Please note: These questions and answers are by their nature quite general. We are afraid that the OAA cannot enter into discussions about nor answer enquiries about specific cases. If you have any questions, comments or complaints about your own care, you should take this up with the unit responsible. Please note that all hospitals have a Patient Advice and Liaison Service (PALS) who can help you if you are unsure how to go about this.
General anaesthetic
General anaesthesia is where you're unconscious and unaware of the procedure. It may be needed for an emergency caesarean birth when the baby needs to be delivered urgently.
These are some of the reasons why you may need a general anaesthetic:
- If you have certain conditions when the blood cannot clot properly, it is best not to have a spinal or epidural anaesthetic – a general anaesthetic is preferable.
- If you need a caesarean very urgently, there may not be enough time for a spinal or epidural anaesthetic to work.
- Abnormalities in your back may make a regional anaesthetic difficult or impossible.
- Occasionally, a spinal or epidural anaesthetic can’t be put into the right place, or doesn’t work properly.
You will be asleep while the obstetrician carries out the caesarean birth. General anaesthetic may be needed for emergency caesarean when the baby needs to be delivered very urgently, or if regional anaesthetic isn’t suitable for you (due to blood clotting disorders or abnormalities in your back), or if you experience pain during your surgery or if you prefer to be asleep.
You don’t always need to have a general anaesthetic for an emergency caesarean birth. If you've already been given an epidural for pain relief during your labour and it is working well, then the anaesthetist may give you more and stronger local anaesthetic through the epidural (a ‘top-up’) for it to work as your anaesthetic for an emergency caesarean. This extra dose of local anaesthetic will make give you numb enough to have surgery. Another alternative is to give you a spinal anaesthetic.
The anaesthetist will have to judge whether there is enough time to ‘top up’ an epidural with an extra dose of local anaesthetic, or as an alternative, give you a spinal if you either don’t have an epidural already or if your epidural hasn’t been giving you good pain relief during your labour. You may need to have a general anaesthetic for a very urgent emergency caesarean birth if there isn’t enough time for the anaesthetist to ‘top-up’ an epidural or to give you a spinal anaesthetic. If you have told the anaesthetist you'd prefer a regional anaesthetic, the chances of having to have a general anaesthetic for a caesarean birth are very low for most women. Only about one in 10 caesarean births is very urgent.
Sometimes, if there is a great hurry, the team may not have time to explain to you and your birth partner more fully everything that is going on. But you can still ask questions and ask for a more detailed explanation later. Your partner may also have to wait in the delivery room while you have the operation. This may worry or upset you, but the staff will talk to you afterwards to explain what happened and why.
The anaesthetist will give you oxygen to breathe through a tight fitting face mask which they put on your face for a few minutes. Once the obstetrician and all the team are ready, the anaesthetist will put the anaesthetic in your drip to send you to sleep. Just as you go off to sleep, the anaesthetist’s assistant will press lightly on your neck. This is to prevent stomach fluids getting into your lungs. The anaesthetic works very quickly.
When you are asleep, the anaesthetist will place a tube into your windpipe to allow a machine to breathe for you and also to prevent fluid from your stomach from entering your lungs. The anaesthetist will continue the anaesthetic to keep you asleep and allow the obstetrician to deliver your baby safely. But you won’t know anything about any of this. The anaesthetist or obstetrician may put in some local anaesthetic which will help with the pain relief afterwards. At the end of the operation, you may be given a suppository (tablet) up your bottom to help relieve pain when you wake up.
Most of the preparations are similar to those for a regional anaesthetic. In theatre, equipment will be attached to you to measure your blood pressure, heart rate, and the amount of oxygen in your blood. This won’t hurt.
The anaesthetist will put a cannula (a thin plastic tube) into a vein in your hand or arm and will set up a drip to give you fluid through this. Then the anaesthetist will start the anaesthetic. You will be asked to lie down on the operating table, tilted to the left.
You will be given an antacid to drink (to reduce the acid in your stomach) and a midwife may insert a catheter into your bladder before the general anaesthetic is started.
Unfortunately, your birthing partner will not be able to come into the operating theatre with you. However, he will be near to the operating theatre and he will be able to see your baby when he or she is born.
When you wake up, your throat may feel uncomfortable from the tube you had in your windpipe during the general anaesthetic. You may feel sore from the operation. If you have any pain, you'll be given some more medicine to help with pain. You may also feel sleepy and perhaps a bit sick for a while, but you should soon be back to normal. After the operation, you'll be taken to the recovery area where you'll join your baby and your birthing partner.
General anaesthetics can be given very safely but they have certain risks and complications. These risks and complications are listed below, together with their chances of happening. This is based on the best published information that is currently available. The numbers shown are estimates and may be different for different hospitals and for different circumstances.
| Possible problem | How common the problem is |
|---|---|
| Shivering | Common – about 1 in 3 people |
| Sore throat | Common – about 1 in 2 people |
| Feeling sick | Common – about 1 in 10 people |
| Muscle pain | Common – about 1 in 3 people |
| Cuts or bruises to lips and tongue Damage to teeth |
Occasional – about 1 in 20 people Quite rare – about 1 in 4,500 people |
| The anaesthetist failing to insert a breathing tube when you are asleep Chest infection Acid from your stomach going into your lungs |
Uncommon - about 1 in 250 people Common – about 1 in 100 people – but most infections are not severe Quite rare – about 1 in 1,000 people |
| Awareness (being able to recall part of the time during your anaesthetic) | Uncommon – about 1 in 670 people |
| Severe allergic reaction | Rare – about 1 in 10,000 people |
| Death or brain damage |
Death: Brain damage: |
