adequately working before surgery is started.
At that point, once everything is settled, many hospitals will allow your significant other to come in to sit next to you.
What will I feel during my C-section operation?
If you are awake for the C section, a lot will be going through your head. Don’t worry, you will have multiple highly trained specialists making sure that everything goes smoothly.
Once the operation starts, pain is not normal. However, pulling, tugging, and pressure are absolutely normal and expected.
Most of my patients are surprised how much tugging they feel. It is usually only mildly uncomfortable for several minutes, but is usually not painful. Again, if you feel pain, you should speak up.
Once the baby is about to come out, you will feel even more pressure. Essentially the obstetrician has to press on your belly to push the baby out, and it’s typically not a gingerly process. However after this last push, it will all be over!
A baby is born, now what?
Once the baby is born, they will be taken to another table to be assessed, stabilized, and cleaned. As that happens, your partner may walk over to see the assessment (it will usually be in the same room), and you may hear the baby cry which is typically a very good sign!
Once the baby is cleaned, we will bring him/her over to you, wrapped in a blanket, and you will be able to meet your newborn for the first time! Sometimes this is the moment that many shed a tear, and it's completely normal, even some of us occasionally do. (Although we won’t admit it!)
At this point just try your best to relax. You will likely feel exhausted at this point, which again, is completely normal. While getting the baby out only takes a few minutes after the operation has begun; closing all the different layers of your abdomen and achieving hemostasis will take more time, sometimes up to an hour and a half.
Although some surgeons will do the procedure from start to finish in 30-45 minutes, the average is probably an hour to two hours from my experience.
Things to tell your anesthesiologist about?
Make sure to make us aware of all medical conditions that you have, your anesthetic history and past surgeries, and whether there were any issues.
As mentioned above, if you feel short of breath, tell us! We are watching the oxygen in your blood very closely, so if you need oxygen we will provide some for you.
If you have any pain throughout the procedure, it is also important to let us know particularly at the beginning of the procedure.
Lastly, patients will almost universally get nauseated during a C-section. It is important to notify your anesthesiologist at the earliest onset of nausea so that medications can be given to you to prevent it getting worse.
What happens after the C-section?
At the end of the procedure, the drapes will be taken off, you will be washed up, monitors will be disconnected and you will be transferred onto a gurney to be wheeled to a recovery room for a few hours.
Soon, sensation will return to your feet and abdomen and some pain medication will be administered at your request. Our suggestion would be to ask for pain medication when you first start to feel the pain and before the spinal/epidural anesthetic has completely worn off.
C-section is a major abdominopelvic operation, and when it comes to diet, it will take some time until you can eat. You will be started very slowly with either ice chips or water, and if you tolerate those, will progress very slowly to juices, and then to a regular diet.
C-Section Recovery tips?
We have another post fully dedicated to C-section recovery where we discuss what to expect and how to optimize recovery.
In a nutshell:
Be patient and take it easy! C-section surgery is a major procedure and will take time to recover. Have a family member stay with you to aid with the chores.
Do not neglect your post-surgery nutrition, this is critical. After all the trauma your body has taken, it will be starved for nutrients many of which are critical to healing.
Keep activity light but consistent, it’s important to the healing process.
Maintain a balance on pain medication, not too much but not too little. Pain after this surgery is to be expected, control pain enough to provide relief but not enough to block it out completely.
Speak to your doctor and warn them of certain symptoms you encounter. Some of them may be signs of surgery complications and should not be neglected.
Out of the points above, I think the most neglected item is nutrition. If you follow our Blog regularly and have seen our website then you know that our mission is to help people recover faster from surgery and injuries.
There are some concerning stats that show how poor nutrition can lead to poor recovery from bodily trauma; and this is the last thing that we want for you and your baby. So please, make sure to speak with your doctor and consider adding recovery supplements of some kind to your recuperation plans.
We hope you have enjoyed this 2 part C section post! I have helped deliver countless babies at this point and each time has been its own wonderful and unique experience.
I am sure you will be in good hands and hope that the information provided above has been useful to you! Until next time stay informed and be healthy!
General Disclaimer: All information here is for educational purposes only and is not meant to cure, heal, diagnose nor treat. This information must not be used as a replacement for medical advice, nor can the writer take any responsibility for anyone using the information instead of consulting a healthcare professional. All serious disease needs a physician.